CRNA VS anesthesiologist MD

Specialties CRNA

Published

I am trying to decide weather I should become a CRNA or anesthesiologist.

Can anyone help with the pro's and con's of each

What do CRNA do that is different than a anesthesiologist?

What can a anesthesiologist do that a CRNA can't?

Any other information would be great (I have a huge interest in anesthesiology, and I am in a BSN program now, but I have been told to look into becoming a MD instead of a CRNA.)

Any help would be great. And thanks!

I am sorry did you say that I pay too much attention to the LAWS and REGULATIONS governing my practice? That hospital policy somehow trumps them? Nice try that defense in court buddy it will be short at least.

It is refreshing to see however that you admit that your experience is limited to your one whole academic practice, gosh such a deep well of experience, you will have to forgive me but as you say "where the rubber meets the road" AKA the real world what you do there does not mean squat.

I hope that you are not so caviler in understanding your obligations and responsibilities legally speaking, I suggest you arm yourself with FACTS nor ASA propaganda or opinion, one will save you the other sink you guess which is which.

You didn't describe your practice setting.

Are anesthesiologists employed? If they are, then they are responsible for you. They may not be in the room with you, but the hospital dictates that they're responsible for you.

If I were an MDA (hypothetically speaking, of course), why would I want to take "responsibility" for a CRNA who is not even in the same room as me???

Specializes in Anesthesia, Pain, Emergency Medicine.

I don't think super is actually an MDA. He seems to be obsessed that if we happen to be in the OR suite when an MDA is present, they will magically be in "charge" if something happens.

You really don't understand credentialing and bylaws. You blew it, bud.

I don't think super is actually an MDA. He seems to be obsessed that if we happen to be in the OR suite when an MDA is present, they will magically be in "charge" if something happens.

You really don't understand credentialing and bylaws. You blew it, bud.

Clue me in, what did I blow here?

Check your hospital policies, Nomad. If there are anesthesiologists available, then there's a heirarchy. Saying this casts into doubt that I'm an anesthesiologist? Unbelievable.

Specializes in Anesthesia.

I think it is time to stop feeding the troll and let them crawl back to some other corner of the internet.

your point is that if an anesthesiologist is there then they are supervising and are in charge, that is not the case as pointed out in many practice environments. The multiple misunderstandings and misstatements defiantly call your "expertise" into question.

Perhaps if you were limit your statements to fact instead of opinion it would improve your credibility.

Specializes in Vents, Telemetry, Home Care, Home infusion.

asa response to ny times a-bomb editorial on crna supervision: paradigm shift

the law med blog

posted by lawmed on september 9th, 2010

...indeed 'supervision' and 'medical direction' are terms born of the insurance industry, not of the health care community. actual state practice laws vary in their requirements from total independent practice in iowa where crnas are considered equal colleagues with physicians under the law, to "collaboration" in maryland where crnas work independent of any physician but collaborate with a designated physician as needed, to states which require supervision but fail to define it in a meaningful way. such 'supervision' states fall short of the insurance definitions of supervision which generally spell out the activities of a supervising or medically directing physician. however only medicare requires physician supervision in order for a crna to get paid for their services (which the physician gets a percentage of), and only in states which have not opted out of the requirement. other insurance supervision requirements are used to determine whether a physician will be paid part of the anesthesia reimbursement or it will all go to the crna.

no state requires that a crna be supervised by an anesthesiologist.

...no study has been produced which supports the asa position convincingly, despite multiple attempts. the safety record of anesthesia is indisputable and no one has been able to show that anesthesiologist involvement is responsible for that safety. meanwhile crnas are the sole anesthesia providers in various surgical settings across the country absent any cries of alarm or indications of increased morbidity or mortality in patients....and this has been the practice for over 130 years. surely we would have seen some indication of a problem by now? or is the health care community part of a vast conspiracy supporting nurse anesthetists while ignoring patient safety?

aana - fact sheet: concerning state opt outs

Specializes in CRNA, Law, Peer Assistance, EMS.

