Anesthesiologists being replaced by CRNAs???

Specialties CRNA

Published

I was vacationing in the tropics a few weeks ago and met three handsome Anesthesiologists while sun bathing at the pool. We all chatted a little until the topic of our professions came up. I told them I was starting nursing school (ABSN Program) in a few weeks & how excited I was. I then proceeded further by saying I also hope to pursue a graduate degree as a CRNA or NP (note at this point I had no idea these guys were anesthesiologists). Why did I mentioned becoming a CRNA, b/c the stares I got from all three were nothing but pure EVIL STARES! By their looks I knew I said something wrong but had no idea what it was until they told me they were Anesthesiologists & fear that CRNAs were taking away their jobs at a cheaper price, and with the new health care laws just passed its going to get worst for them. This was totally unexpected 'cause all I planned to do that day was to relax by the poolside & sip pina coladas all day! However, they went on trying to convince me of all the reasons as to why I should not pursue a CRNA career & that eventually the national anesthesia board (not sure if this was the organization they mentioned) was no longer going to certify CRNA training and eventually they'll be no more training because there is no longer a shortage of Anesthesiologists. The shocker of this whole conversation was two of the anesthesiologists mentioned, with conviction, they wish they had pursue a CRNA career instead where they would have accumulated less debt with almost the same income or they wish they had chosen another specialty.

I was pretty shocked hearing these remarks & would love to hear your opinions :)

Comparing the abilities and training of an anesthesiologist to a CRNA is a bit silly. I work with a lot of CRNA and not one of them thinks that they are equal in any way, shape of form to an anesthesiologist. Closely supervised by an anesthesiologist, C RNA have a support tole; nothing more, nothing less. On the net you hear all kinds of comments about equality, but it's really quite silly.

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Specializes in Anesthesia.
Comparing the abilities and training of an anesthesiologist to a CRNA is a bit silly. I work with a lot of CRNA and not one of them thinks that they are equal in any way, shape of form to an anesthesiologist. Closely supervised by an anesthesiologist, C RNA have a support tole; nothing more, nothing less. On the net you hear all kinds of comments about equality, but it's really quite silly.

Really I must have missed the anesthesiologist that has been on call with me for the last year. Where was the anesthesiologist when I was alone in the hospital with the fresh gun shot wound, lacerated spleen on the ASA 3 patient that I ended up giving 8 units of PRBC plus FFP on a Saturday afternoon with no other anesthesia providers in house, must have missed them for all those OB epidurals/meconium babies/crash c-sections, emergency intubations, the CVL that the covering physician in ICU couldn't get,.........

Trying to compare what a CRNA does in strict ACT practice to what independent CRNAs do is silly. I do everything from pre-op through post-op that an anesthesiologist does.

When you have worked with independent CRNAs in a non-ACT practice then you might have some idea what you are talking about until then you are just an ignorant bystander trying to stir up trouble. Simply working with CRNAs/Anesthesiologist does not make you an expert enough to discount every research study out that shows equal outcomes between CRNAs and Anesthesiologists.

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Specializes in CRNA.
Closely supervised by an anesthesiologist, C RNA have a support tole; nothing more, nothing less. On the net you hear all kinds of comments about equality, but it's really quite silly.

That may be true where you work, but many CRNAs work without supervision. I work for anesthesiologists, but I always do my own cases, often without an anesthesiologist in the building. It is the way of the future as it is most effective. Nothing silly about it.

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Comparing the abilities and training of an anesthesiologist to a CRNA is a bit silly. I work with a lot of CRNA and not one of them thinks that they are equal in any way, shape of form to an anesthesiologist. Closely supervised by an anesthesiologist, C RNA have a support tole; nothing more, nothing less. On the net you hear all kinds of comments about equality, but it's really quite silly.

The CRNAs at the small community hospital in my rural community are being "closely supervised" by an anesthesiologist at another hospital 45 minutes' drive away. The hospital and the CRNAs seem to be managing just fine, and the sky hasn't fallen.

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Read my comment again, I said: "Comparing the abilities and training of an anesthesiologist to a CRNA is a bit silly"....nobody said that crna do not have a role etc, etc.....but equating the abilities of a nurse/crna to that of an anesthesiologist is more than silly. it's dangerous. properly supervised, crna do indeed have a role. and as far as the "small community hospital in my rural community" being serviced by crna only (supervision is 45 min away)...sorry, I don't buy that. country folk deserve an anesthesiologist just as much as city folks. when something goes wrong that's beyond the ability of a crna to handle, the sky will indeed fall; maybe some people don't think that people who live in a rural setting deserve proper anesthesia care.....I do. whenever possible, they should be transported to the nearest "city" hospital.

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Backscatter's a Troll or just plain ignorant.

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Specializes in Anesthesia.
Read my comment again, I said: "Comparing the abilities and training of an anesthesiologist to a CRNA is a bit silly"....nobody said that crna do not have a role etc, etc.....but equating the abilities of a nurse/crna to that of an anesthesiologist is more than silly. it's dangerous. properly supervised, crna do indeed have a role. and as far as the "small community hospital in my rural community" being serviced by crna only (supervision is 45 min away)...sorry, I don't buy that. country folk deserve an anesthesiologist just as much as city folks. when something goes wrong that's beyond the ability of a crna to handle, the sky will indeed fall; maybe some people don't think that people who live in a rural setting deserve proper anesthesia care.....I do. whenever possible, they should be transported to the nearest "city" hospital.

You make inflammatory statements, but yet you cannot back up your statements anymore than the ASA can. There are numerous studies that show equal outcomes/safety between independent CRNAs and MDAs.

