Here's what AAs really think of CRNAs

Specialties CRNA

Published

And this comes from the PRESIDENT of the American Society of Anesthesiologist Assistants

Again, assertions that AAs and CRNAs function at the same level -absolutely misleading.

And, what's with "anesthesia nurse"? If it sounds condescending in print, can you imagine how it would sound out of his mouth? What arrogance.

At least there is a phone number listed at the end of the article. Let's call Rob and let him know what we think of his little article!

Read carefully, SRNAs, this is a grim foreboding...

Licensed anesthesiologist assistants help access to medical care

By Rob Wagner

MY VIEW

Re: "Don't weaken the standards for anesthesia providers" (My View, April 11).

Maybe you or someone you know has had surgery delayed. Perhaps hospitals in your

area have closed operating rooms as they have in Miami, Jacksonville, Tampa and

elsewhere in Florida.

One reason for growing problems of this nature for patients is a shortage of

anesthesia providers. These are the assistants who help

physician-anesthesiologists perform the critical task of putting you to sleep

before surgery.

There is a common-sense solution rapidly making progress in the Florida

Legislature and around the country, which is to license anesthesiologist

assistants (called AAs). Key legislative action is expected today in Florida's

House Health Care Committee on HB 1381/SB 2332 and it is important that

lawmakers support it.

They need to be assured that this legislation will not weaken standards because

AAs are highly trained and perform the same function as anesthesia nurses. AAs

like myself serve patients in 16 states and have impeccable safety records. AAs

have worked with a high level of safety for 30 years in Georgia and Ohio.

AAs are required to have three times the hands-on, clinical training than are

most anesthesia nurses who currently assist anesthesiologists. Before we are

allowed to enter AA school, we must take the same courses physicians take as

pre-med students. Nurses do not do that. In fact, as the chief anesthetist at

St. Joseph's Hospital in Atlanta, I am in charge of both AAs and anesthesia

nurses.

If you are "going under," who would you rather have assisting the

anesthesiologist; someone trained to work directly with him or her, or a nurse?

We enjoy our professional relationships with our nursing colleagues. Yet nursing

organizations in Florida continue to misinform, even scare the public, calling

our profession "new" and "experimental."

Try telling that to the prestigious Emory University in Atlanta or Case Western

in Cleveland, which have been training AAs for more than three decades. Or try

to tell that to boards of medicine that oversee AAs in the states in which we

practice and whose members readily vouch for our safety record.

Try telling that to Medicare, the nation's largest health insurer, which

reimburses AAs and anesthesia nurses at the same rate. This means our skill

levels are viewed equally. And tell the insurance companies. They charge no

difference in fees between anesthesia nurses and AAs,

meaning our safety records are equal. Try telling that to the Florida Medical

Association, American Medical Association and American Society of

Anesthesiologists, whose members resoundingly support our working in Florida. In

the era of malpractice crisis, doctors are certainly not going to support

"experimental" health care providers.

Why, then, would the anesthesia nurses be opposed to this? In a word, money.

Because of nurse shortages, their salaries are artificially high, up to $150,000

in Florida. If you made that kind of living, wouldn't you try to keep the

competition out?

This nursing shortage is well documented on the Web sites of Florida schools

that train anesthesia nurses, the U.S. Department of Health and Human Services,

and yes, even on the anesthesia nurses' own Web site, http://www.aana.org, where the

shortage is called "serious" and "acute."

To help relieve the problem, two institutions, the University of Florida and

Nova Southeastern, are ready to open special schools for anesthesiologist

assistants in Florida. Would those schools offer programs if they didn't think

AAs are in great demand? Would they risk their reputations on an "experimental"

profession? Of course not.

One AA can mean five more patients per day will get their surgery. That's 1,200

patients per year treated with the help of only one AA. If you are or know one

of those patients, I'm sure you would be grateful to the Florida Legislature for

passing this common-sense legislation.

--------------------------------------------------------------------------------

Rob Wagner is chief anesthetist at St. Joseph's Hospital in Atlanta and

president of the American Academy of Anesthesiologist Assistants, PO Box 13978

Tallahassee, FL 32317 Phone: 656-8848.

Why does the ASA support us. Very simple - we are not their competitors. We exist solely for one purpose and that is to allow the MDA to supervise and bill for up to 4 anesthetizing locations at once. I have heard the term physician externder used when discussing AAs and CRNAs in this type of practice. It is entirely accurate. You as CRNAs are going up against the ASA at the national level on a regular basis. You see yourselves as their equivalent and that is why they are less than friendly when it comes to the politics of anesthesia.

