AANA members

[heartICU]

To all CRNAs and SRNAs:

Check out your e-mail for the latest alert from AANA...do your thing and write your senator/house rep.

heartICU

[rn29306]

If the admission numbers were not pumped up you would see a glut of CRNAs retiring and noone to take their place.

You know dang well that society will fill this void with other practitioners if we don't.

[MmacFN]

Exactly.

You know dang well that society will fill this void with other practitioners if we don't.

[platon20]

I'm not a CRNA, I'm an NP in another field so I dont care if you pump out millions of new grads.

Just remember what I said though.... if CRNAs start pumping out everywhere, WAGE SUPPRESSION will be the inevitable result.

Its the same for MDAs. If MDAs started pumping out triple or quadruple the normal number of grads, the same thing will happen.

[MmacFN]

platon

Here is the thing about supply and demand: UNTIL demand is met SUPPLY is always needed.

~1/2 of the current CRNAs and MDAs will retire in the next 10 years. With current numbers (~ 30 K crnas and ~30 K mdas) that means a glut of ~30K providers in 10 years alone. Now, add to that people are living longer,the babyboomers are retiring and plastic surgery is much more popular (hehe) i see nothing but an increase in numbers over time, not a decrease.

Chances are supply will never meet demand in the USA, not now and not in 20 years. MDA residencies are not ramping up much and CRNA increase will just meet losses. It may seem that the AANA is massively increasing CRNA schools. However, remember that most schools take ~20-30 students per year and they all require RNs. The RN profession is in the exact same situation, so where will alot of new applicants come from?

Every year RN wages increase, every year anesthesia wages increase. Let me clue you in, wages dont go down once they go up. They simply stop going up and jobs are harder to come by. That is the history of the job market in healthcare for RNs in all areas of practice.

I'm not a CRNA, I'm an NP in another field so I dont care if you pump out millions of new grads.

Just remember what I said though.... if CRNAs start pumping out everywhere, WAGE SUPPRESSION will be the inevitable result.

Its the same for MDAs. If MDAs started pumping out triple or quadruple the normal number of grads, the same thing will happen.

[skipaway]

platon

It would appear you may have skipped the research statistics classes for your NP degree since your making no sense at all.

.

Mike,

Your post was good without the slam.

[MmacFN]

hey skip

I resemble that remark, its the sarcastic bastard commin out in me

I edited it out! :)

Mike,

Your post was good without the slam.

[skipaway]

I edited it out! :)

You're a good guy

[plimpington]

I'm only a second year, so I don't really know all that much about how things work, but what I do know is that unless the under-supply issue becomes so bad that physicians find themselves workin more hours than they want too (or other logistical realities make the practice generall unpleasant) physician groups (whether they are Radiologists, MDA's, Dermatologists, etc.) do everything they can to create provider shortages, not solve them.

It seems to me that CRNA's (or SRNA's or MDA's) should endevour to do everything they can to reduce the provider numbers if salary protection is the number one goal. That goes for any provider. History suggests that all physician groups have followed this tact for at least 75 years and it is probably responsible for the salary structurers present there.

Am I wrong about this?

Plimp

[MmacFN]

Hey Plimp

That seems to make total sense to me as well. However, there is a fine point which really suggests CRNAs should be increasing number, hopsital perspective.

So imagine your a hospital administrator. You see an amazing potential for billing on OR cases but you are told there is a consistent lack of providers. Currently, the standard of care for anethesia providers is either CRNA or MDA but more likely a combo of each. You also are told that it dosent look like their numbers will meet need at all, let alone this year based on limiting their grads. What that translates to you as an admin is LOST profits.

So, you begin to investigate the issue a little more. Not being clinical in anyway, you dont care how it gets done, you just want to make it happen. One of your peons from sector 9 (simsons reference for you homer fans) presents you with a solution to the problem! Anesthesia Assistants.

Im not going to get into the argument about competancy differences, real of assumed, between CRNAs and AAs. That isnt the issue. The issue is that because you have limited your own numbers, you have created the need for alternatives for profit. Now, not only are your numbers low, but a new group fills the void who are paid the same and "get the cases through".

Currently, AAs are pretty restricted in the country. Besides their inability to practice without an MDA, they are limited to particular states. While you may have a case to keep them out (or limited) as long as you can meet the needs of the future, it will be signifigantly harder if you limit your ability to do so in the face of lost profits.

So, will wages go down? Absolutely not. The nature of anesthesia is that there is enough work for everyone and enough is getting done that a 3rd providers is not a nesessity everywhere. At the end of the day, who would you rather have the jobs? CRNAs or AAs? Hence the need to increase school numbers and graduates.

I'm only a second year, so I don't really know all that much about how things work, but what I do know is that unless the under-supply issue becomes so bad that physicians find themselves workin more hours than they want too (or other logistical realities make the practice generall unpleasant) physician groups (whether they are Radiologists, MDA's, Dermatologists, etc.) do everything they can to create provider shortages, not solve them.

It seems to me that CRNA's (or SRNA's or MDA's) should endevour to do everything they can to reduce the provider numbers if salary protection is the number one goal. That goes for any provider. History suggests that all physician groups have followed this tact for at least 75 years and it is probably responsible for the salary structurers present there.

Am I wrong about this?

Plimp

[TheLemur]

A glut is an excess, not a shortage. :angryfire

[MmacFN]

ooops

wasent thinking when i wrote it. Edited and fixed.

A glut is an excess, not a shortage. :angryfire

[CRNAtoMD]

Actually Mike, in the private hospitals I worked at before going on to academic practice, there was an increasing trend toward competition among the CRNA's at that hospital and new groups of CRNA's that functioned under a professional association. The latter approached the hospital to place its members for more work by arguing that their members were better trained and had significantly more experience that the hospitals' current group of CRNA's.

They did not receive any exclusive contract, but one of the hospitals shifted 50% of the case load to the outside group, creating a lot of acrimony between the two groups. As more and more providers emerge from training looking for work in desirable locales, you will see more of this type of competition. I suspect it is already happening to a significant degree, especially at the private hospitals in desirable locales. In the academic community, the number of positions are largely dicated by funding and the salaries tend to be lower, but with a larger benefit package being offered.

If all providers ramp up their training programs, you WILL see a glut of providers and lower salaries/income as the providers cut back their fees or demands just to secure jobs and/or hospitals start to reduce salaries or benefits simply because there are enough people willing to work for less just to work at all.

An example of this can be found in the field of ophthamology which experienced a tremendous surge of interest in the 90's and through this decade leading to a nationwide glut of ophthamologists. Three of my med school classmates who went into ophtho emerged with metro job offers with starting salaries in the $90-120K range with 4-5 year partnership tracks. Better pay in smaller communities, but not by much.

I would rather see that both sides keep their training program sizes at the current level and keep an inherent demand for anesthesia providers at a high level. As more providers flood the marketplace, you will first see locums opportunities start to dry up, and I have already heard from recent graduates that locums opportunities are being limited geographically by increasing supply, except in the smaller towns and most rural of locales.