[surgpa]

Originally Posted by rodvigcrna

I say CRNA's and AA's UNITE !!!!

Here is my view:

Some surgeons are trading their higher paid PA's for RN first assistants. Paying them less money than PA's but more money than RN's. So prominent is the trend that RN's are entering this field in droves.


Stop and think before everyone starts bashing each other.

OK, how does that make any sense? RNFAs are not reimbursed by Medicare or Medicaid, plus they aren't making rounds and writing orders. If they are doing this on their own (I know some who have TRIED) they might be in hot soup with the BNE.

I'm a PA and an RN.

Mike

[SigmaSRNA]

Originally Posted by platon20

SHOW ME THE EVIDENCE THAT CRNAS HAVE BETTER OUTCOMES THAN AAS

You cant, because that evidence doesnt exist. However, there is ample evidence in peer reviewed pulbications like JAMA, NEJM, etc that outcomes are the SAME regardless of whether you are an MDA, AA, or CRNA.

Until then, all this talk about ICU experience, training period is worthless. MDAs go to school a lot longer than CRNAs, so using your logic MDAs must be better than CRNAs. The evidence shows clearly that is NOT the case. Therefore, all that "extra" training doesnt mean jack.

Again, it is extremely hypocritical for the CRNAs to attack AAs based on training. MDAs have been pushing for years trying to cut out CRNAs, and what was the AANA response? That CRNAs have equivalent outcomes to MDAs. The MDAs didnt have a leg to stand on, and the CRNAs likewise dont have a leg to stand on regarding attacking AAs for lack of training.

Until you prove that CRNAs have better outcomes, then this is all just posturing based on politics and money that hurts patient care. It hurts patient care when MDAs try to force out CRNAs, and it also hurts patient care when CRNAs try to force out AAs. Patients need all of us for their anesthesia care. For CRNAs to fight against AAs when they dont have any evidence of superiority means that those CRNAs are just as greedy/hypocritical/politically motivated as the MDAs were who tried to keep CRNAs out of the OR

Interesting point and I can see that perspective. I'll say this; Lets try to do a study comparing the outcomes of CRNAs and AAs in rural settings or settings outside of an anesthesia care team model. OH Wait!! That can't happen because AAs can't work outside of an ACT model and the supervision rules and lack of MDAs in the rural setting prevents them to work in such. That's the problem with healthcare. ACCESS!!!. 80 to 85% of the counties in Texas don't have an MDA working in them. So how the hell is an AA going to help??
Another way to think about it. In the setting of a big city, big anesthesia group, shrinking healthcare dollars. AAs/CRNAs cheaper alternative and in an ACT, same results of an MDA. AAs won't just take up CRNA jobs; MDAs won't exactly be sitting pretty either (especially those coming out of residency). Its already happening in big hospitals in Dallas. 6 years ago you couldn't find a job in Dallas. Now they are all over the place. At least for CRNAs

[jwk]

Originally Posted by SigmaSRNA

Interesting point and I can see that perspective. I'll say this; Lets try to do a study comparing the outcomes of CRNAs and AAs in rural settings or settings outside of an anesthesia care team model. OH Wait!! That can't happen because AAs can't work outside of an ACT model and the supervision rules and lack of MDAs in the rural setting prevents them to work in such. That's the problem with healthcare. ACCESS!!!. 80 to 85% of the counties in Texas don't have an MDA working in them. So how the hell is an AA going to help??
Another way to think about it. In the setting of a big city, big anesthesia group, shrinking healthcare dollars. AAs/CRNAs cheaper alternative and in an ACT, same results of an MDA. AAs won't just take up CRNA jobs; MDAs won't exactly be sitting pretty either (especially those coming out of residency). Its already happening in big hospitals in Dallas. 6 years ago you couldn't find a job in Dallas. Now they are all over the place. At least for CRNAs

What percentage of surgery is done in small rural hospitals around the country? 10%? 15% If you CHOOSE to live in a rural county, you have to accept the fact that medical care is farther away. You can't support an open heart surgery program in a one-OR hospital in a county with 1500 residents in rural Montana. Don't expect to have a Level III NICU or a Level 1 Trauma Center in the middle of a Kansas wheat field.

And I've heard the Texas argument numerous times - the problem is that many of those 80-85% of those Texas counties DON'T HAVE A HOSPITAL EITHER!!!

