Wow. Louisiana Legislature Votes To Ban AA's - page 2

Now the bill goes to the governor. (P.S. Obviously I was wrong on the legislative issues. I guess Florida wasn't a bellwether decision afterall. Congrats to CRNA's on this one.) ;)... Read More

  1. by   athomas91
    jwk - you are mistaken - i know of no SRNA or CRNA that is anti AA...but most of us are looking to the future - and if the AA use proliferates - it will ultimately effect us - it would be stupid not to pay attention and aggressively fight for ground (the AA's are doing it)....it is not a personal issue but rather a professional issue. i apologize if i have in anyway made you feel that way - for it was not my intention...but here is my breakdown....

    when you have professions that begin "crossing" lines of distinction - you blur the confines of a profession...this leads to loss of positions, decreases in salary etc.... for example - just because CRNA's can do anything an MDA can - even function idependently - they are still not making the same money an MDA is...why is that?? it is because the "doctors" have such a stronghold that even though CRNA's function the same - they cannot and will not be able to shake that stronghold - we will never make the same money...we will never take their jobs... but what is happening with the AA movement is they are essentially saying - we are the same as CRNA's - and yes - you all do many of the same functions and i am sure you do them well - but there are a few VERY UNIQUE distinctions....and they are being downplayed as the lines of distinction are blurred ... therefore - they are making the same money - and they will eventually compromise positions...that is where the ruffled feathers come into play...CRNA's have been around for more than 100 yrs - LONGER THAN MDA'S - we have to get a 4 yr nursing degree then work (and very hard i might add) in a critical care setting - all this before we can even be considered for anesthesia school - no mind you the GRE's...etc... then we train for anesthesia...if you hear us argue "we are better" it is pride ...not malice...
    good luck to you jwk. Andrea
  2. by   Sheri257
    Quote from jwk
    All it takes is a better-informed legislature.
    Based on the votes, it looks like you have a lot of work to do.

    Last edit by Sheri257 on Jun 10, '04
  3. by   gaspassah
    having lived (and plan on returning to louisiana) the scope of aa use was to ease the lack of anesthesia providers to rural hospitals. (as stated by the rural hospital coalition)
    but there are very few mda's that practice rurally. if aa's come into la then the only place to work would be in cities (where they can be supervised by mda's), essentially taking away jobs of crna's already working there, and forcing the crna's to move their families to rural settings to work, ie take their kids out of schools and away from friends etc, same for the parents and spouses.
    a better idea is, lets get more crna's trained and give them incentives to work rurally. they wont need supervision and they are paid less than an mda. sounds like cost productive healthcare to me.
    the ability to do this is already in place. no need for new aa schools, time to get them up and running or any other hurdles.
    i wonder why the a$a doesnt support care that is beneficial to small communities, their patients, hospitals and the cost of healthcare but supporting the training of more crna's.
  4. by   Sheri257
    Quote from gaspassah
    having lived (and plan on returning to louisiana) the scope of aa use was to ease the lack of anesthesia providers to rural hospitals. (as stated by the rural hospital coalition)
    but there are very few mda's that practice rurally. if aa's come into la then the only place to work would be in cities (where they can be supervised by mda's), essentially taking away jobs of crna's already working there, and forcing the crna's to move their families to rural settings to work, ie take their kids out of schools and away from friends etc, same for the parents and spouses.
    a better idea is, lets get more crna's trained and give them incentives to work rurally. they wont need supervision and they are paid less than an mda. sounds like cost productive healthcare to me.
    the ability to do this is already in place. no need for new aa schools, time to get them up and running or any other hurdles.
    i wonder why the a$a doesnt support care that is beneficial to small communities, their patients, hospitals and the cost of healthcare but supporting the training of more crna's.
    So, why do you think the Rural Hospital Coalition said this in support of AA's?

    "Rural hospitals cannot afford the luxury of employing large number of anesthesiologists and CRNAs, even if they were willing to regularly provide services in our hospitals."

