Anesthesiologists being replaced by CRNAs???

Specialties CRNA

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I was vacationing in the tropics a few weeks ago and met three handsome Anesthesiologists while sun bathing at the pool. We all chatted a little until the topic of our professions came up. I told them I was starting nursing school (ABSN Program) in a few weeks & how excited I was. I then proceeded further by saying I also hope to pursue a graduate degree as a CRNA or NP (note at this point I had no idea these guys were anesthesiologists). Why did I mentioned becoming a CRNA, b/c the stares I got from all three were nothing but pure EVIL STARES! By their looks I knew I said something wrong but had no idea what it was until they told me they were Anesthesiologists & fear that CRNAs were taking away their jobs at a cheaper price, and with the new health care laws just passed its going to get worst for them. This was totally unexpected 'cause all I planned to do that day was to relax by the poolside & sip pina coladas all day! However, they went on trying to convince me of all the reasons as to why I should not pursue a CRNA career & that eventually the national anesthesia board (not sure if this was the organization they mentioned) was no longer going to certify CRNA training and eventually they'll be no more training because there is no longer a shortage of Anesthesiologists. The shocker of this whole conversation was two of the anesthesiologists mentioned, with conviction, they wish they had pursue a CRNA career instead where they would have accumulated less debt with almost the same income or they wish they had chosen another specialty.

I was pretty shocked hearing these remarks & would love to hear your opinions :)

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Although I am not a CRNA I do think that CRNA's are taking the jobs of Anastheologists. They do the same work for less money; yet, the money CRNA's make is sufficient. This is why I'm working so hard towards becoming a CRNA.

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It's pure business and all about the green. If another could do the same task with the same level of expertise, why would you then want to spend more, when you could go for the cheaper rate.

As is business, everything is all about the bottom line. Opportunity cost..alternative forgone. What did I save?

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Specializes in Anesthesia.
However, they went on trying to convince me of all the reasons as to why I should not pursue a CRNA career & that eventually the national anesthesia board (not sure if this was the organization they mentioned) was no longer going to certify CRNA training and eventually they'll be no more training because there is no longer a shortage of Anesthesiologists. The shocker of this whole conversation was two of the anesthesiologists mentioned, with conviction, they wish they had pursue a CRNA career instead where they would have accumulated less debt with almost the same income or they wish they had chosen another specialty.

1) There is only one organization that certifies CRNAs and that is AANA. CRNA training doesn't require the ASA or anesthesiologists at all to continue or complete so that argument is a mute point.

2) Anesthesiologist aren't going anywhere, but the current ASA anesthesia care team model that has made being an anesthesiologist so profitable in the past is extremely inefficient so we may see this model eventually give way to a more efficient models that don't require "supervision" by anesthesiologists for billing purposes or otherwise.

3) It is not common to hear anesthesiologists say they should have become CRNAs instead. There are a lot of anesthesiologists that think are job is much easier than theirs, a lot of them think we make a lot more money than we actually do, and that it only takes a couple of years to become a CRNA (at the very least it takes 7yrs to become a CRNA with the average time to become a CRNA taking about 10-12+ yrs), but this is a common theme from anesthesiologists.

4) Medical school is highly subsidized by states so tuition is highly variable between medical schools. CRNA schools do not usually get any extra state or federal support. Physicians are paid during residency, and SRNAs are not. It isn't unusual for an SRNA to come out of with 100-200K in debt. Debt is highly variable between anesthesiologists and CRNAs, so more debt between an anesthesiologist or CRNA is highly dependent on the medical school and the individual.

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I was pretty shocked hearing these remarks & would love to hear your opinions :)

Sounds like sour grapes. Shine it on.

Meanwhile, I hate you for vacationing in the tropics. Damn you and your pina coladas! (OOOoooooo! Imagine the evil look you're getting!)

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Specializes in CRNA.

Wow, What an intro to the world of anesthesia! I think you have heard a common line of thinking amoung young anesthesiologists. They are threatened/worried that CRNAs are going to 'take away jobs' (and actually regretful that they chose anesthesiology.) There is some basis as areas that have not utilized CRNAs much in the recent past-mountain states and west-are beginning to utilize CRNAs more. I know of at least 3 large practices that went from all anesthesiologist, to approximately a 50:50 split between CRNAs and anesthesiologists.

