CRNA VS anesthesiologist MD

TXCRNA · Jul 17, 2009

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 defenitely should know what you are talking about before replying to a question. This statement is untrue. Obviously not written by an anesthesia provider. Sorry, but it frustrates me when I see these kind of posts. You can work independently in many states, mine (Texas) included. And no states have the requirement of working under an anesthesiologist. There are some medicare billing requirements that apply when an anesthesiologist wants to bill mediacare for supervision of a CRNA on a particular case, but they are not required to supervise the case. They do supervise in alot of facilities, but this is so they can bill for the service & make more $$ for the dep't. Although, you may work for a hospital that writes into their bylaws that CRNAs must be supervised, but this is decided by a facility. Alot of rural areas have independent CRNAs practicing w/o any supervision. CRNAs can provide the same anesthesia- regional and general anesthesia. Also invasive lines, etc...

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 1, 2009

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That he doesn't think his kids have what it takes to become an anesthesiologist.

That is wrong... and actually pretty darn rude. We here at All Nurses.com are not rude to other nurses. If you are here as a Doc or RT please respect our site.

My neighbor is an anesthesiologist. I am a CRNA. He tells his daughter to become a CRNA. His reasons are partly because we have a life. We do not have $120,000 in education loans to repay. We work relatively sane shifts. We are respected in our field. We make decent money. What more could a father ask for? He is feeling the pressures of poor medicare reimbursement, of insurance companies failing to pay his full fees, of socialized medicine circling the wagons. What will happen to all of those doctors who went through all of that schooling, pain, hardship and money when nObama takes away their livelyhood?????

PageRespiratory! · Aug 1, 2009

That is wrong... and actually pretty darn rude. We here at All Nurses.com are not rude to other nurses. If you are here as a Doc or RT please respect our site.
My neighbor is an anesthesiologist. I am a CRNA. He tells his daughter to become a CRNA. His reasons are partly because we have a life. We do not have $120,000 in education loans to repay. We work relatively sane shifts. We are respected in our field. We make decent money. What more could a father ask for? He is feeling the pressures of poor medicare reimbursement, of insurance companies failing to pay his full fees, of socialized medicine circling the wagons. What will happen to all of those doctors who went through all of that schooling, pain, hardship and money when nObama takes away their livelyhood?????

You know what I consider rude? CRNA's testifying under oath to prevent legislation for licensure of other mid-level anesthesia providers. Many people consider that beyond rude, some people consider it perjury. I do respect this site, thats why I post here. Why don't you respect me (and other non-nurse practitioners) and advocate for AA's?

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 1, 2009

You know what I consider rude? CRNA's testifying under oath to prevent legislation for licensure of other mid-level anesthesia providers. Many people consider that beyond rude, some people consider it perjury. I do respect this site, thats why I post here. Why don't you respect me (and other non-nurse practitioners) and advocate for AA's?

What has that got to do with the price of tea in China???? This is a totally different discussion.

If you are interested in my personal opinion on AA, please refer to the latest AA blog.

PS: why would I ADVOCATE for someone who does NOT have necessarily have any degree in any type of medicine, who may very well have had a degree in Childhood Education and decided to do anesthesia now. Sounds like fun, dont'cha think?

PageRespiratory! · Aug 2, 2009

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What has that got to do with the price of tea in China???? This is a totally different discussion.
If you are interested in my personal opinion on AA, please refer to the latest AA blog.
PS: why would I ADVOCATE for someone who does NOT have necessarily have any degree in any type of medicine, who may very well have had a degree in Childhood Education and decided to do anesthesia now. Sounds like fun, dont'cha think?

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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???

chrisciwi · Aug 2, 2009

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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???

I have made my decision on this whole deal, I have talked to a few MD anesthesiologist and 2 CRNAs. I am a people person, and from what the MDs have told me nurses and MDs look at a patient. Accord to the MDs they focus more on the illness while nurses focus more on the patient in a whole. Which has led me to decide to go for CRNA. Money isn't an issue, I know people hear that and say I am full of it, But I really am not.

