Bottom-feeders in the hierarchy of anesthesia caregivers

[gasmaster]

i've recently been reading "the anesthesia fact book" by dr. frank sweeney, the medical director of a large or (published 2003). dr. frank, i might point out, is a surgeon...not a mda. anyway, thought you would find his point of view interesting....

"ranked from most highly trained to least trained (or untrained), they are:

1. physician anesthesiologists

2. certified registered nurse anesthetists (crnas)

3. "the others"

"the second most highly trained of all those who administer anesthesia are the certified registered nurse anesthetists....with approximately 28,000 crnas, they deliver about half of all anesthetics given in the united states today....others who administer anesthesia are by far the least trained (he mentions dentists, physicians in private-practice, rns and techs here but no mention of aa's at all)....few will argue that "the others" are relative bottom-feeders of the hierarchy of anesthesia providers....the highest mortality rate was seen with nonspecialists (surgeons and dentists) providing anesthesia. the next highest mortality was seen with crnas practicing independently....the mda practicing alone had a lower mortality than either of these two groups. however, the mda working with the crna in the anesthesia care team model had the lowest mortality of all groups."

[deepz]

This surgeon's opinions do not constitute research.

Research shows that the safety record of CRNAs and MDAs is indistiguishable and of very high quality across the board. Very few of the OJT anesthesia docs he mentions still exist in America.

Ignore these posers. ---And don't waste your money on their books.

[DreamMatrix]

Actually, he is a board certified anesthesiologist...not a surgeon...although he may play one sometimes!

DM

[nurselizk]

Does he provide citations to back up these claims? Particularly about CRNAs in ACTs vs. independent CRNAs?

[DreamMatrix]

This surgeon's opinions do not constitute research.

Research shows that the safety record of CRNAs and MDAs is indistiguishable and of very high quality across the board. Very few of the OJT anesthesia docs he mentions still exist in America.

Ignore these posers. ---And don't waste your money on their books.

Have to second this post by deepz.

DM

[gasmaster]

Dr. S never identifies himself as an MDA in the book, only a chief of the OR so my bad! Anyway, he does site his sources for the info as the following:

Bechtoldt, A. A. Jr. (1981), "Committee on Anesthesia Study Anesthetic-Related Deaths, 1969-1976," North Carolina Medical Journal 42: 253-259

Forrest, W. H. (1980), "Outcome: The Effect of the Provider," in R. A. Hirsh et al, eds., Health Care Deliver in Anesthesia (Philadelphia: George F. Stickley), pp. 137-142.

Silber, J. H., et al. (2000), "Anesthesiologist Direction and Patient Outcomes," Anesthesiology 93: 152-163

Warden, J. C., and B. F. Horan (1996), "Deaths Attributed to Anesthesia in New South Wales, 1984-1990," Anesthesia and Intensive Care 24: 66-73.

Of course I take all that is written in stride. Some of these sources are fairly old so I plan on looking at more recent data. However, I have to say that for the most part Dr. S actually was very pro-CRNA which suprises me much, especially if he is really an MDA!