O.R. cases for CRNA's vs. Anesthesiologists - page 4

by ICU, RN, BSN, B.S. 9,287 Views | 38 Comments

Hey guys. I was hoping I could get some CRNA's opinions on this matter. Do you find that the CRNA's tend to do the "easier cases"....i.e. ENT and ortho, and then the MDA will do the more difficult cases, i.e. cardiac or... Read More


  1. 1
    Ok, so you don't understand evidenced based medicine. That's ok.

    S by your reasoning, an MDA who is employed is improperly supervised? You do realize many MDAs are employed? LOL.

    It is very apparent that you really do not have a clue.
    Even when provided with the differences between medical direction and supervision, you are unable to grasp the meaning.

    I'm done. I feel like I'm arguing with my teen, LOL.

    Have a nice life


    Quote from paindoc
    Actually you can only supply studies showing statistical but not relevant clinical significant differences... By definition an employee does not have completely independent decision making otherwise they would be either independent contractors or improperly supervised. You can't have it both ways much longer
    wtbcrna likes this.
  2. 0
    Actually there are studies that demonstrate statistically significant differences, but not clinical differences in outcome. What does this prove: 1. anesthesiologists and CRNAs deliver virtually the same product 2. anesthesia has become so safe that it is virtually a technician's job unlike any other area of medicine that cannot duplicate the outcomes. The upshot of all of this is that given the expense of anesthetic delivery with the cost of the provider plus equipment plus drugs, it is probably overpriced and healthcare trends will seek out the low hanging fruit, replacing the technicians job with a real technician (2 year associates degree after high school) with supervision, whacking reimbursement, and cutting out the fluff devices being used that are not EBM. Both anesthesiologists and CRNAs will lose significantly if this is to occur. So we will have to wait and see what transpires.......
  3. 0
    Quote from paindoc
    Actually there are studies that demonstrate statistically significant differences, but not clinical differences in outcome. What does this prove: 1. anesthesiologists and CRNAs deliver virtually the same product 2. anesthesia has become so safe that it is virtually a technician's job unlike any other area of medicine that cannot duplicate the outcomes. The upshot of all of this is that given the expense of anesthetic delivery with the cost of the provider plus equipment plus drugs, it is probably overpriced and healthcare trends will seek out the low hanging fruit, replacing the technicians job with a real technician (2 year associates degree after high school) with supervision, whacking reimbursement, and cutting out the fluff devices being used that are not EBM. Both anesthesiologists and CRNAs will lose significantly if this is to occur. So we will have to wait and see what transpires.......
    There are studies show exact same outcomes, mortality, adverse advents, length of stay in the hospitals etc. No matter what the comparison is you will find similar outcomes between the two types of providers.

    1. The low hanging fruit as you call it would be the MDA that sits in the break room getting paid a double reimbursement to not do anything. The federal government is set to look at renewing the federal opt out, and at that point if it does get passed it won't be CRNAs that will have trouble finding jobs. It will be the aforementioned "supervising" MDAs.

    2. Anesthesia is very safe, but the risk of anesthesia has recently increased. The reason for this is attributed to the increased age and comorbidities of anesthetic patients.

    3. You basically post this same thing over and over. Do you really expect a different response? CRNAs won't be replaced by technicians in the foreseeable future. One day there maybe a machine that can safely do it all, but that time is in the very distant future.

    4. What is the purpose of posting on here anyways? Per your own statements you do not even practice anesthesia anymore. You practice pain medicine.
  4. 0
    Paindoc--you are sadly mistaken about the law of vicarious liability. Everyone involved gets named in a lawsuit, including the CRNA. There is a very important Washington case where an anesthesiologist who practice in a substandard fashion paid $1,000,000 settlement in a lawsuit and the CRNA had a jury rule against her to the tune of $6,000,000. Shoulder surgery under GA by CRNA. MDA decided to do a suprclavicular block and said he didn't care if patient was under GA. Patient got a total spinal and ultimately had her arm amputated.
  5. 0
    And you don't understand deep pockets. CRNAs may be named, but in a team model, even if the CRNA screws up badly and causes permanent injury or death, the anesthesiologist is ALWAYS NAMED. You can rarely find cases where the CRNA was found liable for malpractice in a team model while the anesthesiologist gets off scott free. This definitely is contrary to the assertion that even in a team model, the CRNA is capable of making completely independent decisions. If they are, then they should be sued independently of the anesthesiologist.....doesn't happen.
  6. 0
    Quote from paindoc
    And you don't understand deep pockets. CRNAs may be named, but in a team model, even if the CRNA screws up badly and causes permanent injury or death, the anesthesiologist is ALWAYS NAMED. You can rarely find cases where the CRNA was found liable for malpractice in a team model while the anesthesiologist gets off scott free. This definitely is contrary to the assertion that even in a team model, the CRNA is capable of making completely independent decisions. If they are, then they should be sued independently of the anesthesiologist.....doesn't happen.
    That is because it has to be shown that the CRNA or MDA acted completely independently of each other, if the CRNA does something that the MDA neither consented to or knew about that was outside of normal/standard practice there is a chance that MDA can be found not liable.

    MDAs put themselves in these situations, if they don't want to be held potentially liable for something that a CRNA or AA does while under their "supervision" then get a job doing anesthesia not "supervising.
  7. 0
    I completely agree. Supervising is non-sensical. I can't seem to get that across to my anesthesiology friends....they are more interested in the $$.
  8. 1
    Please refrain from feeding the troll.
    nomadcrna likes this.
  9. 0
    Quote from paindoc
    I completely agree. Supervising is non-sensical. I can't seem to get that across to my anesthesiology friends....they are more interested in the $$.
    Well if they weren't in it for just the money then they probably wouldn't be doing those kind of jobs.


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