CRNA VS anesthesiologist MD

in2b8ix2b8 · Dec 24, 2010

The pay is definately a BIG difference. More schooling to become a MD. You can do more than a CRNA. A CRNA work under the MD.

You are incorrect on a few points: CRNAs do not have to work under an MD/anesthesiologist. I work as a solo CRNA. As a credentialed member of the medical staff of several hospitals, I have been granted privileges by the medical staff members (physicians) to do the following: Administer a general anesthetic, insert central or arterial lines, even PA catheters, perform regional anesthesia including spinals, epidurals, femoral nerve blocks, interscalene blocks, axillary blocks, ankle blocks, Bier blocks, etc as well as write any necessary preop orders for any medication/diagnostics/consults with another specialty and I write post op orders for the recovery room. That list doesn't really differ from the privileges of the 2 anesthesiologists I work with....the same ones I cover when they go on vacation! I love what I do and the patient's appreciate what I do for them. Anesthesia school is no walk in the park. Medical school gives you a lot more very detailed anatomy, histology, biochemistry, neuroanatomy, etc., most of which have no bearing on your ability to be an excellent anesthesia provider...much of which is forgotten by the time a resident enters anesthesia training!

BCRNA · Dec 26, 2010

A crna can do everything a mda can do, and can work without an mda. They don't work "under" them. We are independant providers, ie not dependant on mdas. Our scope of practice is exactly the same, and even though we do exactly the same thing it is the practice of nursing for us, the practice of medicine for them. But a rose by any other name is still a rose.

I put this mainly becuase people assume we need supervision by mda, or are dependant on them for our practice. AA's can not practice without a mda. To my knowledge NP's need to put a consulting md on their advanced practice license with the state boards, correct me if I am wrong. CRNA's dont have this requirement. I believe that requirement is due to writing prescriptions, since we administer the drugs personally, we never write prescriptions.

And many physicians recommend crna schools becuase of the high pay, lower length of school time, and not having to put up with health care bs. I think it is a better investment. Less school debt, start younger, and doesnt take nearly as long to pay of school loans. I make more than most of the general surgeons I work with. We have no overhead to pay for; no answering service, office people, billing service, place of employment to pay for, etc. It is actually those reasons we make more, might clear almost half a million, but after all that there isnt much left. And the work schedule is much better, actually have a family life.

I have a lot of resepect for physicians, but I dont envy their work schedule or lenth of school. Just in terms of a time and money investment, get a much better return in a crna education. I only had 40000 in school loans, with seven years college. I cant say exactly what physicians do, but i hear of 125000 plus in loans and twelve years before making money. Any physicians reading this with accurate numbers for their loans/school time.

Have to take into account how long you work as a physcian before paying off your debt and actually getting a positive net worth. I have figured out that if I ever wanted to go to medical school to be a mda, I should just work 80 hours a week for 8 years as a crna while living poorly, and just retire rich while I am young. I would be a multi-millionaire.

nomadcrna, DNP, CRNA, NP · Dec 27, 2010

I happen to also be an FNP as well as CRNA. The states I practice in as an FNP (Montana, Idaho, Wyoming, Washington, Oregon, Alaska) all have independent practice for NP. This includes full prescriptive authority.

And on another note. I DO write prescriptions as a CRNA and before I became an FNP, I also had prescriptive authority as a CRNA. Many CRNAs do chronic pain and of course prescriptions are a part of that type of practice.

subee, MSN, CRNA · Dec 27, 2010

Page Respiratory: The RT's are the mavens of respiratory physiology; that's just a fact. However, that's only a fraction of anesthesia. Most CRNA students have 5-7 years of total patient care experience. It's that whole that's greater than the sum of the parts experience we bring to the table because we address other than the respiratory expressions of disease. There's no reason why a "seasoned " ICU nurse should know the minutae of the respiratory boards questions - that's your job! (: If the ICU nurses knew what you knew, then what would be need an RT for?

BCRNA · Dec 28, 2010

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!

