Anesthesia Assistants

jenn71 · Mar 2, 2002

I am not sure if the article Craig is referring to is specifically talking about AA's or if there is a new certification program out there. But, FYI, I just finished visiting the American Association of Anesthesiologist Assistants website and here is some info. I found. It states that there are 2 programs in the U.S. currently and they are both at the master's level. Candidates have to have a B.S. with premedical course work similar to what is needed to get into med/PA school and they have to take the MCAT. Their FAQ section states that AA's have the same training as CRNA's and are paid the same and the only difference is that AA's have to work under direct MD supervision.

I wonder if comparing AA's to CRNA's is similar to comparing PA's to NP's. Until now I had no idea AA's existed; I thought there were Anesthesiologists and CRNA's and that was it. Makes me wonder what the differences are out there in the marketplace. Anybody have any insight about this?

Home Health Columnist / Guide · Mar 2, 2002

Check out 'Who should "Pass Gas"?' thread in nursing advocacy forum.

https://allnurses.com/forums/showthread.php?s=&postid=93275#post93275

jenn71 · Mar 2, 2002

Well, after reading the info you posted, it sounds to me like this is the same type of situaton I have seen with PA's and NP's.................their jobs are really the same in many regards except that NP's have more autonomy and a much stronger lobbying base. I have heard lots of pros and cons in the NP/PA competency debate such as PA's being trained in a "medical model" that more closely resembles medical school which promotes independent, critical thinking, etc... while NP's are trained in a "nursing model" that does not. Of course, people who work with NP's and PA's know that much of what is said in the "which one is better" debate is a bunch of BS. I suppose that the same goes for AA's as compared to CRNA's. After reading the AAAA's website, I feel that they give the impression that they are trained in a medical school setting, following a "medical model" that closely mirrors MD training.

What I'd like to know is what do professionals in the field of Anesthesiology think of AA's; do they feel there is no difference as compared to CRNA's?

The biggest concern I would have as an aspiring CRNA deals with the recent ruling to allow independent practice for CRNA's. Since MD's are really ticked off about this, I wonder if we'll start to see them giving more support to AA's since they have to work under an MD's supervision. Anyone else have any thoughts about this topic? :confused:

jenn71 · Mar 3, 2002

Found this and thought it was appropriate for this thread

http://community.nursingspectrum.com/MagazineArticles/article.cfm?AID=5818

OC_An Khe · Mar 3, 2002

The issue is really economic competetion, the MDs want to control all of healthcare and not have to deal with other independent practioners, ie RNs.

jfpruitt · May 10, 2002

Been doing lots of research on this subject and after reading these articles, I'm very disappointed and somewhat irrate. First of all, I have NOTHING against the AAs, however, I think its ludicrous to allow someone from 'engineering or math' backgrounds to be able to give anesthesia!!!! I understand they have medical knowledge when they graduate, however, how does a book explanation of 'malignant hyperthermia' compare to seeing it first hand as an RN?????!!! It Doesn't!!! Doesn't these greedy MDAs see that??? Why did they go to medical school for a million years when all they are concerned with is themselves!!! I always thought the 'purpose' of being an MD was to care for patients. Then we have these wonderful AAs that think taking a 'shortcut' will allow them good pay. What about that 6am surgery when you have a MDA breathing down your neck. CRNAs dont have to worry about that. This is just a poor excuse for MDAs to fill their bank accounts and egos!! it really saddens me!!!!

meandragonbrett · May 10, 2002

I don't think i'd let an AA do my anesthesia b\c as you guys know, in most places the "MD supervision" is the CRNA or AA in the OR and the MDA in the lounge drinking coffee, or at least that's how it is around here. For the most part CRNAs do their own stuff w\o MD's, unless needed.

Brett

kmchugh · May 11, 2002

Jenn71 and Ocankhe both make good points.

AA's have actually been around for a while (10 years or more) in a couple of states. As a practice, it's not really taking off, YET. However, the differences between AA's and CRNA's are very similar to the differences between PA's and ARNP's, as pointed out by Jenn71. There is also the factor of control (both financial and actual). Anesthesiologists have much greater control over AA's than CRNA's. CRNA's can bill directly for services, while AA's cannot.

Kevin McHugh

BRobison · May 11, 2002

You have all made good points.

I fear the "trend" the ASA would like to see towards use of AAs is just a means of gaining and keeping more control over the field. They have forgotten or do not acknowledge that anesthesia was first a NURSING specialty. Over 65% of the anesthesia given in the US today is given by CRNAs. There has never been a study of any merit that shows a significant difference in outcome based on provider being an MD or CRNA. You will never, ever, see this information on the ASA website.

The argument for AAs doesn't even make sense, really. The MD's main complaint about CRNAs is that we aren't competent to do the job, even with our BS degree, 3 years or more of acute/intensive/critical care (ie autonomous as can be in a facility) experience, then 24-36 months of internship. If THAT doesn't prepare us, how then can the program the AAs do prepare THEM? It saddens me to such a great degree that this is such a political mine field. I was naive when I started out: I thought the CRNAs I'd seen (they did hearts, for pete's sake!) were the smartest nurses I'd ever seen, so that's what I wanted to do. I had NO idea that "right to practice" issues would be SO big a part of the experience. Heavy sigh!