Why do anesthesiologists make more than CRNAs?

[Mully]

Is it because they can bill multiple cases at the same time within ACT practices?

I've heard that reimbursement is the same for CRNAs or MDAs providing the anesthesia, is this true? In other words, if an independent CRNA performs the same case as an independent MDA, will they be reimbursed the same amount?

Thanks!

P.S. This is not a should MDAs/CRNAs make more than each other etc. etc. question. This is specifically about current practices with billing and cost of anesthesia.

[gasdoctor]

Well our CRNA's out earn us? They are employees and we are subcontractors per the hospital. They work 40 hours a week and I average about 80 including 24 hour in house Trauma call. I have 26.5 years at the hospital, when I leave I get a cake, when the CRNA leaves she will collect about 200K a year in retirement. She has 6 weeks vacation, I have zero. She has a week CME, I have zero. She has health, dental and childcare and yes we are ZERO. The best part?

Even though the Governator made it legal for our CRNA's to work under THEIR licenses, they chose NOT too. They practice under MINE so our hospital pays our malpractice insurance, because if my CRNA makes mistake while another patient is trying to die, I GET SUED, not them. Two rooms is maximum for optimum medi-cal(public hospital) reimbursement and any doctor worth their salt wouldn't SUPERVISE more than two rooms simply because the liability becomes staggering. I did 3 years of college(finished early) 4 years of medical school, 4 years of residency, six months of a fellowship and am board certified. I voluntarily re-boarded. I would harken a guess, I'm in theory, supposed to be paid more because I have more education? Or possibly because I shoulder the burden of the CRNA's practice under MY license. I don't know, it's not my world.

[wtbcrna, MSN, DNP, CRNA]

Well our CRNA's out earn us? They are employees and we are subcontractors per the hospital. They work 40 hours a week and I average about 80 including 24 hour in house Trauma call. I have 26.5 years at the hospital, when I leave I get a cake, when the CRNA leaves she will collect about 200K a year in retirement. She has 6 weeks vacation, I have zero. She has a week CME, I have zero. She has health, dental and childcare and yes we are ZERO. The best part?

Even though the Governator made it legal for our CRNA's to work under THEIR licenses, they chose NOT too. They practice under MINE so our hospital pays our malpractice insurance, because if my CRNA makes mistake while another patient is trying to die, I GET SUED, not them. Two rooms is maximum for optimum medi-cal(public hospital) reimbursement and any doctor worth their salt wouldn't SUPERVISE more than two rooms simply because the liability becomes staggering. I did 3 years of college(finished early) 4 years of medical school, 4 years of residency, six months of a fellowship and am board certified. I voluntarily re-boarded. I would harken a guess, I'm in theory, supposed to be paid more because I have more education? Or possibly because I shoulder the burden of the CRNA's practice under MY license. I don't know, it's not my world.

I have serious doubts that the CRNAs out earn an anesthesiologist on an annual salary basis, if you mean on an hourly basis then I could possibly see that even though that is highly unusual.

Unless, you are in the military you have chosen this job and the consequences that come with it. There are plenty of jobs for anesthesiologists throughout the U.S. with much better benefit packages. We have never had any of our anesthesiologists have trouble finding lucrative jobs throughout the U.S. upon leaving our hospital.

I am assuming you are referring to California with the "Governator" comment. The CRNAs in California and every state work under their own license before the state opt-outs and still do. It was never illegal for CRNAs in California to work independently under their own licenses. The only thing that changed with the state opt-out is now CRNAs can bill medicare independently without physician "supervision". The "supervising" physician never had to be an anesthesiologist in the first place.

Liability does not change in an ACT practice for CRNAs. The CRNA is still responsible for their actions and having a "supervising" physician/anesthesiologist does not absolve them in any way of liability. It also means that the "supervising" anesthesiologists is not always liable in these cases where the CRNA is found to be at fault. The myth that the "supervising" physician is liable for all CRNA actions is a myth perpetrated by the ASA and AMA in order to try to maintain control and profits for physicians.

https://www.aana.com/aboutus/Documents/legalissuesnap.pdf

[Mrhanddiya]

Even though the Governator made it legal for our CRNA's to work under THEIR licenses, they chose NOT too. They practice under MINE so our hospital pays our malpractice insurance, because if my CRNA makes mistake while another patient is trying to die, I GET SUED, not them.

These statements are 100% wrong, and quite frankly ridiculous.