CRNA independent states

yoga crna · May 5, 2005

It is imperative that you remember that Opt-Out has only to do with Medicare reimbursement for Part A hospital payment. It does not apply to Part B, direct reimbursement. I am in private practice and receive Medicare reimbursement directly. Even though I practice in an non-opt-out state and have not seen an anesthesiologist in my operating room (except as patients) in over 20 years, there is no problem getting reimbursement. By the way, no one is having anesthesia complications, either.

Yoga

AWDC · May 6, 2005

Wrong--1% to 100% supervised means just that. The MD can come in and change your plan if he or she feels necessary. They will be there on induction, sometimes push your drugs (that they decide), start your lines etc.. and leave, then come back for emergence and extubation. (Try to do a locum job in Pennsylvania and you will see what I mean) To them you are a technician, uncapable of making a sound decision on your own. Why do CRNA's need to "collaborate"? Define collaborate.
True autonomy is making your own SOLO decisions, depending only on yourself.
Anyway,
Gotta go do my next case--(All by myself on call 24 hours as it should be)
Mike CRNA

After reading this, I think I now know why MDAs would have an issue with CRNAs being independent practitioners. I'm in med school right now and all throughout med school, we are being trained as the providers that take the ultimate responsibility. That's the mentality. Physicians make the ultimate decisions and because of education, training, and scope of practice, we are given the right to overturn the decisions of other providers. Pretty much the only time you defer is to another physician specialist. Apparently, I guess it's not how it always works in anesthesia. So it just might seem inherently strange to MDs/DOs (and myself) how CRNAs can be a true "soloist." I'll even admit that I'm still trying wrap my finger around the concept of nurses being given the same rights and responsibilities as a physician. To me, it's just a very new/radical concept... Please share your thoughts.

chattypattyCRNA2B · May 6, 2005

After reading this, I think I now know why MDAs would have an issue with CRNAs being independent practitioners. I'm in med school right now and all throughout med school, we are being trained as the providers that take the ultimate responsibility. That's the mentality. Physicians make the ultimate decisions and because of education, training, and scope of practice, we are given the right to overturn the decisions of other providers. Pretty much the only time you defer is to another physician specialist. Apparently, I guess it's not how it always works in anesthesia. So it just might seem inherently strange to MDs/DOs (and myself) how CRNAs can be a true "soloist." I'll even admit that I'm still trying wrap my finger around the concept of nurses being given the same rights and responsibilities as a physician. To me, it's just a very new/radical concept... Please share your thoughts.

Wrap your finger around this...

http://www.aana.com/crna/history.asp

CRNA's were the first group BEFORE PHYSICIANS, to perform anesthesia. It would be reasonable that they would be given the same rights and responsibilities as a physician in this particular area. If you do a little history on it maybe you would come to a better understanding and respect for the field.

Sheri257 · May 6, 2005

It is imperative that you remember that Opt-Out has only to do with Medicare reimbursement for Part A hospital payment. It does not apply to Part B, direct reimbursement. I am in private practice and receive Medicare reimbursement directly. Even though I practice in an non-opt-out state and have not seen an anesthesiologist in my operating room (except as patients) in over 20 years, there is no problem getting reimbursement. By the way, no one is having anesthesia complications, either.
Yoga

Thanks for that insight. I've often wondered how Medicare affected CRNA practice in non-opt out states. So, what you're saying is that it really doesn't affect CRNAs at all, as long as they bill direct? Interesting.

:coollook:

deepz · May 6, 2005

.......I'm in med school right now and all throughout med school, we are being trained as the providers that take the ultimate responsibility. ...... Apparently, I guess it's not how it always works in anesthesia. ......

http://www.gaspasser.com/unique.html

.

lmdscd · May 6, 2005

AWDC , just for the record we pratice under are own license that should give us right's to how we pratice anesthesia. M D sometimes want to push certian drugs and ways we think different. Something goes wrong you think md will stand up for me? My two cents in.

yoga crna · May 7, 2005

AWDC

Welcome to America where the capitalistic system is alive and well. I compete with anesthesiologists and other CRNAs for business. The two areas of competition that are the mainstay of our country are: service and price. If I can provide a better service at a good price, I get the business. It is one of the major tenets of economics. Everything else is rhetoric.

What you are really afraid of is that a nurse can do the same thing you will be someday able to do (after the same anesthesia education), do it well and get paid appropriately for the value of the service performed. I can assure you that if CRNAs were not clinically excellent, we would not be in practice long. We are not killing patients or do not have major complications, so get over it. Also, you have been misinformed by the arrogant physicians who teach you--nurses are responsible for our own progessional acts and the doctors are not legally, the "captain of the ship". I can show you many legal cases where nurses were held liable for the acts of the physician.

I know I am coming off strong, but frankly I am tired of doctors thinking they have all of the answers. I can assure you that nurses will bail you out of trouble many times in your career and the good doctors know and respect that. The mediocre ones look for others to blame for their inadequacy.

Yoga CRNA

sonessrna · May 7, 2005

AWDC
Welcome to America where the capitalistic system is alive and well. I compete with anesthesiologists and other CRNAs for business. The two areas of competition that are the mainstay of our country are: service and price. If I can provide a better service at a good price, I get the business. It is one of the major tenets of economics. Everything else is rhetoric.
What you are really afraid of is that a nurse can do the same thing you will be someday able to do (after the same anesthesia education), do it well and get paid appropriately for the value of the service performed. I can assure you that if CRNAs were not clinically excellent, we would not be in practice long. We are not killing patients or do not have major complications, so get over it. Also, you have been misinformed by the arrogant physicians who teach you--nurses are responsible for our own progessional acts and the doctors are not legally, the "captain of the ship". I can show you many legal cases where nurses were held liable for the acts of the physician.
I know I am coming off strong, but frankly I am tired of doctors thinking they have all of the answers. I can assure you that nurses will bail you out of trouble many times in your career and the good doctors know and respect that. The mediocre ones look for others to blame for their inadequacy.
Yoga CRNA

Well said.

lmdscd · May 7, 2005

Amen, Yoga. Well stated!!!

jwk · May 7, 2005

It will be interesting to see what happens when a state opts back IN.

sandman1914 · May 7, 2005

It will be interesting to see what happens when a state opts back IN.

What gives you the indication that a state would "Opt back in?"

gaspassah · May 7, 2005

It will be interesting to see what happens when a state opts back IN.

as it will be interesting when...

AA's are deemed no longer a worthwhile option. :rotfl:

md's leave the anesthesia arena :balloons:

iran becomes a democratic government

north korea becomes a vacation hotspot. :rolleyes:

all states opt out... :Melody: :Melody:

there goes jwk ruffling feathers again.

d