~~ my friend is in crna school. i do er and icu, and have NO interest in who is better. i just wanted to say that it sounds like the mds are 'using' you. sooner or later insurances (medicare included) will catch on to that, and put a stop to it. in the end, it will be cheaper for them to pay 1 crna for 1 procedure, than 1 md for 4. they won't care about the 'wait.'

you might not care about that point bc you're making good money now, but some in your field may get disgusted with being the 'tool' through which the md gets paid. hey, take it from us nurses... there was a time when we didn't do foleys or hang blood or put in simple ivs! YOU should always be paid for the service you provide directly by the payor/insurance. otherwise, your future is as secure as a dixie cup at a picnic.

Do you really want to start this up again?

Have nurses ever been paid directly for putting in foleys or hanging blood? Nope. So what does that do for your comment that "YOU should always be paid for the service you provide directly by the payor/insurance. otherwise, your future is as secure as a dixie cup at a picnic".

It's about competition. Period. AA's provide the competition - CRNA's are scared of it. Unless you have something new and insightful about AA's (and obviously you don't), why not just give it a rest and read through the other 23 pages of this discussion and the others that have already discussed and bashed AA's ad nauseum.

Specializes in Anesthesia.
Do you really want to start this up again?

..... AA's provide the competition - CRNA's are scared of it. .....

In your dreams, buddy.

deepz

please i beg of you, let this thread die, someone call the dr kevorkian of threads please.

d

In your dreams, buddy.

deepz

please i beg of you, let this thread die, someone call the dr kevorkian of threads please.

d

deepz and gaspassah - just making sure you were still around :)

How about this...

I worked in an ICU in ATL for 4 years prior to starting anesthesia school. When meeting with the head MD of the Anes. Dept ( an AA-friendly Anes. dept I might add) regarding a job when I got out of school, I shyed away when he offered me a starting salary for $76,000. That's a memorable number.

How about this...

I worked in an ICU in ATL for 4 years prior to starting anesthesia school. When meeting with the head MD of the Anes. Dept ( an AA-friendly Anes. dept I might add) regarding a job when I got out of school, I shyed away when he offered me a starting salary for $76,000. That's a memorable number.

In reference to my recent post under "washington DC CRNAs," I will direct everyone's attention to the blatant GREED factor underlying this post.

This post is also misleading. The hospitals here in Atlanta tend to give student loan reimbursement - this officially counts as INCOME. Maybe the base is 76,000, this sounds low to me. I think it is more like 90,000. There is all sorts of money to be had for hours worked over a standard shift, weekend, night call. As a midwife 60 hour weeks were standard with no extra for 24 hours straight, weekends, nights.....AND I had as many patients as there happened to be - maybe 2, maybe 7. In anesthesia, you get one patient at a time, guaranteed. Hmmm, no wonder the malpractice is so much less than what a midwife has to pay. After 11 years my top income was around $106,000. $90,000 plus loan repayment and overtime is really hard to hate for a starting salary. If your tastes require more money, hooray, you're a CRNA and you can drive up North and run your own show, make tons of money - the luxury of choice is all yours.

How about this...

I worked in an ICU in ATL for 4 years prior to starting anesthesia school. When meeting with the head MD of the Anes. Dept ( an AA-friendly Anes. dept I might add) regarding a job when I got out of school, I shyed away when he offered me a starting salary for $76,000. That's a memorable number.

It's a free market - you can go anywhere you want. Isn't that the biggest advantage to being a CRNA?

You'll find if you check again that salaries keep rising, as well as sign-on incentives. Many of the major hospitals in Atlanta are offering significant tuition reimbursement and sign-on bonuses.

In reference to my recent post under "washington DC CRNAs," I will direct everyone's attention to the blatant GREED factor underlying this post.

This post is also misleading. The hospitals here in Atlanta tend to give student loan reimbursement - this officially counts as INCOME. Maybe the base is 76,000, this sounds low to me. I think it is more like 90,000. There is all sorts of money to be had for hours worked over a standard shift, weekend, night call. As a midwife 60 hour weeks were standard with no extra for 24 hours straight, weekends, nights.....AND I had as many patients as there happened to be - maybe 2, maybe 7. In anesthesia, you get one patient at a time, guaranteed. Hmmm, no wonder the malpractice is so much less than what a midwife has to pay. After 11 years my top income was around $106,000. $90,000 plus loan repayment and overtime is really hard to hate for a starting salary. If your tastes require more money, hooray, you're a CRNA and you can drive up North and run your own show, make tons of money - the luxury of choice is all yours.

First of all, I'm agreeing w/ you. I thought $76,000 sounded like a low salary to me also. Your might call this greed, but don't be blind to the business aspect of the profession. When I was in the ICU, I was making about $15,000/yr less than the salary offered to me if I were start work as a CRNA at that hospital. Their was a $20,000 educational rembursment offer to me. Sure, I had to stay for 3 years, but it was offered. So now we are up to $83,000/yr. This, of course, after I borrow $90,000 and quit work for 2 1/2 years. Sound greedy? I saw from your previous posts that your husband is an OB. Some of us don't have the luxury of a supplemental 6 figure income in the house. This is gonna be more than a hobby for me.

