Here's what AAs really think of CRNAs - page 10

And this comes from the PRESIDENT of the American Society of Anesthesiologist Assistants Again, assertions that AAs and CRNAs function at the same level -absolutely misleading. And, what's... Read More

  1. by   user69
    [font='Times New Roman']I have an idea on how the AANA can stop the whole model of an "Anesthesia Team" where the MDA "sits in his office and "checks the stock ticker". If evry CRNA refused to work for an MDA and only practiced on there own or in CRNA groups there supply of AAs could not fill the void. And the AANA could force the MDAs into not supporting the legislation for AAs and kill off the profession. And I am guessing that the AANA (or specific regulating body) has the power to pull or refuse to renew the license for any CRNA tries to work with a MDA. It has been said many times that there is plenty of demand for anesthesia, so why not make a play and force the removal of the entire AA issue. And next year once this is done we can use the same power to push all of the medical schools (that are turning out those pesky MDAs that compete with us) to convert their Anesthesiologist programs to CRNA programs. Then we will be unstoppable!!!
  2. by   Sheri257
    Quote from athomas91
    as far as pay...and job availability...it is a simply supply vs demand...they flood the market w/ AA's - there goes not only job availability but also $$...
    If, by chance, the ASA floods the market with AA's, that's life. It's called capitalism. The same capitalism that provides the great salaries for CRNA's. If all you can do is whine about the competition, you're going to lose.

    Nobody is trying to stop tech companies from exporting high paying IT jobs to India because a bunch of American tech workers lost their $100,000 a year jobs.

    Why do you think you deserve more consideration? They too are an educated work force that invested heavily in their education. And they're screwed. But nobody is trying to stop the forces of capitalism on their behalf.

    And nobody is going to feel sorry for CRNA's if they're only making $80,000 a year with AA's in the marketplace, instead of $120,000 or more, when the average American makes lot less than that.

    The ASA might have tried to take control of your practice in previous years, but that's not on the table anymore. If they want their own assistants, and it fulfills a need without any patient safety issues, it is a free country, afterall.

    The ASA is greedy. I'll give you that. But you guys are too. In the end, that's your only argument, and it's lame. It's all about the money and the fact that AA competition might drive down your salaries. I don't blame you for complaining, actually, but don't expect everybody else to feel sorry for you until you can come up with a better argument that's backed up by evidence.

    The AANA may be making promises to remedy the situtation, but there is a shortage, and there's no good reason not allow AA alternatives if you can't prove patient endangerment.

    In the end, it's supposed to be about the patients, not your salaries.

  3. by   user69
    [font='times new roman']is it a new record that we have reached 13 pages in two days? the thread only started at 05-03-2004, 10:20 pm
  4. by   deepz
    Quote from lizz
    ....The ASA might have tried to take control of your practice in previous years, but that's not on the table anymore. .......

    Excuse me, Lizz -- there's no kind way to express this, and I really do not wish to sound offensive to you -- but you apprently don't know what you're talking about.

    The A$A bought entry into Florida for their AA lackeys with hard cash. Read the Palm Beach article:

    http://www.palmbeachpost.com/opinion...3c01e00db.html

    deepz
  5. by   Sheri257
    Deepz, I was referring to this quote from Loisane:

    Quote from loisane
    ASA tried for decades to gain complete control of nurse anesthesia practice. They are driven by many motives. Power, greed, and maybe even the honest belief that anesthesia really is the practice of medicine. We have successfully fought them off at every turn. The latest round was the supervision regulations. They decided then to try an alternate approach.

