I am sorry if you perceive my response to you as defensive. I was trying to be very careful to present my opinion in a professional manner, for the purposes of discussion.
I used the term "assumption" within that context. It has no negative connotation. All arguments have underlying assumptions. The only error is to not recognize them. They need to be addressed, and identified.
You may not believe you have made a normative judgement, but my observation of your question framework suggested you may have. I don't know for a fact that you have, I only asked you to examine and decide for yourself.
Your statement/question is based on the assumption that IF there is a role for MDAs, then neccesarily there is an upper limit to the scope of CRNA practice. In order to give you my answer to your question, I have to share with you that I disagree with the assumption inherent within the question. I believe that there is a role for both MDAs and full scope of practice CRNAs within anesthesia. This opinion is based on my personal underlying philosophy.
Of course, philosophically is only one way to look at these issues. You mention the economic forces of a free market economy. And actually there are people within our community who make exactly the argument you quoted. If CRNAs have the exact same skill set as MDAs, why would the free market support the MDA role?
I guess it is an understatement to say these issues are complex. People more learned than you and I have made careers out of analyzing our health care system, how we got here, and where we should aim for the future.
Do MDAs do anything CRNAs do not do? No, CRNAs are educated to perform all anesthesia tasks (Now, I am talking abstract, globally. Obviously you can find individual MDAs who have abilities some individual CRNA does not. The reverse is also true).
All you want is career advice
. Well, you have to look at all the angles, and then make your own judgement of what the future will most likely bring. We are all speculating-no different from picking a racehorse or a stock.