FTC Paper: State Legislators Should Carefully Evaluate Proposals to Limit APNs

jwk · Mar 9, 2014

And yet somehow, the efforts of CRNA's nationwide to prevent and limit AA practice is acceptable - to CRNA's of course. Staggering hypocrisy.

allnurses Guide · Mar 9, 2014

And yet somehow, the efforts of CRNA's nationwide to prevent and limit AA practice is acceptable - to CRNA's of course. Staggering hypocrisy.

And yet CRNAs help diversify the anesthesia job market. CRNAs have been shown to lower costs of anesthesia care, hence the FTC comments, whereas AAs do none of the above.

When AAs can practice independently, have been proven to lower anesthesia costs, and have shown to be as safe working independently as CRNAs and/or MDAs then maybe the FTC will issue the same statement for them.

jwk · Mar 9, 2014

And yet CRNAs help diversify the anesthesia job market. CRNAs have been shown to lower costs of anesthesia care, hence the FTC comments, whereas AAs do none of the above.
When AAs can practice independently, have been proven to lower anesthesia costs, and have shown to be as safe working independently as CRNAs and/or MDAs then maybe the FTC will issue the same statement for them.

Your argument has nothing to do with my statement. I'm talking about YOUR profession preventing MY profession from working in every state. You want to practice independently? Fine - do so and let AA's who want to practice as part of an ACT practice do that unencumbered by your opposition. Let ACT practices decide if they want to use AA's, CRNA's or both. Oh wait - you think that's wrong - because it's competition, which you're scared of and can't handle in a free market.

allnurses Guide · Mar 10, 2014

Your argument has nothing to do with my statement. I'm talking about YOUR profession preventing MY profession from working in every state. You want to practice independently? Fine - do so and let AA's who want to practice as part of an ACT practice do that unencumbered by your opposition. Let ACT practices decide if they want to use AA's, CRNA's or both. Oh wait - you think that's wrong - because it's competition, which you're scared of and can't handle in a free market.

The sole purpose of this thread was to discuss the FTC paper on APN practice.

But the sole purpose of AAs is to give the ASA leverage over CRNAs and to further control and try to monopolize the anesthesia market. AAs cannot work independently. AAs are not even trained to work independently. AAs have to work in ACT/supervised environment. AAs do not have a choice in the matter. AA training is restricted in order to not interfere with skills that MDAs would rather do/bill themselves i.e. PNBs, CVLs etc. There is absolutely no reason that CRNAs should not oppose another profession that is only there to try help the ASA monopolize the anesthesia market and control CRNA income. When AAs become independent anesthesia providers that are not controlled solely by the ASA then we can discuss how the world has not been fair to AAs.

jwk · Mar 12, 2014

AAs cannot work independently. AAs are not even trained to work independently. AAs have to work in ACT/supervised environment. AAs do not have a choice in the matter.

Total straw man argument - like they say, if you can't dazzle them with brilliance, baffle them with BS. Nothing to do with the anti-competitive actions of CRNA's. You CANNOT criticize anesthesiologists and organized medicine for what you perceive as limiting your right to practice and then turn around and try to limit AA practice and not be a TOTAL hypocrite. An elementary school child could understand this simple concept.

AA training is restricted in order to not interfere with skills that MDAs would rather do/bill themselves i.e. PNBs, CVLs etc.

Really? Where did you get this false tidbit? I have done countless regionals, central lines, and Swans over the years - far more than you'll ever do in your lifetime. Once again - you're only able to repeat the claims of others who also don't know what they're talking about because you have zero first-hand knowledge about AA's.

allnurses Guide · Mar 13, 2014

Total straw man argument - like they say, if you can't dazzle them with brilliance, baffle them with BS. Nothing to do with the anti-competitive actions of CRNA's. You CANNOT criticize anesthesiologists and organized medicine for what you perceive as limiting your right to practice and then turn around and try to limit AA practice and not be a TOTAL hypocrite. An elementary school child could understand this simple concept.
Really? Where did you get this false tidbit? I have done countless regionals, central lines, and Swans over the years - far more than you'll ever do in your lifetime. Once again - you're only able to repeat the claims of others who also don't know what they're talking about because you have zero first-hand knowledge about AA's.

Okay, how do AAs help bring costs down? How do AAs help provide an alternative to ACT or MDA only practices?

What AA school or accreditation agency requires AAs to learn regional or CVLs? Who were all those regionals and CVLs that you did actually billed under?

Unless you are in specialized practice I doubt you do more regional than the average military CRNA.