As for closing the schools, that was tried in the early to mid 80's. The American Society of Anesthesiologists challeneged the accreditaion of the nurse anesthesia programs and tried to take the accreditation function away from CRNAs and they had the support of several CRNAs (the 'Dr knows best' line of thinking). They were not successful thanks to a group of talented, committed CRNAs, most prominently Ira Gun. A lot of schools were closed, but they are back now and graduating more CRNAs than ever. Read 'Watchful Care" by Marianne Bankert, it's very interesting. I am a little surprised that the 'we're closing the schools' threat is still being spread.

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Thanks for the book suggestion, I will definitely add it to my list of to reads. Well, I guess the "closing the CRNA schools" argument is still being used, in my opinion, merely as deterrent for those considering the field. They said so many negatives in trying to dissuade me from pursuing a CRNA career I can hardly remember much of it.

What's more interesting is that these physicians reside & practice in NYC where I'm sure there's more than enough employment for both CRNAs and Anesthesiologists!

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Wtbcrna, the AANA could have been the organization mentioned, I just couldn't recall as stated. Thanks for the clarification.

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***, the AANA could have easily been the governing organization mentioned, I just couldn't recall the

name as I stated. Thanks for the clarification.

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Specializes in CRNA.
***, the AANA could have easily been the governing organization mentioned, I just couldn't recall the

name as I stated. Thanks for the clarification.

It's actually the Council on Accreditation of Nurse Anesthesia Programs (COA) that is currently the only accrediting body approved by the federal Department of Educaiton. The AANA was the accrediting body, and that was the basis for the challenge. The argument was that the AANA is/was not autonomous enough to assure quality and enforcement of the standards. (the officers and BOD are all elected positions, so if a program was 'well connected' would that play an influence? actually a good question I think) The ASA put together the International Federation of Nurse Anesthesia (IFNA), each program was to be represented by an anesthesiologist and a CRNA, and they were to set/enforce the standards. The stated goal was to improve nurse anesthesia education, but some wise CRNAs recognized it as a threat to the profession. At least a portion of the ASA saw it as a vehicle to 'close the schools' or at least to dilute the education. The COA was developed and CRNAs successfully argued in a federal hearing that CRNAs are the only appropriate people to set/enforce educational standards for nurse anesthesia. It was a privotal time in our history, and only one example of the importance of professtional involvement.

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It is ALL about the money, make no mistake about that. CRNA's ARE replacing anesthesiologists and will continue to do so. Here's the latest study that was just released comparing outcomes.

http://www.medscape.com/viewarticle/726427?src=emailthis

I know a couple of physicians, one is an anesthesiologist and the other an internist, and they both encouraged their sons to become CRNAs. The internist told me that CRNAs make more $$$ than him and he's been practicing for over 25 years! These doctors are well aware of what lies ahead in health care. Interesting they would encourage their children to become advanced practice nurses instead of doctors, huh? ;)

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Specializes in Anesthesia.
It is ALL about the money, make no mistake about that. CRNA's ARE replacing anesthesiologists and will continue to do so. Here's the latest study that was just released comparing outcomes.

http://www.medscape.com/viewarticle/726427?src=emailthis

I know a couple of physicians, one is an anesthesiologist and the other an internist, and they both encouraged their sons to become CRNAs. The internist told me that CRNAs make more $$$ than him and he's been practicing for over 25 years! These doctors are well aware of what lies ahead in health care. Interesting they would encourage their children to become advanced practice nurses instead of doctors, huh? ;)

I haven't heard or seen of any studies that have shown CRNAs are replacing anesthesiologists. What I have heard is that ACT practice models are being replaced with independent practice models where CRNAs and anesthesiologists both do their own cases.

There is no way to accurately compare an Internist salary vs. CRNA. Our jobs are totally different and so are the reimbursements. Physicians encouraging there children to become CRNAs is nothing new, and a lot of it is built around misconceptions (CRNAs job is easy/easier than being a physician, the school is quick/easy compared to medical school, responsibility is less, better hours etc.).

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