Withing the scope of practicing anesthesia, there is nothing an anesthesiologist can do than a crna can't. An anesthesiologist does exactly the same things,though it is called the practice of nursing for crnas and the practice of medicined for physicians. The difference is an anesthesiologist can choose to practice medicine in another area outside of anesthesia. We are specific to anesthesia, unless we also become nurse practioners or one of the other specialties. I think people need to be more specific than "practice medicine". The scope of practice overlaps greatly. Physicians protect their turf by demanding only they "practice medicine", even though the actual skills and activities are the same. It is just another way for them to say we are physicians, you are not. A rose is still a rose, even if under another name, just my opinion. I have always found it funny that two groups can do exactly the same thing, but yet you have to call them seperate names; not saying we need to be called doctors or anything like that. But at least admitting that some parts of medicine can be handled by non-physicians; assuming that they practice within their scope of practice and know their limits.

But in anesthesia the scope of practice between mda, crna are exactly the same. CRNA's can creat all CRNA groups to provide anesthesia services, completely without mda's supervision. And there is no limit on their practice. In other specialties the scope of practice for non-physician providers is a subset of the md scope--i.e. md's scope iof practice includes alot more. Even then their are plenty of other providers that can act completely independtly of physicians, except for PA's and AA's. Their practice arrangement is governed directly by md's, naturally md's have used their ability to make them completely dependant on them.

BCRNA · Dec 28, 2010

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It is quite frustrating for someone like me, who is extremely well qualified to learn non - physician provided anesthesia, to be impeded (in part) by a bully lobby. Why should I have to retrogress to nursing school in order to have a shot at anesthesia school? Anecdotally - There are 3 anesthesiologists and one CRNA at the hospital where I work, he is nothing short of brilliant, and does his job exceptionally. I've assisted him in the OR on a few occasians, and over the years gotten to know him fairly well. One day while sitting at lunch I asked him about AA's. He gave me a rank/file/serial number answer shoved down his throat by his professioanl organization. I also have noticed he never introduces himself to a Pt as a nurse anesthesist...it's always "I'm one of the anesthesisits here at xxx hospital". You know why? Because in his mind he equates himself with a physician, and he'd like the Pt to as well. We are a non profit hospital and are required to make the top salary's public info. The CRNA made the same as 2 other anesthesiologists, by your own logic (see above) this should not happen. BTW - he made well over 200K, works Mon thru Thurs, takes call one week a month and is off one week a month. And that, in a nutshell, is why the nurse anesthesist agenda wants to continue monopolizing the mid level anesthesia provider arena, all the while hiding behind a weak "Pt. safety" argument. You're correct in the sense that this discussion has zilch to do with the OP, but c'mon.....do you honestly think that the statement "I'm trying do decide whether to become an MD anesthesiologist or a CRNA" isn't a loaded one???

Does the anesthesiologist there actually identify themselves as an anesthetist? Just wondering, its just that I have never known an anesthesiologist to do this. They always say anesthesiologist. Technically I know they can use the title, but I have never known an American md to do this. I have read many articles originating in Europe where they do this, and to my knowledge the places that do this don't have crna's; they don't exist in some of those places.

This if of topic from the original thread, but you should consider an AA program if you want to do anesthesia, most will take a wide range of undergraduate degrees. I don't think any of them require health care experience, and your being a resp. therapist should help out alot in getting in. There is much more to anesthesia than just respiratory. Vasoactive drugs, pathophysiology of non respiratory disease, and so on. I have talked to many rt's who have gone into or want to go into an aa program.

Honestly, most crna's wont support aa's because it could potentially hurt our careers. If their is an abundance of providers that physicians could control completely and dictate their scope of practice, they would use it to gain control and get rid of us--and at the very least use it to manipulate our practice in some way. That isn't a "nice" explanation I know, but neither is the mda's misuse of the term "for patient safety" trying to limit our practice.

I haven't met any AA's or worked with them, but I hear most actually do a great job from my co-workers. If it weren't for them being completely controlled by MD's they would be accepted. I couldn't imagine trying to learn anesthesia and all about healthcare and disease processes at the same time; like many aa's who have no prior healthcare experience. Imagine trying to learn to give an anesthetic to a patient with severe COPD, renal failure, and CHF for the first time; and your very first exposure to any of these diseases was a quick overview just a month or two ago. Not to mention absolutely no experience with giving vasoactive drugs or running codes. Not bashing AA's; I just personally wouldnt want to try to do this. Apparently they make this work for them.

