CRNAs as Independent Contractors

Specialties CRNA

Published

I was in an oral surgeons office the other day and there was a CRNA putting people to sleep for their surgeries. I was interested in how CRNAs can get opportunities like that as independent contractors in dentists offices and the like. Where do you find job offers like this?

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I'm curious about this also. I'm assuming a CRNA can make more money doing this kind of work? Is that true?

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i'm not a CRNA yet, 2 more months. but i know several independant contractors. yes you can make more money, however, you usually pay your own , most new grads dont have enough experience to do it full time. experienced practitioners will tell you that you learn the most in your practice the first 2 years after you graduate. also if you contract work you need your own health insurance, and if you bill independantly you will probably need a billing service. and depending on the type of contract work you do, you may not have much backup in the OR.

just some thoughts.

d

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I have been an independent contractor for over 20 years and have some strong opinions about it. Having practiced in all types of employment settings (that is one of the wonderful parts of being a CRNA), I love independent practice the best. Most of all, I am my own boss and am responsible for my own practice decisions, which is both good and bad.

While there are notable exceptions, I would offer several pieces of advise. One. Stay in a hospital based practice for at least 5 years and in that time, get as much clinical experience as you can. Two. If you go independent--most of those settings are in small institutions, ambulatory surgery or office settings. It looks like it will be difficult to get for office settings with less than 5 years experience. Do your homework before making that decision to determine if you can meet all of the responsibilities and requirements. Three. Learn about the business and economics of anesthesia. If you are going to be independent, you need a good accountant to help you set up the business and someone to help you with a contract.

Most CRNAs who have gone independent are happy that they did and never want to go back to making money for someone else. But, it is not the best practice model for everyone and has limitations. If you need a set income, lots of paid benefits and paid time off, an employed setting may be best for you.

You may want to join [email protected]. There is a lot of good information there posted by CRNAs in business.

Good luck.

YogaCRNA

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Just out of curiosity is having a condition of licensure or employment for CRNA's in most states? If not why not keep most of your assets in an oversea's account (say the Cayman's or Nevis) and keep your primary residence in a trust (preferably in a state like Texas or Florida where it is all but untouchable anyway)? In any case are not people less likely to sue if they believe that you don't have insurance (attorney's almost always lose interest when the prospect of deep pockets seems unlikely).

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No facility will touch you without having proof of insurance................working as an independent contractor, goes as well with straight RN positions.

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It looks like my schemes are foiled once more by the system! Okay, so here's the modified plan. I pay a large sum of money to a relatively small, corrupt African dictatorship to give me diplomatic immunity in the United States. Then, I set up practice as a CRNA faking any necessary credentials (why bother with the schooling since I will be untouchable!).

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You have got to be kidding.......................... :o

And if not, it is a slap in the face to all that have worked so hard to get to that level.

By the way, any facility will thoroughly investigate credentials before hiring you.

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You have got to be kidding.......................... :o

And if not, it is a slap in the face to all that have worked so hard to get to that level.

By the way, any facility will thoroughly investigate credentials before hiring you.

well...i think it's pretty obvious that he is joking...

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Just out of curiosity is having malpractice insurance a condition of licensure or employment for CRNA's in most states? If not why not keep most of your assets in an oversea's account (say the Cayman's or Nevis) and keep your primary residence in a trust (preferably in a state like Texas or Florida where it is all but untouchable anyway)? In any case are not people less likely to sue if they believe that you don't have insurance (attorney's almost always lose interest when the prospect of deep pockets seems unlikely).

Keep in mind that even if you can hide your money that you have you can still get a large judgement against you based on future earnings...there seems to always be a catch to a well thought out plan. The thing several CRNA's that I know do as independent contractors is incorporate to help relieve some of the financial liability if their policy doesn't cover the judgement amount.

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I fully agree with Yoga ....BTW could you repost that URL - it doesn't seem to go anywhere...anywho couple of other points....

Do get as much broad clinical experience as you can ....the HARDEST part of going independent, that I found, was not necessarily that Anesthesia .... but the Medicine. Differential diagnosis/assessments is an integral part of the pre-anesthetic eval to determine a safe course for the patient and to guide the patient to an appropriate consultation with what ever specialty that that patient needs.

The new grads I have seen, from a multitude of programs, fall woefully short of these skills- d/t the degree of medical direction that is instituted in many programs and on top of the that need to develop greater clinical maturity (this only comes with time). The old adage of "you don't know what you don't know" applies fully here.

....case in point - when starting as an independent - I asked my partner (CRNA) his technique for determine level of cardiac risk in noncardiac surgeries - and he said (no joke) - "just ask them if they have had any chest pain and if they have cancel it"....Hmmm not good enough for me - so I had to put to heart the risk criteria based on symptomotology, revascularization history, drug combinations, ect...- you understand - and put it to use - meaning canceling cases and be able to articulate the rationale to the very upset surgeon....this happened on a few occasions but the surgeon back off d/t his argument of his schedule vs. patient operative risks was a weak one at best. But cardiac is easy - what about a nonsymptommatic 9 month old for an elective urology case just placed on antibiotics for a possible URI? Do you cancel??..... for how long - what if they present w/ s/s - then how long?

Well you get the picture - get your feet wet and feel completely comfortable with your practice before adding a few other dimensions to it...

The Business part of it is also something of a complete shift for many who have not had any business experience (licensing, medicare/caid, billing, setting up medical, life, disability, malpractice, Keoghs, ect...) - Its a bit much - but really worth it. - I cant go back to working for someone else....

But this discussion can go on for a while so I will take my leave - thanks for reading

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