MDA Or CRNA?

BRobison · May 9, 2002

I have a friend that faced the same dilemma. He chose the CRNA route mainly for the time factor that you describe. You might be interested to know that he works independently in a small community and makes upwards of $250K/year.

I haven't been so lucky, ending up in a community that is "all MD," and not being able currently to follow my chosen career path. However, when I was actively working "at the head of the table," there was never a circumstance that arose that made me think "gee, I wish I had a medical degree, THEN I'd know what to do in this case."

Nurse anesthesia schools will prepare you very well for what you will face in the "real world."

For what it's worth.......

jfpruitt · May 9, 2002

Well, I guess the main reason I ask, is that one CRNA told me that the MDA NEVER comes in the OR unless there is some sort of crisis, yet, he gets paid more. Is this true?

ma kettle · May 9, 2002

Our MDs in some cases do the fiberoptic intubations. And some o the very risky inductions. Patients that have multiple complications. But the nurse anesthetists are the ones general that stay the whole case.

The MD at the one hospital I work at take call from home. But they live close and the hospital is a level three. If the aptient is that bad they are air lifted to a level one hospital.

GOOD LUCK

Sandy

jfpruitt · May 9, 2002

Here's my focus: 9 years/150k+ debt MDA Income 250+k

4 years/50k debt CRNA Income 150+k

BRobison · May 9, 2002

your question about MDs coming into the OR...well, that depends on your facility. Some places are set up so that MDs "sup" the CRNAs, and they can sign off on up to 4 cases at a time, being reimbursed for "supervising" each one. In some places, CRNAs do their own thing, alone, and the MDs do theirs, alone. But in facilities where there is a mix, or a "team" approach, generally the first scenario is the case. I've known many many CRNAs that work "solo," but I don't know any MDs that do.

**SKM-NURSIEPOOH, BSN, RN** · May 10, 2002

originally posted by jfpruitt
i've been around and doing lots of research and questions about crna. i had the opportunity to go to medical school about 3 years ago and declined b/c i thought it would be too expensive and i have medical bills that wouldn't allow me not to have insurance, so i've been working this whole time and finishing up my rn. i know i want to be a crna, however, a lot of people keep telling me to do mda. why? if i do crna, i have 1 year left of adn(already have bs in biology) then 1 year of ccu, and then i'll apply and go for 2+ years. that's give or take 4 years assuming i get in immediately. if i want to do med school, i'd have to take the mcat this summer and apply for 2004 then go 4 years, plus 3 years residency. that's about 2010, 9 years. now, what would be the advantage of 9 more years vs. 4 more years??? i know the money, but other than that??? i just want to make the right decision and med school seems so long and so much more money to be doing the same work. can anyone advise here???? or at least tell me why you did crna and not mda??? thanks!!!

hi j.f. pruitt,

perhaps your friend meant aas (anesthesiologist assistants) as opposed to becoming an anesthesiologist, md or do?? if so, then the following links for aas should help-out. aas & crnas are on equal footing as to their scope of practice. the only difference that i can see is that aas belong to the ama & are licensed as pas in some states...where as the crnas are not licensed as nps; & of course, aren't part of the ama. also, it's not necessary to have a medical background in order to be accepted in the aa program...one just have to have a strong background in biology/chemistry/biochemistry/physics/& calculus. a bs degree is required but it could be in any area...again, not restricted to medical. lastly, aa students don't have to work in the icu/ccu or critical care areas prior to enrolling either. why crnas' are required to work at least 1-1.5 years prior to enrollment is not clear, but it's not required of the aas. both programs requires a master's degree & national certification for practice. i hope these url links help both you & your friend...good luck in your continued research in this area...& in your endeavors :blushkiss!!!

american medical association (ama) website on anesthesiologist assistant:

http://www.ama-assn.org/ama/pub/category/3836.html

american academy of anesthesiologist assistants website:

http://anesthetist.org/faq.html

wisconsin medicaid handbook website:

http://www.dhfs.state.wi.us/medicaid2/handbooks/nurse-anes/services.htm

and/or

http://folio.legis.state.wi.us/cgi-bin/om_isapi.dll?clientid=117895&infobase=code.nfo&jump=hfs%20107.065&softpage=document

and/or

http://folio.legis.state.wi.us/cgi-bin/om_isapi.dll?clientid=117895&infobase=code.nfo&jump=hfs%20105.055&softpage=document#jumpdest_hfs%20105.055

commonwealth of kentucky website:

http://www.lrc.state.ky.us/kar/201/009/175.htm

lgcv · May 10, 2002

AA's are different, they are required to be directly supervised, whereas CRNA's are not. From the kentucky website: (d) Notwithstanding Section 9 of this administrative regulation, the physician assistant shall not administer or monitor general or regional anesthesia unless the supervising physician, who must be a board certified anesthesiologist, is physically present in the operating room during induction and emergence, and thereafter physically present in the operating suite and not concurrently performing any other clinical procedure.

This type of language is the same in every state in which AA's can practice. Read the scope for CRNA's there is a vast difference.

They do not learn how to perform regional anesthesia or insert invasive lines in school, although the anesthesiologist can teach them after they graduate.

There are many states that do not recognize AA's (they have no scope of practice), of the states that do recognize them, they are not usually classified as PA's.

At this point there are only two schools. Although I think another one is opening in Louisianna.

CRNAs are licensed as advanced practice nurses in ALL states. The ASA will certainly allow any CRNA who wants to join, join as an associate member....all they have to do is give up their membership to the AANA. Of course doing that would be ridiculous, there are some issues where the two groups are at opposite ends of the pole.

Unlike the American Nurses Association the American Association of Nurse Anesthetists is a very proactive organization. The PAC for AANA is one of the most effective in the country.

BRobison · May 10, 2002

thank you, LCGV, for that concise but thorough reply to the AA vs CRNA issue. RE; the ICU background: I can't speak for the schools as to why specifically they require that, but having "been there, done that," working as an ICU nurse certainly develops your ability to think and act with some autonomy and high level critical thinking skills. Those are essential in the practice of anesthesia. The exposure you get to critically ill patients, codes, intubations, extubations, arrythmias, etc, etc, etc, is also invaluable in your work in the OR. I've had no exposure to AAs....in fact, I admit, I didn't know they were in existence yet, thought that was just an avenue the ASA was exploring.