The reason why I asked this question was because my ex-fiance's mother would pay 100% of my tuition, book, room and board etc if I became a doctor, including a 10,000 a month salary while in school. If I go nursing, I pay for everything myself. So yes it was a hard decision, but wouldn't you think that if money was my main concern I would be pre-med right now instead of Nursing?

So CRNA it is!

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 2, 2009

Let's take this line by line:

"We are a non profit hospital and are required to make the top salary's public info."

I don't understand this statement. Sorry. (It may have to do with the 24 hours shift I just survived). I guess that brings me to the next quote:

"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."

Wow, great job if you can get it. But this is not always the case. There are always going to be the high and the low of both salary and shifts. I work one 16 hr shift and one 24 hr shift. Call once a week and 1-2 weekends a month. If I work the schedule, I can get a 4-5 day stretch off to go somewhere nice with my family. If this CRNA is doing the same work as the anesthesiologist, then good for him for managing to get a contract that pays the same. It sounds like this is a pretty small hospital/clinic. Is it rural? You can demand more if the desire to be located in this market is low. I'm sure you can find a discussion somewhere on this blog where it discusses the CRNA and the rural setting. Too involved to get into here.

If there is not a need for advanced or specialized anesthesia and they are truly doing the same job (community hospitals don't do difficult cases, they refer them out) then they should get paid for the work that is performed. It makes a difference if this practice is using a model that the CRNA works for the hospital, the medical group or the surgeon. It makes a difference if the CRNA is under "supervision" or "direction." All very detailed and specific billing and legal practices. If you are not familiar with these details, you can not honestly participate or have an informed opinion on the pay practice. (AA are ALWAYS under "direction" of an anesthesiologist.)

PageRespiratory!, are you a RT? Are you in AA school or thinking of attending this school? I think if we all knew where you are coming from, it may be easier to explain and understand each other.

"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?"

Looking at your "name" on this site leads me to believe that your are a RT. If this is the case, you would not be "retrogress" in going to nursing school. It would be a increase in your education considerably. So much so that I will not even consider wasting my effort in explaining this one. If I am wrong in assuming you are a RT, I'm sorry. "who is extremely well qualified" Well qualified as what? I await clarification.

Somewhere in your post you said the CRNA lead the patient to believe that he/she was an anesthesiologist. That is unacceptable. It is this individuals responsibility to represent himself with truth and, I might add, pride. I would hope this is an exception instead of a common practice, but I have to see the otherside also. Pts in general could care less. They want to know they are going to be ok. (AA, CRNA or Anesthesiologist) They are generally afraid of "going under." Sometimes when you are in a hurry, (we are a large facility and have a max turnover time of 30 min) you skip over the introductions. Pts do not know who a nurse anesthetist (or AA) is and are so tunnel focused on their surgery that they can not think outside their tiny little box. I would suggest this provided be very careful not to go too far. He is not a doc. If asked, he MUST stop and explain to the patient to their satisfaction. To hell with turn-over times. Pts come first.

There are some really knowledgeable CRNAs and AAs on this site. They bring much to the academic table. We can learn from each other, (and some anesthesiologists that I love blogging with). But we all must face our limitations. Those limitations are up for debate. I'm not going to solve the (anesthesia) world problems here. I can only ask that you keep an open mind so that when, if, or during your practice you will able to learn and contribute to this site.

I look forward to hearing more from you and about you.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 3, 2009

Congrats Chris on making your own informed decision. Either way, you made the choice that was right for you. I know you will be happy and proud.

Good luck! And remember: Never, never, never, never give up.

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 3, 2009

I apologize for the typos above. I'm tired. 24 hr shift ended this am and another starts tomorrow at 0700. Gonna be a tough week.

