Does it bother CRNA's that MDA's get so much more...?

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Hey guys,

I'm not a CRNA yet. I want to be. I just got hired in a MICU/SICU. I was just wondering if it bothered any CRNA's the fact that MDs who practice anesthesia get paid wayy more for doing the same thing? I know some hospitals/facilities require the MDA oversee the CRNA, but does that equate to a couple hundred K more?

I don't know...I just feel CRNA's are not compensated enough for the ENORMOUS amount of responsibility and knowledge they hold.

I believe a lot of people are misunderstood in this forum about the role of the CRNA and what the future holds. I believe it is a state by state basis, but there are CRNA independent groups to where they do 100% of the anesthesia under no medical direction. The physician that you're 'practicing under' would be the surgeon - who has no anesthesia training whatsoever. There are also CRNAs who branch off with a surgeon and have an independent practice. There are also practices where MDAs and CRNAs practice in the same hospital, but the MDA does not oversee or manage the CRNA at all. Finally the most common in which most people know about is the ACT practice where an MDA will manage 3-4 suites and has to be present during certain stages of the case, which is basically them opening the door and giving a head nod. With cost cutting initiatives running rampant in today's healthcare suspect the aforementioned to become more of the norm over the ACT practice.

Yes MDA's have more knowledge and education; No their patient outcomes are not better than CRNAs

Yes MDA's have more knowledge and education; No their patient outcomes are not better than CRNAs

Is the percentage of CRNA that do transplants/open heart/difficult cases equal to that of MD anesthesiologists? I am afraid that we might be comparing apples to oranges..

Specializes in Anesthesia.
Is the percentage of CRNA that do transplants/open heart/difficult cases equal to that of MD anesthesiologists? I am afraid that we might be comparing apples to oranges..

Which type of anesthetic cases are the patients most often to be least optimized for surgery and have the greatest chance of morbidity and mortality?

By the way those are the cases that are most likely to be done by CRNAs.

Is the percentage of CRNA that do transplants/open heart/difficult cases equal to that of MD anesthesiologists? I am afraid that we might be comparing apples to oranges..
Show me the proof.
Specializes in Urology.
Is the percentage of CRNA that do transplants/open heart/difficult cases equal to that of MD anesthesiologists? I am afraid that we might be comparing apples to oranges..

Are you refering to % of personel or were you trying to say are the outcomes similar? We do not do thorasic cases at my facility but I do know for a fact, that all of our CRNA's did a thorasic rotation. If you want my expert opinion, I would take a CRNA doing my full anesthesia over a anesthesiologist anyday. I'm not bashing MD/DO's im just saying that when I walk into a room, and see the CRNA behind the curtain and the ologist on the ipad playing candy crush you know who does the work for every case.

CRNA's do all the anesthesia grunt work, they are experts at what they do. When you do something over and over and over again, you tend to get good at it. The ologists at my facility seldom do cases by themselves. I think some of them do them only to remain familiar with the equipment and technique. As for open hearts/thorasic cases, you'll have CRNA's managing the anesthesia all the time.

I have some good stories from my CRNA friends (and some crazy pictures to boot) about insane cases they have done. One of our CRNA's ran a room for a orthopedic oncologist removing a tumor from a back. 60 units of blood later! He showed me the picture of all the blood bags on the floor, it was insane! The whole case was ran by two CRNA's at a major university medical center (fyi my CRNA buddy is wicked smart and very good at his job).

get educated Ders.

Specializes in ICU, CVICU, E.R..
Hey guys,

I'm not a CRNA yet. I want to be. I just got hired in a MICU/SICU. I was just wondering if it bothered any CRNA's the fact that MDs who practice anesthesia get paid wayy more for doing the same thing? I know some hospitals/facilities require the MDA oversee the CRNA, but does that equate to a couple hundred K more?

I don't know...I just feel CRNA's are not compensated enough for the ENORMOUS amount of responsibility and knowledge they hold.

Everyone should have just answered the question as follows:

Nobody in their right mind would be bothered that MD's get paid more. I would be bothered if a CRNA was paid more than an MD Anesthesiologist! LOL!

Specializes in Anesthesia.
Everyone should have just answered the question as follows:

Nobody in their right mind would be bothered that MD's get paid more. I would be bothered if a CRNA was paid more than an MD Anesthesiologist! LOL!

Why don't you think CRNAs should make equal pay for equal work?

Specializes in CRNA.
Everyone should have just answered the question as follows:

Nobody in their right mind would be bothered that MD's get paid more. I would be bothered if a CRNA was paid more than an MD Anesthesiologist! LOL!

Why would 'anybody in their right mind be bothered' if a CRNA was paid more than an MD? Some CRNAs are paid more than some MDs (not many, but some). Why does that bother you?

I understand why a MDA gets paid more than a CRNA even for the same job with the same outcomes across the board. I believe MDAs have different experiences and thus bring different views into practice as do CRNAs that MDAs don't, which both views are equally valuable to a holistic patient approach. MDAs are less abundant and cost more to produce, thus should get paid more - basic economics. What I don't understand is how they make double, and in some cases almost triple the amount as a CRNA. It's absurd to undermine the Nurse Anesthetist's knowledge by inflating MDA wages for the same job and same outcome. I understand MAYBE 20-50k more than a CRNA, anything more and the system is blowing smoke up their a**.

Specializes in Anesthesia.
I understand why a MDA gets paid more than a CRNA even for the same job with the same outcomes across the board. I believe MDAs have different experiences and thus bring different views into practice as do CRNAs that MDAs don't, which both views are equally valuable to a holistic patient approach. MDAs are less abundant and cost more to produce, thus should get paid more - basic economics. What I don't understand is how they make double, and in some cases almost triple the amount as a CRNA. It's absurd to undermine the Nurse Anesthetist's knowledge by inflating MDA wages for the same job and same outcome. I understand MAYBE 20-50k more than a CRNA, anything more and the system is blowing smoke up their a**.

Price to produce has nothing to do with it. The argument is if you are selling/receiving the exact same product with no differences then why is reimbursement different for one than the other. That is basic economics. CRNAs use the price to produce MDAs and limitations on producing MDAs to our economic advantage, but realistically there should not be a difference in reimbursement rates when both do the exact same job.

Price to produce has nothing to do with the it. The argument is if you are selling/receiving the exact same product with no differences then why is reimbursement different for one than the other. That is basic economics. CRNAs use the price to produce and limitations on producing MDAs to our economic advantage, but realistically there should not be a difference in reimbursement rates when both do the exact same job.

surely there are multiple factors in play here. If it was strictly same job - same outcomes - same pay, then we wouldn't see ACT practices today skewed towards MDA>CRNA income. The only place I see this actually happening is in the CRNA independent practices in the future.

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