Should Anesthesia Be an only MD Profession - page 5
I knew this would get your attention. This question is for those seeking, in current studies, and practicing anesthesia. I understand the economics and statistics for various practice... Read More
Mar 2, '04In speaking with a fellow anesthetist today, he indicated that the aggressiveness of many MDA groups (as well as the ASA dictums) have been increased .......seeking to ensuring limiting CRNA practice and to further provide the settings in which CRNAs are supervised.
The turning point? Possibly the lawsuit in Minnesota (Minnesota Association of Nurse Anesthetists vs Unity Hospital, et al).
In a time of increased public concern about healthcare costs - the anesthesiologist have to be business savvy and to ensure that they can maintain the higher compensation for those every shrinking healthcare dollars.
Greater control / Greater reimbursement = limiting CRNAs scope of practice
Money always seems sacrosanct when it comes down to it....
Mar 2, '04If MDA's are being more aggressive in limiting the scope of CRNA's practice then it would behoove the AANA and CRNA's everywhere to consider an effective response. Do you have any suggestions as to techniques that could be employed to limit this effort? Below is a link to a paper which covers the issue at some length, but may be worth the time to read. The conclusion of the author seems to be that CRNA's need to undertake a proactive rather than reactive posture when it comes to establishing their scope of practice both with regard to public relations and litigation.
http://126.96.36.199/search?q=cache...hl=en&ie=UTF-8Last edit by Roland on Mar 2, '04
Mar 3, '04Thank you for your post and link....
I find that many points are very detailed in description - but one seemed to catch my attention where Judge Bennet had remarked from Randall v. Buena Vista City. Hosp:
"...there is no dispute that "tied" products were created by the Hospital's exclusive contract for anesthesia services with the Clinic Foundation, because, under that agreement, the Clinic Foundation had the exclusive right to provide anesthesia services at the Hospital. What remains to be seen, inter alia, is whether there are genuine issues of material fact concerning exploitation of the Hospital's control over its services to force patients to purchase the "tied" anesthesia services. Cf. Jefferson Parish Hosp., 466 U.S. at 12. On that question, the court finds the barest suggestion from the record that consumers actually differentiated between the anesthesia services provided by the Clinic Foundation and other providers, and thus, by the barest of margins, there is a genuine issue of material fact as to whether the exclusive provider contract professions have been well established by case law, academics, legislation, and sheer common sense."
Hence, are patients (consumers) really able to differentiate between the anesthesia services provided to them?
I doubt it very much.
Nor are they able to be objective consumers - since the belief that MDA's can provide the highest quality of anesthesia care, has been ever pervasive in the public's mind.
But this also brings up the other real issue.....That patients, because of the ASA work, have been FORCED to pay for the highest Tiered Service when both MDA's and CRNA's are in the same hospital setting.
How have the MDA's gotten around this?
To ensure that CRNA's CANNOT COMPETE and offer equal services (by restricting practice, writing supervision bylaws, etc....)
.....Hence the patient will NOT have a choice in service costs......
Where does the answer lie? On this, I must take some time to think....