Future trend of CRNA's

jewelcutt,

i am just starting out - but from what i have read, and from what current crna's and crna students have told me - there is no limit - the field and the economics of the field are wide open and getting better all the time.

Jenni

I haven't seen anything "in writing" on the future of CRNA's in a while, but I'll be happy to give you a perspective from a practicing CRNA.

The short version is that there is really no where to go but up for at least the next ten years. Currently, there are about 80 schools that produce CRNA's. The combined number of graduates they produce annually is less than the number of CRNA's who are retiring annually, so there's going to be a shortage for the foreseeable future. That translates into increasing salaries and better benefits as more and more anesthesia groups and hospitals compete for a shrinking number of CRNA's. In 1999, Newman University opened an anesthesia program, then I read a rumor here on the BB of another school opening soon. That's two schools in five years. Now, consider that the population of the US is aging, and as baby boomers reach later middle age, more and more people are seeking health care for chronic problems. As a result, the number of surgeries being performed is also rising. All these facts combine to mean that trends are not likely to change in the near future.

Though I am less familiar with the medical side of anesthesia, I believe that same facts hold true for MDA's. Unfortunately, there isn't as much "up" left for MDA salaries, since top end salaries are dictated by how much revenue can be generated through billing.

The last figures I read said that the average anesthesia provider, CRNA or MDA, working full time (40 hours a week) can expect to be able to bill about $200,000 to $250,000 annually. (If someone out there has newer figures, please jump in.) CRNA's are aware of these figures, and are demanding (and getting) higher salaries from anesthesia groups and hospitals. When I started in anesthesia school (I was in Newman University's first class), anesthesia groups in Wichita were offering new grads $75,000 to $90,000 per year. When I finished anesthesia school, the starting salary had risen to $90,000 to $100,000.

If you go to any one of a hundred different sites now that are trying to recruit CRNA's, you will find it is not uncommon in some areas (there are regional differences) to offer new grads $125,000, and $150,000 to $175,000 positions are becoming increasingly common. There are even some places out there offering as much as $200,000 a year for a CRNA with some experience. And remember that none of these figures I've quoted include benefits, which are usually quite substantial.

There are a couple of kinks that could change some of this. Currently, the American Society of Anesthesiologists is pushing the expansion of Anesthesia Assistants, essentially a PA trained specifically to do anesthesia. The last time I checked, AA's were only allowed to practice in two states. However, if the ASA gets their way, this will expand, and more AA programs will start to crop up around the country. AA's are paid less than CRNA's, therefore there may be a downturn in CRNA salaries at the larger hospitals. More CRNA's will look to practice in more rural areas, and market forces being what there are, as supply begins to approach demand, CRNA salaries in rural communities could go down. However, even if the ASA fully gets what it wants, the impact from AA's probably won't be felt for at least 10 - 15 years. And the AANA is actively working to discourage states from allowing AA's to practice. (For the purposes of this reply, I'm staying away from the political fight.)

Another kink is what hospitals are willing to do to keep anesthesia. With the shortage, it is becoming imperative for hospitals to keep a good anesthesia staff. There are cases where MDA or CRNA salaries are being supplemented by hospitals, since surgery is the one place most hospitals can actually count on turning a profit. No anesthesia, no surgery. No surgery to some rural hospitals means closing the doors.

Kevin McHugh