    If they could not be succesful making CRNAs the type of dependent practitioner they wanted, they would create/promote another type of provider. One that is more congruent with their philosophy.

    loisane crna
    Last edit by Sheri257 on May 6, '04
  6. by   deepz
    Quote from lizz
    Deepz. I was referring to this quote from Loisane:

    It's an ongoing struggle, Lizz, the A$A power grab; that's my point, not, as the saying goes 'past history,' but *present* history. Thanks for clarifying.

    deepz
  7. by   duckboy20
    Its funny to me. Some AA's seem to feel like they provide very good anesthestic care, which they might do. All us CRNA's seem to feel like we provide quality anesthetic care, which we hopefully do. At least Georgia AA seems to feel like he can stand his own independantly, but like he said likes to have a safety net around, like we all do. Both AA's and CRNA's make considerably less than the MDA. If all supposedly provide quality anesthetic care but the MDA costing more money, phase out MDA's and CRNA's and AA's can work together.
    I know I know that AA's by law must be under and MDA but if all provide safe care, who needs the MDA?
  8. by   loisane
    Quote from lizz
    If, by chance, the ASA floods the market with AA's, that's life. It's called capitalism. The same capitalism that provides the great salaries for CRNA's. If all you can do is whine about the competition, you're going to lose.
    Excuse me, Liz, but I tried to make it clear I was speaking to philosophy and personal professionalism. I am not making a case here for the media or legislators. I would present that in an entirely different way.

    And health care is not completely ruled by market forces that define pure capitalism. There is the artifical influence of legislation and regulation that alters the picture from what it would be if market influences were the only consideration. Interestingly, there are CRNAs who are not the least bothered by the prospect of AAs, because they believe CRNA practice to have advantages that will naturally "win" because of these very same market forces of capitalism.

    Are you a nurse? My position is grounded in my view of professional nursing and its role in health care. Wouldn't any nurse like to see a group of advanced practice nurses who have practiced with autonomy for a century retain that scope of practice? Wouldn't any nurse like to see that protected, and maybe trickle over to other (appropriate) areas of nursing?

    But I agree with you about salaries. It bothers me to see people look at this issue completely as "How will this affect me and the money I make". I did not go into nurse anesthesia for the money. None of us who have been around awhile did, because back then the money was not really there like it is now.

    Actually, I believe it is this same "I, me, mine, show me the money" that ruined anesthesiology, and is now threatening to ruin nurse anesthesia. But I guess that is another thread.

    loisane crna
  9. by   athomas91
    Excuse me, Liz, but I tried to make it clear I was speaking to philosophy and personal professionalism. I am not making a case here for the media or legislators. I would present that in an entirely different way.
    And health care is not completely ruled by market forces that define pure capitalism. There is the artifical influence of legislation and regulation that alters the picture from what it would be if market influences were the only consideration. Interestingly, there are CRNAs who are not the least bothered by the prospect of AAs, because they believe CRNA practice to have advantages that will naturally "win" because of these very same market forces of capitalism.
    well said....

    just for the "record" - i don't believe it was any of the CRNA/SRNA's that brought money into the discussion...it was others stating that was our motivating factor in this debate...i didn't go into this for the money (i will not lie and say it doesn't make it more tolerable...buy anyway...) - i went into it for the advanced education, the advanced training and the chance to treat my patients one on one which is nearly extinct in anyother nursing realm.

    i think that all of us have made very valid points for why we will continue the fight in the use of AA's (sorry Georgia...)

    I have an idea on how the AANA can stop the whole model of an "Anesthesia Team" where the MDA "sits in his office and "checks the stock ticker". If evry CRNA refused to work for an MDA and only practiced on there own or in CRNA groups there supply of AAs could not fill the void. And the AANA could force the MDAs into not supporting the legislation for AAs and kill off the profession. And I am guessing that the AANA (or specific regulating body) has the power to pull or refuse to renew the license for any CRNA tries to work with a MDA. It has been said many times that there is plenty of demand for anesthesia, so why not make a play and force the removal of the entire AA issue. And next year once this is done we can use the same power to push all of the medical schools (that are turning out those pesky MDAs that compete with us) to convert their Anesthesiologist programs to CRNA programs. Then we will be unstoppable!!!
    i also think there is no reason to be absurd in the matter......

    i will say one thing to you lizz...i remember when i was younger..i too believed that "there was always a better way"...but then real life slapped me in the face and i realized that you cannot fight deceptive maneuvering with good hearted hopes. for USER69- when i spoke of "them" - i was referring to the ASA and the power that lies therein.