When have you ever pulled call as the sole anesthesia provider? When have you ever worked as the only anesthesia provider for a rural hospital? When is the last time you were the sole anesthesia provider for military MFST in another country whose sole purpose was to support the special operation teams? I have done all those and many other things that as an AA you will never be able to do.

Again, there is absolutely no reason for the FTC to support AAs, because AAs do nothing to diversify anesthesia practices. The AAs profession sole purpose is to help support the ASAs efforts to monopolize anesthesia practices.

Yes, I have no first hand knowledge of working with AAs, and that is my choice. You have no first knowledge of working as an independent provider, because AAs are the political/economic pawns of the ASA. I can work in any type of anesthesia practice where as an AA you will always be limited to working under MDA.

jwk · Mar 13, 2014

Okay, how do AAs help bring costs down? How do AAs help provide an alternative to ACT or MDA only practices? What AA school or accreditation agency requires AAs to learn regional or CVLs? Who were all those regionals and CVLs that you did actually billed under? Unless you are in specialized practice I doubt you do more regional than the average military CRNA. When have you ever pulled call as the sole anesthesia provider? When have you ever worked as the only anesthesia provider for a rural hospital? When is the last time you were the sole anesthesia provider for military MFST in another country whose sole purpose was to support the special operation teams? I have done all those and many other things that as an AA you will never be able to do. Again, there is absolutely no reason for the FTC to support AAs, because AAs do nothing to diversify anesthesia practices. The AAs profession sole purpose is to help support the ASAs efforts to monopolize anesthesia practices. Yes, I have no first hand knowledge of working with AAs, and that is my choice. You have no first knowledge of working as an independent provider, because AAs are the political/economic pawns of the ASA. I can work in any type of anesthesia practice where as an AA you will always be limited to working under MDA.

Again - none of this matters. How about this - leave all the ACT practices to the AA's, and let all the CRNA's practice independently. Would you go for that? Of course not, because the majority of CRNA's in the US actually work in ACT practices. That would be unfair competition, right?You are so sure that AA's are un-needed - you are so sure of your massive superiority - then why do you, your buddies, the AANA and it's state associations spend so much money and effort fighting the expansion of AA practice? I can tell you why - you're afraid to let the free market decide. You claim anesthesiologists are trying to limit your practice, and then for NO other reason other than being afraid of the competition and scared to death that AA practice will keep growing (which it is BTW) you turn around and try to prevent us from practicing. This is the heart of anti-competitive behavior. AA's don't go into practices trying to displace CRNA's simply because they're CRNA's - the converse is not true.

loveanesthesia · Mar 15, 2014

Phasing out the ACT model will hold down costs. The ACT practices that can be found now are typically practices that were started before the 1990's and it's really difficult to change for the anesthesia providers who have only known the ACT. When new practices are started they are more often non ACT practices. That's because it's more financially viable. In some areas of the country where the ACT is firmly entrenched everyone is anxious about going away from ACT-hospital administrators, surgeons etc-but as non ACT becomes the norm that will become less of an issue. The number of CRNA graduates has been thought to be too high, but it does make it possible to replace AAs without too much trouble.

allnurses Guide · Mar 15, 2014

Again - none of this matters. How about this - leave all the ACT practices to the AA's, and let all the CRNA's practice independently. Would you go for that? Of course not, because the majority of CRNA's in the US actually work in ACT practices. That would be unfair competition, right?You are so sure that AA's are un-needed - you are so sure of your massive superiority - then why do you, your buddies, the AANA and it's state associations spend so much money and effort fighting the expansion of AA practice? I can tell you why - you're afraid to let the free market decide. You claim anesthesiologists are trying to limit your practice, and then for NO other reason other than being afraid of the competition and scared to death that AA practice will keep growing (which it is BTW) you turn around and try to prevent us from practicing. This is the heart of anti-competitive behavior. AA's don't go into practices trying to displace CRNA's simply because they're CRNA's - the converse is not true.

AAs are there to prevent competition not increase competition.

An AA is worthless entity without an MDA. You must have direct supervision at all times. AAs lock in one type of practice and one type of practice only (ACT).

How about this why not eliminate the ability for MDAs to bill for medical direction or supervision, and we move to all independent anesthesia providers doing their own cases. This will automatically increase the number of anesthesia rooms that surgery can run by 20%, provides increase access to care, and reduces overall costs.

So, how again can AAs increase access to care or reduce anesthesia costs?

Fighting AA expansion is a fight against anti-competition. It is fight to prevent an ASA monopoly on anesthesia care in U.S.