It's a free market - you can go anywhere you want. Isn't that the biggest advantage to being a CRNA?

You'll find if you check again that salaries keep rising, as well as sign-on incentives. Many of the major hospitals in Atlanta are offering significant tuition reimbursement and sign-on bonuses.

Should have included this in my prev. post. I think that's great. Last I checked, the salaries were up @ the hospital I was at, but why should a major metropolitan area like ATL (where, if you wanted to, you could spent $5.95 on a cup of coffee) be so behind the times? I'm not insinuating that this hospital is the rule; I believe it is the exception. But it exisits. And in reference to your first sentence, that's the problem w/ tuition rembursement. You ARE stuck somewhere for 2-3 years. Their goes some of the mobility.

Should have included this in my prev. post. I think that's great. Last I checked, the salaries were up @ the hospital I was at, but why should a major metropolitan area like ATL (where, if you wanted to, you could spent $5.95 on a cup of coffee) be so behind the times? I'm not insinuating that this hospital is the rule; I believe it is the exception. But it exisits. And in reference to your first sentence, that's the problem w/ tuition rembursement. You ARE stuck somewhere for 2-3 years. Their goes some of the mobility.

I can probably guess which hospital you're talking about (or narrow it down to 2 or 3). But it seems as though tuition reimbursement / signon bonuses are becoming the norm. That's one of the questions we get asked early on from the prospective employees that we interview. And as the demand for anesthetists continues to increase, so will compensation packages. Ya gotta have people to do the cases. And although staffing is sometimes extremely tight, we have never had to hire locum tenens staff.

I'm sure Atlanta is not the highest paying area, but it also has a lower cost of living than the Northeast and West Coast, which means more net income in your pocket. I have friends that have moved to California and they brag about their salaries, but they also pay twice as much a month for half the house that I have. Their net disposable income taking into the cost of living into consideration is about the same.

Okay - I can't stand it any longer.

I am an AA with over 14 years of experience and currently practicing in Georgia. I have nothing but the highest regard for my CRNA colleagues and count some of them as among my closest friends. The article that you are referring to was written by Rob Wagner our association president over 1 year ago during the unsuccessful bid for licensing legislation in Florida in 2003. If you do a Google search, his is the ONLY article that you will find written by an AA attempting to set the record straight. Meanwhile you will find article after article and editorial upon editorial written by CRNA's calling us a bunch of incompetents. Now I ask you, who has been more professional and courteous through this whole thing.

Rob's characterization of AA's functioning the same as CRNA's is exactly correct in medically directed departments. Here in Georgia, our job descriptions and salaries are exactly the same (I made over $160k last year). That's alot of money for a tech isn't it?? ;).

If you would like to engage in a friendly discussion about AA's in an attempt to educate yourselves about us, I would be very happy to participate. Please understand, I am PRO - CRNA. I have no reason not to be. I work by definition under the supervision of an MDA. I can't practice alone, nor do I want to. If you want to flame me and get me thrown off the forum, be my guest. But it would behoove you to learn more about us because we will be coming soon to a state near you.

Georgia aa,

Thank you for your input. This is the kind of example of professionalism that needs to be set. I am interested in hearing more about your practice. Please feel free to contact me.

I can probably guess which hospital you're talking about (or narrow it down to 2 or 3). But it seems as though tuition reimbursement / signon bonuses are becoming the norm. That's one of the questions we get asked early on from the prospective employees that we interview. And as the demand for anesthetists continues to increase, so will compensation packages. Ya gotta have people to do the cases. And although staffing is sometimes extremely tight, we have never had to hire locum tenens staff.

I'm sure Atlanta is not the highest paying area, but it also has a lower cost of living than the Northeast and West Coast, which means more net income in your pocket. I have friends that have moved to California and they brag about their salaries, but they also pay twice as much a month for half the house that I have. Their net disposable income taking into the cost of living into consideration is about the same.

I see where you are commin' from. You gotta put someone at the head of the table to give the gas. Comming from the hospital I did, I met many AA's that were perfectly competent. I personally don't have any problem w/ an educated and experienced AA or CRNA putting me to sleep, but the babysitter-type, "I'm the doctor, you're the assistant" atmosphere was fostered where I came from. AA's and CRNA's were never seen performing a task w/o an MDA glaring over their shoulder. That is not an "anesthesia team." As you can see, it goes well beyond my alleged "greed" that CNMTOCRNA spoke of. The fact that you got a pretty good idea which hospital I'm talking about out of some 50 greater ATL metro hospitals says it all.

Secondly, in comparison, ATL does have a lower cost of living than most urban areas. The bottom line is that their will be more jobs than graduates, AA, CRNA, or MDA, no matter what city you live in. Thanks for the reply JWK

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