PageRespiratory! · Aug 3, 2009

ok....line by line it is............

let's take this line by line:
"we are a non profit hospital and are required to make the top salary's public info."
i don't understand this statement. sorry. (it may have to do with the 24 hours shift i just survived).
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no sweat, i work 24 hr shifts at my per diem gig, i know the feeling. i should've clarified; i am a registered respiratory therapist, i did much of my initial training as well as first several years of employment at a 1200 bed, level 1, tertiary care center outside nyc. for the last few years i've worked for a small rural hospital in northern new england. (without a doubt the best move i've ever made!!) the crna, as well as the physicians, are hospital employees. our critical access/not for profit status requires the hospital to make the top 5 salarys public as i understand it.
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"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."
wow, great job if you can get it. but this is not always the case. there are always going to be the high and the low of both salary and shifts. i work one 16 hr shift and one 24 hr shift. call once a week and 1-2 weekends a month. if i work the schedule, i can get a 4-5 day stretch off to go somewhere nice with my family. if this crna is doing the same work as the anesthesiologist, then good for him for managing to get a contract that pays the same. it sounds like this is a pretty small hospital/clinic. is it rural? you can demand more if the desire to be located in this market is low. i'm sure you can find a discussion somewhere on this blog where it discusses the crna and the rural setting. too involved to get into here.if there is not a need for advanced or specialized anesthesia and they are truly doing the same job (community hospitals don't do difficult cases, they refer them out) then they should get paid for the work that is performed. it makes a difference if this practice is using a model that the crna works for the hospital, the medical group or the surgeon. it makes a difference if the crna is under "supervision" or "direction." all very detailed and specific billing and legal practices. if you are not familiar with these details, you can not honestly participate or have an informed opinion on the pay practice.
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i agree, it is a great job. i do only have a limited understanding of anesthesia in the rural market. while a crna most certainly performs the same job at a technical level as an anesthesiologist, are you suggesting an advanced practice nurse (or any mid-level for that matter) can provide the same level of care as a physician? i think we both know that's not typically the case. again, both the mid-levels and the docs are hospital emloyees here, i don't know how their salaries are negotiated, or reimbursment is calculated. i beleive we are an opt-out state and do not require supervision for crna's. that being said, i don't beleive that any mid-level "does the same job" as a physician........ever, they are not prepared to, and thus do not mandate equal compensation to a physician.
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(aa are always under "direction" of an anesthesiologist.)
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ah yes......the crna battle cry. guess what, this won't change nor does the aa agenda want independent practice. why is this something that every crna says when the subject of aa comes up?
pagerespiratory!, are you a rt? are you in aa school or thinking of attending this school? i think if we all knew where you are coming from, it may be easier to explain and understand each other.
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yes, sorry. i should've clarified sooner, i'm an rrt who's looking to persue a masters degree. a masters in anesthesiology is a perfect segue for an rt (whether you want to believe that or not, i'll get to that later). i had a job offer with attractive educational incentives, i begrudgingly declined to relocate my family (wife, 2 kids) after the aa legislation fell through in md as a direct result of mana's testification. although i've found a great niche as a therapist i want at least a masters, and i need a good return on my fiscal / physical / educational investment. considering the looming healthcare reform and the fact that in this economy i'm gainfully employed (own a home, can afford to have wife at home with the kids, generously contribute to 401(k), no high interest debt, 2-3 days off weekly....ect) i'm staying put for the time being.
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looking at your "name" on this site leads me to believe that your are a rt. if this is the case, you would not be "retrogress" in going to nursing school. it would be a increase in your education considerably. so much so that i will not even consider wasting my effort in explaining this one.
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this is obviously the pinnacle of our dissagreement. you are apparently unfamiliar with our schooling, but i assure you ns would be an absolute retrogression, at least in terms of critical care and hard science. i realize i could try and convince you until blue in the face, i urge you to find someone with both credentials, be sure that they have an rt degree and are not ojt. please take note that i'm not saying nurses should'nt be able to advance to anesthesia, just that there are other non nursing practitioners that are just as well qualified to. pre-reqs for rt are the same as nursing. my entry level, basic rt curriculum included; gas laws/physics, mastering the fundamental principles of mechanical ventilation, mastering abg interpretation (not the cookbook pneumonic method, but understanding the fundamentals), cvp placement and pressure tracing analysis and essential hemodynamics, pft interpretation, flow/volume/pressure waveform analysis, flow/volume loop analysis, cxr interpretation, advanced cardiopulmonary a&p, aw management, mastering aerosol and medical gas delivery, ecg interpretation and other cardiac monitoring.....ect. i had 2000 clinical hours, ~1200 of which were spent in the different icu's ~400 in a level 1 nicu, i also had rotations in snf's, or's, chronic vent units, home care, as well as childrens hospitals and others. rt was born from anesthesia, the asa has a direct hand in our educational curriculum and our testing requirements. have you ever heard of robert kacmarek or dean hess? they are both respiratory therapists who teach in anesthesia depts. in medical schools, i know of at least 1 more rt as well, however his name escapes me at the moment. i'm licensed in several states and they all state "the rt may provide any intervention or therapy that facilitates the monitoring of cardiopulmonary status" and "there are no limitations to the type of medication, or route of administration, given by the rt". a fairly wide scope of practice don't you agree? in my experiences even a fairly seasoned icu nurse has only a marginal understanding of things like a:a, alveolar-air equation, oxygen content equation, shunt equation, acid-base balance and (real) abg interpretation........this is why i feel the way i do, i'm not nurse bashing i'm just saying nursing isn't the end all be all of health care practitioners. also keep in mind, just like you would want the best of the best representing your profession, i feel the same.
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somewhere in your post you said the crna lead the patient to believe that he/she was an anesthesiologist. that is unacceptable. it is this individuals responsibility to represent himself with truth and, i might add, pride. i would hope this is an exception instead of a common practice, but i have to see the otherside also. pts in general could care less. they want to know they are going to be ok. (aa, crna or anesthesiologist) they are generally afraid of "going under." sometimes when you are in a hurry, (we are a large facility and have a max turnover time of 30 min) you skip over the introductions. pts do not know who a nurse anesthetist (or aa) is and are so tunnel focused on their surgery that they can not think outside their tiny little box. i would suggest this provided be very careful not to go too far. he is not a doc. if asked, he must stop and explain to the patient to their satisfaction. to hell with turn-over times. pts come first.
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just to be clear, i don't think (s)he would intentionaly mislead a pt, i just find it amusing that its almost an unconcience effort to equate themselves with a medical doctor.
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there are some really knowledgeable crnas and aas on this site. they bring much to the academic table. we can learn from each other, (and some anesthesiologists that i love blogging with). but we all must face our limitations. those limitations are up for debate. i'm not going to solve the (anesthesia) world problems here. i can only ask that you keep an open mind so that when, if, or during your practice you will able to learn and contribute to this site.
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agreed 100%
i look forward to hearing more from you and about you.

