Does it bother CRNA's that MDA's get so much more...?

[ICU, RN, BSN, B.S.]

Hey guys,

I'm not a CRNA yet. I want to be. I just got hired in a MICU/SICU. I was just wondering if it bothered any CRNA's the fact that MDs who practice anesthesia get paid wayy more for doing the same thing? I know some hospitals/facilities require the MDA oversee the CRNA, but does that equate to a couple hundred K more?

I don't know...I just feel CRNA's are not compensated enough for the ENORMOUS amount of responsibility and knowledge they hold.

[wtbcrna, MSN, DNP, CRNA]

surely there are multiple factors in play here. If it was strictly same job - same outcomes - same pay, then we wouldn't see ACT practices today skewed towards MDA>CRNA income. The only place I see this actually happening is in the CRNA independent practices in the future.

There are multiple factors at play with anesthesia provider incomes, and it all comes down to politics. MDAs have not shown to give greater care and are no more effective in delivering better outcomes than their CRNA counterparts.

[offlabel]

There are over 85 CRNA's in my private practice group. Some work independently in small rural community hospitals doing general ortho, ob/gyn, gen'l surgery with simple pain on the side, some work in ACT's in larger community hospitals with a little more complex case load and some work in ACT's serving a regional tertiary care referral center doing tertiary peds, neonatal, obstetric, cardiothoracic and vascular cases. Three large groups, neither doing each other's jobs, but all in the same private practice group with all areas of practice open for anyone to join if they wish and every single one on the same pay, vacation and benefits scale which is pretty reasonable. Very difficult to beat this situation.

The owners are docs and they pay themselves very well. And with few exceptions, the CRNA's could not care less. The professional satisfaction we have from our jobs, the standard of living we enjoy, the area of the country we live in is the trade off. It would be idiotic to try to approximate what the docs make. We'd price ourselves right out of the market because however naïve and unfair it would be, why would an private anesthesia group hire a CRNA over a doc if they'd have to pay the same salary? Why would a hospital do that?

The pay difference is job security where I am.

[Chaserr]

Exactly

[wtbcrna, MSN, DNP, CRNA]

There are over 85 CRNA's in my private practice group. Some work independently in small rural community hospitals doing general ortho, ob/gyn, gen'l surgery with simple pain on the side, some work in ACT's in larger community hospitals with a little more complex case load and some work in ACT's serving a regional tertiary care referral center doing tertiary peds, neonatal, obstetric, cardiothoracic and vascular cases. Three large groups, neither doing each other's jobs, but all in the same private practice group with all areas of practice open for anyone to join if they wish and every single one on the same pay, vacation and benefits scale which is pretty reasonable. Very difficult to beat this situation.

The owners are docs and they pay themselves very well. And with few exceptions, the CRNA's could not care less. The professional satisfaction we have from our jobs, the standard of living we enjoy, the area of the country we live in is the trade off. It would be idiotic to try to approximate what the docs make. We'd price ourselves right out of the market because however naïve and unfair it would be, why would an private anesthesia group hire a CRNA over a doc if they'd have to pay the same salary? Why would a hospital do that?

The pay difference is job security where I am.

I understand and I have said similar things throughout this thread.

This why many MDAs won't work in non-subsidized anesthesia departments and/or in rural areas.

[jwk]

I understand and I have said similar things throughout this thread.

This why many MDAs won't work in non-subsidized anesthesia departments and/or in rural areas.

My large group has never been subsidized. I know quite a few anesthesiologists what work in rural areas, despite the fact that CRNA's are subsidized by the federal government in critical access hospitals and anesthesiologists are not.

Your generalizations are opinions not based in reality.

[nomadcrna, DNP, CRNA, NP]

Simple not true. I would expect a mod to know this or not comment. We practice under our own license. We are also independent in the majority of states. I'm not sure where you got this from.

CRNA's are still acting under the MD license and direction.......and technically orders. I believe a MD needs to be present on induction and emergence. If you want the pay of the MD then go to school to be one. It taks 4 years of pre-med, 4 years of medical school, 3.5 years of anesthesia and another 2-5 if they specialize like Open heart or transplant near death anesthetics.

You are a nurse. A CRNA is a specialized nurse. You have 4 years BSN, 15-18 months masters, 1 year critical care experience and 2.5 years CRNA school (when you add all these up...24 months+ of schooling). You go to school less and pay less liability, you will paid less, although still a great wage due to only go up. It really really annoys me sometimes.... this line of thinking. NP's are not MD's and CRNA's are not MD's........you are nurses with specialized training that entitles you for more automony and responsibility and therefore more money, but you remain a nurse.

I know I will be flamed.:flmngmd:But here it goes.........

If you want the pay and responsibility of the MD...go to school and be one.:sofahider.

I just hope that the draw of the money for becomming a CRNA is not all about the money but for the love of anesthesia...........Good luck! peace:heartbeat

EDIT 9/2/11 For all reading this post.....continue reading before you flame me, there are some very interesting discussions about this very obvious HOT button topic.......I have cried uncle and conceded to agree to disagree.

[nomadcrna, DNP, CRNA, NP]

But you don't need MDAs, period. Supply and demand works only if you need a product.

I understand why a MDA gets paid more than a CRNA even for the same job with the same outcomes across the board. I believe MDAs have different experiences and thus bring different views into practice as do CRNAs that MDAs don't, which both views are equally valuable to a holistic patient approach. MDAs are less abundant and cost more to produce, thus should get paid more - basic economics. What I don't understand is how they make double, and in some cases almost triple the amount as a CRNA. It's absurd to undermine the Nurse Anesthetist's knowledge by inflating MDA wages for the same job and same outcome. I understand MAYBE 20-50k more than a CRNA, anything more and the system is blowing smoke up their a**.

[wtbcrna, MSN, DNP, CRNA]

My large group has never been subsidized. I know quite a few anesthesiologists what work in rural areas, despite the fact that CRNA's are subsidized by the federal government in critical access hospitals and anesthesiologists are not.

Your generalizations are opinions not based in reality.

To bad the research states the same thing as my opinion.

[MorgantonCRNA]

A lot of misinformation out there.

MDAs get paid more, I am more upset that I am fatter now than when I was 20.

To set the record straight 17 states require no supervision. I work in Alamogordo, NM there isn't a single MDA in the entire hospital.

So no I don't work under anyone's license but my own. No one has any secret knowledge about anesthesia that I do not. No MDA comes in to rescue me or bail me out or any other way you want to put it.

Research has shown time and time again THERE IS NO DIFFERENCE in outcome between providers CRNA v MDA.

Research has also show CRNAs are cheaper. That's why I am working in a CRNA group in my hospital.

MDAs get paid more that we do but 275k/yr is all I need so....

[guest769224]

Research has also show CRNAs are cheaper. That's why I am working in a CRNA group in my hospital.

MDAs get paid more that we do but 275k/yr is all I need so....

Wow, congrats on such a high paying and autonomous position. Do you think that hospitals will continue phasing out anesthesiologists in favor of CRNAs to do the same job for cheaper?

[MorgantonCRNA]

Wow, congrats on such a high paying and autonomous position. Do you think that hospitals will continue phasing out anesthesiologists in favor of CRNAs to do the same job for cheaper?

I don't think, nor hope MDAs will be phased out. I hope CRNAs will be phased in more.

[mimicarey]

How can it bother them?

They basically do half of their schooling--and want all the same pay ? .seems greedy. My girlfriend is a PA, and you know what, she understands with her role. She understands surgically they are some things she just cannot do, even though she has a lot of autonomy. She understood her limitations with being a non physician practitioner, She's happy leading but limiting to what she knows is her scope.