    If AA's aren't practical for rural areas, why did they support them?

    http://69.2.40.145/LANA/Admin/Upload...spitalMemo.pdf

  5. by   gaspassah
    i would guess they would pay aa's a fraction of what it costs for a crna.
    but they would have to contract an anesthesiology group to provide services. so they can be a beeper or phone call away to supervise the aa.
    doesnt sound safe to me, nor cost effective. the hospital would still have to pay the anesthesiologist fee, theyre not gonna do it for free.
    i think it is a shortsided attempt to fix a problem.
    just my .02
  6. by   jwk
    Quote from gaspassah
    i would guess they would pay aa's a fraction of what it costs for a crna.
    A fraction? Dream on.
  7. by   gaspassah
    ok jwk, what is your answer, they say they cant AFFORD mda and crnas, but they want aa's. i know it's not based on the history of outstanding care provided by aa's.
    they are looking for a cheaper alternative. that would be you.
    d
  8. by   TheBigBadDog
    Quote from gaspassah
    ok jwk, what is your answer, they say they cant afford mda and crnas, but they want aa's. i know it's not based on the history of outstanding care provided by aa's.
    they are looking for a cheaper alternative. that would be you.
    d
    [font='times new roman']i don't understand your argument. you are saying that they can't afford mdas and aas? that doesn't make any sense, all louisiana had to do is increase the supply of providers and the price will drop for the service. if the combination of mdas and aas is more expensive than crnas providing the same service then those who are demanding the service will choose crnas, assuming all things other factors are equal. from the perspective of economics, it makes no sense to restrict the supply of service providers if you are trying to get the availability to increase and the price to decrease. you don't need to give crnas an incentive to move out to rural areas, if the supply of service providers is saturated in the cities then they will move to where there is demand for the service and the price is still high in rural areas.
  9. by   CRNA, DNSc
    Not in Michigan

    """"""Where do you come up with two states? Georgia, Alabama, New Mexico, South Carolina, Michigan, Wisconsin, Ohio, Vermont, Texas, Missouri, and Florida coming up. """""


    Let me correct some misinformation- AAs are not legally recognized in Michigan- there are about 3-5 in the state and they practice under "delegated medical tasks" statutes in the Public Health Code.
  10. by   Sheri257
    Quote from CRNA, DNSc
    Not in Michigan

    """"""Where do you come up with two states? Georgia, Alabama, New Mexico, South Carolina, Michigan, Wisconsin, Ohio, Vermont, Texas, Missouri, and Florida coming up. """""


    Let me correct some misinformation- AAs are not legally recognized in Michigan- there are about 3-5 in the state and they practice under "delegated medical tasks" statutes in the Public Health Code.
    That's another thing I don't understand, this "delegatory authority" situation. I know the D.C. CRNA's are disputing the legality of it there, and I believe Texas AA's practice under "delegatory authority" as well.

    How are they able to do this without legislation?

    As far as which states allow AA's, this ASA document says there are ten, 11 if you add Florida. They are: Alabama, Kentucky, Georgia, Missouri, New Mexico, Ohio, South Carolina, Vermont and the above mentioned Texas and D.C.

    http://www.asahq.org/asarc/AA-CRNA_Comparison.pdf

    I don't see Michigan or Wisconsin on that list.

    Last edit by Sheri257 on Jun 11, '04
  11. by   jwk
    Quote from CRNA, DNSc
    Not in Michigan

    """"""Where do you come up with two states? Georgia, Alabama, New Mexico, South Carolina, Michigan, Wisconsin, Ohio, Vermont, Texas, Missouri, and Florida coming up. """""


    Let me correct some misinformation- AAs are not legally recognized in Michigan- there are about 3-5 in the state and they practice under "delegated medical tasks" statutes in the Public Health Code.
    They ARE working in Michigan, legally, and have been for years. YOU may not recognize them, but that's your problem.
  12. by   jwk
    Quote from lizz
    That's another thing I don't understand, this "delegatory authority" situation. I know the D.C. CRNA's are disputing the legality of it there, and I believe Texas AA's practice under "delegatory authority" as well.
    Some states grant physician's the authority to delegate medical tasks to other individuals with appropriate training. It's perfectly legal. AA's are well trained, able to secure malpractice coverage, and are reimbursed for their services by both private and public insurers.
  13. by   Sheri257
    Quote from jwk
    Some states grant physician's the authority to delegate medical tasks to other individuals with appropriate training. It's perfectly legal.
    Not necessarily the case in D.C. CRNA's argue that the medical board acted without legislative authority, i.e. illegally. That's why the issue is now before the city council.

    And, if AA's have been operating in Michigan legally for years, why isn't Michigan on the ASA's list? If it was true, you'd think your own people would include it.

    Last edit by Sheri257 on Jun 12, '04

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