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same here. i admit i come across somewhat abrasive around here sometimes, although justifiable most times. i honestly have a lot of respect for nurses, specifically crna's. i just find the nursing agenda, specifically the aana, full of hogwash propaganda. a good friend from rt school has been an rn for a few years now and was accepted at suny downstate's nurse anesthesia program...ironically he says during his interview they were very interested in his rt experience. grrr.....

PageRespiratory! · Aug 3, 2009

I have made my decision on this whole deal, I have talked to a few MD anesthesiologist and 2 CRNAs. I am a people person, and from what the MDs have told me nurses and MDs look at a patient. Accord to the MDs they focus more on the illness while nurses focus more on the patient in a whole. Which has led me to decide to go for CRNA. Money isn't an issue, I know people hear that and say I am full of it, But I really am not.
The reason why I asked this question was because my ex-fiance's mother would pay 100% of my tuition, book, room and board etc if I became a doctor, including a 10,000 a month salary while in school. If I go nursing, I pay for everything myself. So yes it was a hard decision, but wouldn't you think that if money was my main concern I would be pre-med right now instead of Nursing?
So CRNA it is!

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I'm perfectly willing to admit that I may be wrong........but I find the above to very hard to beleive. If I'm wrong I apologoze, either way good luck.

loveanesthesia · Aug 5, 2009

OK....Line by line it is............
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A good friend from RT school has been an RN for a few years now and was accepted at SUNY Downstate's nurse anesthesia program...ironically he says during his interview they were very interested in his RT experience. Grrr.....

Go to an accelerated BSN program, then nurse anesthesia. You'll never regret it. The sooner you get started the sooner you'll be finished.