And are you referring to some new group that is trying to start up anesthesia services in your quote? Or perhaps just adding resp. ther. in current crna programs? Nurse anesthesia is the oldest advanced nursing specialty, you have to be a nurse to get in. You can do an AA program without being a nurse. Also, check into an accelerated MSN for initial RN licensure. And then do a post-masters anesthesia program--get to focus on just the anesthesia classes whle in school and skip all the theory, research, etc.

BCRNA · Dec 31, 2010

I happen to also be an FNP as well as CRNA. The states I practice in as an FNP (Montana, Idaho, Wyoming, Washington, Oregon, Alaska) all have independent practice for NP. This includes full prescriptive authority.
And on another note. I DO write prescriptions as a CRNA and before I became an FNP, I also had prescriptive authority as a CRNA. Many CRNAs do chronic pain and of course prescriptions are a part of that type of practice.

I am wondering how this works exactly, is it only in a few states? I don't have a prescriptive number in my state, believe it'd called a dea number. I can not write prescriptions, no crna I work with knows about this. That's why I am thinking it must be in only a few states. Is the prescriptions actually under your own prescriptive authority, or are you using a physicians name and number?

bread angel · Dec 31, 2010

The answer is almost totally related to health care economics. Forget all of the other noise and know that a well educated CRNA is where the future is. Sure there will continue to be anesthesiologists and I have no problem with that. They is much we can do as collaborators. But the days of arrogant, greedy and lazy of either group is going to be ancient history. If this is a problem for any of you, please reconsider your career options.

loveanesthesia · Dec 31, 2010

This if of topic from the original thread, but you should consider an AA program if you want to do anesthesia, most will take a wide range of undergraduate degrees. I don't think any of them require health care experience, and your being a resp. therapist should help out alot in getting in. There is much more to anesthesia than just respiratory. Vasoactive drugs, pathophysiology of non respiratory disease, and so on. I have talked to many rt's who have gone into or want to go into an aa program.

As long as the CRNA programs continue to graduate almost 2500 new CRNAs a year, the career potential of the AAs is going to be seriously limited. Also the move away from ACTs is a big issue for the continued survival of AAs. AAs made gains in the 90s when fewer than 1000 CRNAs were graduating and there was a severe shortage. If you are frustrated with being an RT, bite the bullet and get into a 1 year accelerated BSN program. But if you do that go into with an open mind and be ready to be a student again or you will not like it. I know of 2 practices that tried AAs for the first time in the last 2 years (for political reasons) and have not been happy with the results and are now back to hiring CRNAs, there are plenty of CRNAs looking for a job.

remifentanil · Dec 31, 2010

The answer is almost totally related to health care economics. Forget all of the other noise and know that a well educated CRNA is where the future is. Sure there will continue to be anesthesiologists and I have no problem with that. They is much we can do as collaborators. But the days of arrogant, greedy and lazy of either group is going to be ancient history. If this is a problem for any of you, please reconsider your career options.

Hate to rain on your parade.... BUT... with over production of CRNAs nationwide... you are looking at a glut of CRNAs around 2014...

Unless the CoA does something to decrease the number of schools and graduates... CRNAs can look forward to making about what an NP makes..NP overproduction is a FACT..CRNA over production is almost an inevitability.

meandragonbrett · Dec 31, 2010

I am wondering how this works exactly, is it only in a few states? I don't have a prescriptive number in my state, believe it'd called a dea number. I can not write prescriptions, no crna I work with knows about this. That's why I am thinking it must be in only a few states. Is the prescriptions actually under your own prescriptive authority, or are you using a physicians name and number?

In my states CRNAs are issued a certificate of fitness to prescribe and that serves as the authorization of prescriptive authority in our state.

nomadcrna, DNP, CRNA, NP · Jan 1, 2011

I have full prescriptive authority. The dea number, which I have is necessary for ordering controlled substances. It is federal and has nothing to do with state prescriptive authority.

Ron

I am wondering how this works exactly, is it only in a few states? I don't have a prescriptive number in my state, believe it'd called a dea number. I can not write prescriptions, no crna I work with knows about this. That's why I am thinking it must be in only a few states. Is the prescriptions actually under your own prescriptive authority, or are you using a physicians name and number?