    It isn't about money...it is about our patients - and the fact that they deserve to know who is really caring for them - and what experience they bring...and LEGALLY who can provide the most comprehensive responsible care.
  10. by   alansmith52
    I am about ready to see this thread die. its getting run from the global allnurses.com body.
    all in favor.
  11. by   deepz
    Quote from duckboy20
    ......I know that AA's by law must be under and MDA but if all provide safe care, who needs the MDA?
    You've touched on the deepest level of the conflict, Ducky. Who does need them? Bar none, the worst behavior I've witnessed over the years is the blatant HYPOCRISY of certain MDAs. Say one thing, do another. When the gullible are watching, the MDAs're all "We're so indispensable, keeping a close eye on these 'nurses.' Take our word for it -- we're doctors!" When the public's back is turned, however, they're off 'supervising' from the golf course.

    They know that we CRNAs see through their BS. We all know who does the real work. It's our shared 'secret' -- something akin to the way pedophiles have 'secrets' with their victims. Don't tell, or else. They have the power to fire us on a whim. And they do. They also pocket the major share of the cash. Yes, it's fraudulent. All of which drives them to resent us at the same time that they exploit us. It's truly sick.

    Of course MDAs'll always be around. Joe Sixpack's unfounded presuppositions of physician superiority over nurse practitioners will guarantee that. And truthfully we do need them, in certain places on occasion, for their input in that one in a thousand or ten thousand cases complicated patient, to oversee management of perioperative problems. Do I think I'm a peer of anesthesiologists? No way. I may be a colleague of sorts, providing the same services in the OR with the same high quality (or better), but being a colleague in anesthesia in no way makes me the equal or the peer of an MD. Just as AAs are not the equal of CRNAs.

    I'm a simple CRNA, that's all. No more than that. AND NO LESS. 'Anesthesia nurse' I am not, thank you very much. Does the phrase 'where the sun don't shine' ring a bell? Having seen so much of the hypocrisy and the fraud prevalent in the closed environment of the OR, I have no need to be anything more than a simple anesthetist ... off on my own. Occasionally I work alongside anesthesiologists, but not under them, and we get along great. No supervision for me, thank you; I've had all the hypocrisy I can take. (Burp)

    JMHO

    deepz
  12. by   Sheri257
    Nevermind.
    Last edit by Sheri257 on May 6, '04
  13. by   smk1
    Quote from deepz
    When the gullible are watching, the MDAs're all "We're so indispensable, keeping a close eye on these 'nurses.' Take our word for it -- we're doctors!" When the public's back is turned, however, they're off 'supervising' from the golf course.
    Of course MDAs'll always be around. Joe Sixpack's unfounded presuppositions of physician superiority over nurse practitioners will guarantee that. And truthfully we do need them, in certain places on occasion, for their input in that one in a thousand or ten thousand cases complicated patient, to oversee management of perioperative problems. Do I think I'm a peer of anesthesiologists? No way. I may be a colleague of sorts, providing the same services in the OR with the same high quality (or better), but being a colleague in anesthesia in no way makes me the equal or the peer of an MD. Just as AAs are not the equal of CRNAs.
    deepz

    THis paragraph clarified some issues for me. I think that you made a good point with the fact that MDA's will be needed for the paitient that has multiple perioperative issues that are complicated and rare. in this arena the CRNA is not the "equal" of a doctor, just as the AA is not going to be the equal of a CRNA in most perioperative issues because of their lack of training and experience outside of the actual anesthesia administration. I know i never thought of it this way before, so thanks! Also i really appreciate losianes posts for their clear establishment of the issues.

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