If CRNA's are so gung ho to practice independently in small-town rural America, why aren't they flocking there? The same reason many people don't. Poor schools, lack of cultural activities, POOR HEALTHCARE, etc. Using your logic, AA's are in fact the solution to anesthesia access in rural areas - we're more than happy to take your position in the hospitals and medical centers with anesthesiologists that many of you are loathe to work with, which frees you up to offer your services independently to small town USA. Put your money where your mouth is!

[SigmaSRNA]

Originally Posted by jwk

What percentage of surgery is done in small rural hospitals around the country? 10%? 15% If you CHOOSE to live in a rural county, you have to accept the fact that medical care is farther away. You can't support an open heart surgery program in a one-OR hospital in a county with 1500 residents in rural Montana. Don't expect to have a Level III NICU or a Level 1 Trauma Center in the middle of a Kansas wheat field.

And I've heard the Texas argument numerous times - the problem is that many of those 80-85% of those Texas counties DON'T HAVE A HOSPITAL EITHER!!!

If CRNA's are so gung ho to practice independently in small-town rural America, why aren't they flocking there? The same reason many people don't. Poor schools, lack of cultural activities, POOR HEALTHCARE, etc. Using your logic, AA's are in fact the solution to anesthesia access in rural areas - we're more than happy to take your position in the hospitals and medical centers with anesthesiologists that many of you are loathe to work with, which frees you up to offer your services independently to small town USA. Put your money where your mouth is!

80 - 85% of Texas Counties don't have hospitals? Ignorance in its highest form. You must be refering to Georgia counties with that number man. CRNAs are flocking to rural america alot faster than MDAs are and that is the basis of the argument. Basically, its not about being gung ho to do anything. Its about our committment to providing that access that is needed (and will be needed in greater numbers as the years goes on) And who is talking about a damn Open Heart or NICU anyway? I'm talking about the emergent appy, The MVAs, the meth explosion 100 miles outside of Dallas, the "damn, my wife caught me with my best friend and stabbed the s*** out of me". That's what I'm talking about. If you want to talk about money, I'll be able to work in all 50 states and the U.S. territories. Play your role ..........assistant.

[jwk]

Originally Posted by SigmaSRNA

80 - 85% of Texas Counties don't have hospitals? Ignorance in its highest form. You must be refering to Georgia counties with that number man. CRNAs are flocking to rural america alot faster than MDAs are and that is the basis of the argument. Basically, its not about being gung ho to do anything. Its about our committment to providing that access that is needed (and will be needed in greater numbers as the years goes on) And who is talking about a damn Open Heart or NICU anyway? I'm talking about the emergent appy, The MVAs, the meth explosion 100 miles outside of Dallas, the "damn, my wife caught me with my best friend and stabbed the s*** out of me". That's what I'm talking about. If you want to talk about money, I'll be able to work in all 50 states and the U.S. territories. Play your role ..........assistant.

You need to re-read my post. I didn't say that 80-85% of Texas counties didn't have hospitals. I said many of them don't. It may be perfectly true that 80% don't have an anesthesiologist. But the fact remains that many of them don't have a hospital, so they probably don't have a CRNA either.

[SueBee RN-BSN]

AA's are nothing but PA's being used and abused by doctors. CRNA, s are independent and no ones puppet!! CRNA's stand strong by themselves. AA's are proteced by the AMA and can not call their profession their own.

[jwk]

Originally Posted by SueBee RN-BSN

AA's are nothing but PA's being used and abused by doctors. CRNA, s are independent and no ones puppet!! CRNA's stand strong by themselves. AA's are proteced by the AMA and can not call their profession their own.

Uh, gee, but let's not forget that about 2/3 or more of CRNA's work with/for anesthesiologists.

[SigmaSRNA]

Originally Posted by jwk

Uh, gee, but let's not forget that abot 2/3 or more of CRNA's work with/for anesthesiologists.

Is there a regulatory board at the state level for AAs?

[deepz]

Originally Posted by jwk

Uh, gee, but let's not forget that abot 2/3 or more of CRNA's work with/for anesthesiologists.

All these years and you still swallow that particular A$A propaganda hook, line, and sinker. Perhaps you need to get out of Atlanta more often. Have you also seen any MDA personally perform 300,000 anesthetics by himself lately?

[jwk]

Originally Posted by SigmaSRNA

Is there a regulatory board at the state level for AAs?

Yes there is.