First, it bears stating that where a physician (MDA or otherwise) 'supervises' a CRNA whether by statute, insurance requirement or local institution policy they DO NOT become responsible for the negligent acts of the CRNA. Each provider practices under their own license and is responsible for their own actions. Supervision does NOT equate to 'assume responsibility for. On this the courts are clear. SEE:

Ware v Timmons

http://www.scribd.com/doc/38217041/Ware-v-Timmons-Ala-2006

Symons v Prodinger

http://www.scribd.com/doc/47401570/Symons-v-Prodinger-Et-Al

Institutions can create any policies and procedures they like. Often they create such policies thinking that they will limit liability by stating that an MDA must 'supervise' or be present for induction, or do a preop on every patient. The ONLY effect of such policies however is to create a 'local' standard to the hospital which if not followed allows for a lawsuit where one might not otherwise be possible. If an MDA is not present for an induction and the policy says he must be, then the hospital and the MD are now in violation of the standard of care at that institution....but not at the one across the street which has no such policy.

SEE:Hospital Policies Can Create a standard of Care and Surprise Liability

MDAs and CRNAs often work in the same hospital in a situation where each does their own cases and the MDA does NOT supervise the CRNA. By virtue of working or being present in the same institution, regardless of who pays them, the MDA is NOT responsible for the actions of the CRNA in ANY way. That is a fact, that is the law.

Specializes in CRNA, Law, Peer Assistance, EMS.
I'm going to get flamed or banned from the forum for saying this, but it must be said.

Anesthesiologists don't "collaborate" with CRNAs. It never happens. In hospitals where both practitioners are employed, there is a well-defined hierarchy where anesthesiologists ultimately have a supervisory role.

Simply put...you are WRONG.

Specializes in CRNA, Law, Peer Assistance, EMS.
I think there are some assumptions that can be safely made here.

1. An anesthesiologists training is broader than a CRNA's. And an internists training is broader than a DNP's.

2. There is no such thing as 'knowing too much' where skilled labor is concerned. The person delivering a baby who understands the pathophysiology of childhood brain tumors is just as good as the person who does not possess such knowledge. Their ability to practice, at very least, is every bit as good (....if not better).

As mid-level providers, CRNAs -- who have less education and training than anesthesiologists -- are taking the position that the information that they don't have is useless anyway. It's simply impossible to know the significance, or lack thereof, of knowledge you don't possess.

So basically what I'm trying to say is that CRNAs and DNPs, being in possession of a narrow knowledge-base, are not in a position to make an accurate assessment of what knowledge is useful and what isn't. I think this is a very reasonable argument.

That is an not unreasonable argument objectively. Fortunately CRNAs, medicare, the health care community at large, hospitals and patients do not rely on CRNAs to make the determination that CRNAs deliver safe, cost effective anesthesia care when working independently. They rely on over 100 years of safe practice, empirical and research evidence that this is so, as well as personal experience.

Specializes in CRNA, Law, Peer Assistance, EMS.
Just to make it clear an RRT does not need to be a CRNA nor do they have to be a RN to do anethesia. RRT's per CoARC can be AA-T or AA-C's. The RRT as far as the AA-C is a lot more qualified than a CRNA and is considered a PA (they are PA's). AA schooling is a lot different than CRNA schooling and a lot more complex. The classes are far more advanced than that taken by a RN. '

Min Req. MCAT or GRE. MCAT score no lower than 27 GRE I do not remember. Upon completion you need to pass the PANCE exam. PLAIN and SIMPLE.

AS I SAID HUGE DIFFERENCE BETWEEN CRNA AND AA-C.

WHAT in the world are you talking about? None of what you say is true. An RRT cannot "do" anesthesia period. CoARC has nothing to do with determining who can be an AA-C. I have no idea what an AA-T is. An RRT can go to AA school like anyone else but they are given no special consideration. They are the same as the guy with a BS in English who does to AA school having never been in the same room with a sick person.

AA school is not more complex than CRNA school...that is absurd. Classes are not far more advanced. Upon graduation AAs are far less experienced than CRNAs, most having been exposed to health care for only the two years of AA school. The clinical ability differences are very noticeable.

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