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once again, you need to read my comment. if you think that a nurse/crna is "equal" to an anesthesiologist, I disagree with you. many would say that you have a problem with reality testing. I don't trash crna, they have a place when supervised. calling an unsupervised crna an "anesthesi provider" is akin to calling a drug-dealer an unliscenced pharmacist. if you want your anesthesia delivered by an unsupervised nurse, go right ahead. But patients deserve better. it's common sense.

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If you do not by that crna operating without supervision in rural America you are clearly massively ignorant in the role CRNA's role in rural health care. You really should make some effort to educate yourself BEFORE you say something really not so smart.

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Specializes in Anesthesia.
once again, you need to read my comment. if you think that a nurse/crna is "equal" to an anesthesiologist, I disagree with you. many would say that you have a problem with reality testing. I don't trash crna, they have a place when supervised. calling an unsupervised crna an "anesthesi provider" is akin to calling a drug-dealer an unliscenced pharmacist. if you want your anesthesia delivered by an unsupervised nurse, go right ahead. But patients deserve better. it's common sense.

I already read your comments, and you are woefully deluded if you think that CRNAs need to be supervised by anesthesiologists or anyone else. Again and again you make the same comments but you can't provide any proof that CRNAs being supervised provides any better care or safety than CRNAs working independently.

How about the Needleman & Minnick study that showed no difference in OB outcomes based on anesthesia provider type (supervised, independent, or MDA alone).

Simpson OB study also showed no difference in OB outcomes whether provided by independent CRNAs or solo MDAs.

Minnesota State Department of Health Study States: "There are no studies, either national in scope or Minnesota-specific, which conclusively show a difference in patient outcomes based on type of anesthesia provider."

National Academy of Sciences Study "There was no association of complications of anesthesia with the qualifications of the anesthetist or with the type of anesthesia." [House Committee Print No. 36, Health Care for American Veterans, page 156, dated June 7,1977.1

Pine Study: Data reveals no significant differences in surgical mortality rates

when anesthesia is provided by nurse anesthetists

or anesthesiologists working individually or together.

Forrester Study No difference in outcomes based on CRNA only or MDA only care.

Health Affairs Article No Harm Found When Nurse Anesthetists Work Without Supervision By Physicians

What the whole debate over supervision is really about $$$$$$$?

The Journal of Nursing Economic$. "This study considered the different anesthesia delivery models in use in the United States today, including CRNAs acting solo, physician anesthesiologists acting solo, and various models in which a single anesthesiologist directs or supervises one to six CRNAs. The results show that CRNAs acting as the sole anesthesia provider cost 25 percent less than the second lowest cost model. Alternatively, the model in which one anesthesiologist supervises one CRNA is the least cost-efficient model. "

There are still a few more out there, but I think this is enough to prove the point that Independent CRNAs are just as safe and effective when providing complete anesthesia care as anesthesiologists.

Now do you want to debate the facts or just keep making statements that are clearly untrue and have no purpose than to protect the ASAs bottom line. There is no patient safety issues with independent CRNAs. This is nothing more than fear mongering by a political group/ASA.

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For me, the basic question is: "do you want an unsupervised nurse (CRNA) doing your anesthesia"? When asked this somewhat blunt but honest question, most patients will answer with a resounding "no". Virtually every physican will give a more colorful answer, but it will still be no. Many will be o.k. with a closely supervised CRNA; but a surprizingly high number will not be..they never get the chance to decide. A patient (who was in a CRNA program) asked me: "name one thing that an anesthesiologist can do that a CRNA can't)...my answer is simple: "practice medicine"....

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Specializes in Anesthesia.
For me, the basic question is: "do you want an unsupervised nurse (CRNA) doing your anesthesia"? When asked this somewhat blunt but honest question, most patients will answer with a resounding "no". Virtually every physican will give a more colorful answer, but it will still be no. Many will be o.k. with a closely supervised CRNA; but a surprizingly high number will not be..they never get the chance to decide. A patient (who was in a CRNA program) asked me: "name one thing that an anesthesiologist can do that a CRNA can't)...my answer is simple: "practice medicine"....

A patient can choose an ACT practice to goto if they choose (except in emergencies or other extreme cases), but the simple fact is most patients don't even know what a CRNA is. So, it is pretty obvious that a lay person would choose a physician when they have no idea what a nurse anesthetist even is.

Nurse anesthetists don't practice medicine when doing anesthesia it is still a practice of nursing by the simple fact that it is nurse doing the anesthesia this was determined by the courts decades ago.

Here is another quote for you: What is the only nursing speciality that physicians practice? Anesthesia. Nurse Anesthetists have been around a lot longer as an organized profession in this country than anesthesiologists which was a fairly small medical speciality until the 1950's when it became more profitable speciality.

There isn't any reason for CRNAs to be supervised by Anesthesiologists or any other physician. The research shows this simple fact over and over again. The only reason to keep ACT practices is to protect MDAs/ASA's bottom line it isn't for the protection of patients or the betterment of healthcare or anything else. That is nothing more than ASA propaganda. There is plenty of room for anesthesiologists and CRNAs in healthcare, but ACT practices have proven to be unnecessary and expensive.

Again I was the only anesthesia provider in house last night and yet all my patients did just fine despite my lack of a medical degree or supervision of any kind.

I never remember any of the congressmen, Admirals, Generals, Senator's kids, physicians, or other patient complaining that a nurse anesthetist was doing their anesthesia instead of anesthesiologist.

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