CRNA supervision by anesthia MD

CRNAs are board-certified to practice independently. The degree of MD supervision is facility-specific only; in other words, although CRNAs can and do practice 100% independently in many settings, specific facilities may require Anesthesiologist supervision based on their own policies or level of compensation.

The CRNA NEVER has to be supervised byan anesthesiologist, by law. Hospital bylaws may require it but ratios and conditions vary. The customary levels are the CMS regulations they however are ONLY for billing CMS and have no force of law in themselves, it is custom that usually drives these staffing and superviory ratios.

For us: outpatient 1:3. Inpatient 1:3 or 1:2 depending on patient complexity. Tertiary care center.

CRNAs can practice independently etc,etc,etc. The bottom line is my experience over the last 23 years is supervision by an MD everywhere I worked except for Haiti and Guyana. Sometimes it's one on one sometimes it's three on one. Sometimes they're there for induction often they're not. It depends on how busy things are and they're confidence in you abilities to work alone. It would be nice if they would see the next patient if you are in a busy room. Often you see the patient, tell the attending about them and do the case with the attending available if needed. My experience has been in NYC and suburbs. I've gamed the system schedule-wise my entire career and that would be less likely were I some sort of independent practitioner. It's also nice to walk out of work at the end of the day and not have to worry about the bussiness end. Hard work and lifestyle is my credo. ED

Supervision is a billing arrangement, and in this arrangement it is common for a MDA to supervise 2-4 CRNAs. It is also common that a CRNA is not supervised.

No other then dragging a "supervising" anesthesiologist out of the lounge

Its not a problem if the pt wants a MD. As long as the facility has anesthesiologists and if staffing permits. If its at a facility w/ anesthesia care team ( an MD supervising 2-4 CRNAs) staffing may be too limited to permit an MD being in one room. That would leave several rooms/cases now w/o a MD to supervise & the facility may not have another MD to staff the now unstaffed rooms. When this occurs @ my facilty the case is usually delayed until staff is available (Which could be hours. Work @ a busy private practice) or case may be cancelled til another day. Or staffing could permit--then case goes forward w/ no delays.