More Fights between CRNA's and AA's?

deepz · Jan 9, 2004

Lizz, if I understand correctly, there have been only 800 graduates of the two AA programs in thirty years and fewer than 600 remain in active practice today. Compared to 31,000 CRNAs nationwide these AA handmaidens of the A$A don't appear to me to pose a great threat.

Fuggidaboudit.

deepz

Sheri257 · Jan 9, 2004

Originally posted by deepz
Lizz, if I understand correctly, there have been only 800 graduates of the two AA programs in thirty years and fewer than 600 remain in active practice today. Compared to 31,000 CRNAs nationwide these AA handmaidens of the A$A don't appear to me to pose a great threat.

Fuggidaboudit.

deepz

I understand. I just can't figure out why the physicians are pushing for this. Are there plans for additional AA schools perhaps? Or is there some other "training" mechanism in the works?

Certainly they wouldn't go to all of this trouble with the DC government, VA etc. for nothing. Would they?

I'm not disputing what you're saying. I'm just trying to understand what's going on here.

hbscott · Jan 9, 2004

Liz,

I certainly have seen more friction in the past few years between MDA's and CRNA's (over pretty stupid stuff if you ask me). Nonethless AA's are getting attention again but it remains to be seen if this is short lived or a long term trend.

https://allnurses.com/t53691.html

-HBS

CRNA, DNSc · Jan 9, 2004

It's all about control. AA's MUST practice under the direct supervision of an Anesthesiologist- therefore they are completely under the control of the Anesthesiologist. Think about the issue in the VA and military systems, the AA's can only work where there is an Anesthesiologist- CRNAs don't "require" the presence of an Anesthesiologist to practice. So which type provider is more deployable?????? The thought is (from the medical profession) if we can't control the CRNAs lets push another provider we have complete control over (under the guise of being trained in the "Medical Model" and therefore "better prepared").

Headhurt, ADN · Jan 9, 2004

At the risk of sounding like a dork...

What's an AA??

CRNA, DNSc · Jan 9, 2004

Anesthesiologist Assistant

Sheri257 · Jan 9, 2004

I understand why the Doc's are pushing AA's. They're obviously putting a lot of resources into getting AA's approved by the states and the feds.

But with only two schools, HOW are they going to accomplish this? Is the first step getting the regulatory authority in place so that the state schools will come on board and launch more AA programs, perhaps?

I don't know much about the history of PA's, but they seem to be more common now. I wonder if this is a comparable example of how AA's might become more common as well.

swumpgas · May 6, 2004

I understand why the Doc's are pushing AA's. They're obviously putting a lot of resources into getting AA's approved by the states and the feds.
But with only two schools, HOW are they going to accomplish this? Is the first step getting the regulatory authority in place so that the state schools will come on board and launch more AA programs, perhaps?
I don't know much about the history of PA's, but they seem to be more common now. I wonder if this is a comparable example of how AA's might become more common as well.

There are definitely moves afoot, snuck into legisation by ASA minions to begin AA training programs in other states. Many have been shot down..

Also surreptitious attemptst to introduce AA's into the VA healthcare system. Now a given of the VA healthcare system is that a practitioner licensed in any state may work in any VA hospital anywhere.. This is an attempt to get AA's working in VA Hospitals even in states that do not allow the practice of AA's as well as adding to the cost of VA healthcare by requireng that an MDA be present to supervise the AA when providing anesthesia.

PA's (Physician Assistants) came into being initially in the 60's as an attempt to use the skills of medics and corpsmen trained in the military. By using them informally, then formally, the PA came into being, with sub specialties, Ortho, Medicine, Surgery, etc.

there is no aneshtesia counterpart of the Medic/corpsman to be incorporated into the roll as a PA. That roll has traditionally been filled by well trained CRNA's in times of war. The Military schools of anesthesia are excellent.

The web site for the AA's goes into some detail

http://anesthesiology.emory.edu/PA_Program/whatis.html

if you read betwqeen the lines of Emory's own web site, you should be able to see the "Hems and Haws" as the difference between classs A Practitioner (PA) and class B praxctitioner (AA)

Here is a quote from the Emory web site: describing AA's

"Because his knowledge and skill are limited to a particular specialty, he is less qualified for independent action."

the Original PA's will not even accept AA's as PA's.

http://www.aapa.org/

The duties of the PA and the Advanced Nurse practitioner more overlap, with prescriptive authority being given to both under varying circumstances , state by state.

again, it's a matter of background training of the individual.

The web of deception is a tangled one, with legislation being made under the sheets, on the golf course, at cocktail or fundraising parties, etc. Sometimes we are lucky in rooting it out, sometimes some slip by.

CRNAS are traditionally doing the workload while MDA's who are being paid to "Supervise" may be out on the golf course, wheeling and dealing with legislators.

CougRN · May 6, 2004

Now I read that the U of Florida is planning on starting an AA program too. So it seems that the ASA is trying to get more programs out there so that they can put out more AA's. I haven't heard of other programs looking for accreditation though.

RN_Amy, RN · May 6, 2004

Please excuse my ignorance but it seems that there are too many health professionals trying to do other peoples' jobs.... here in Australia, CRNA's, PA's and AA's dont exist....

Does anyone have any statistics research on intra- and post-operative complications versus the education level/designation of the anaesthesia provider?

Amy.

athomas91 · May 6, 2004

RNamy - Nurses - CRNA's were the first to provide anesthesia...they trained "doctors" to help them...when the ASA found it could be profitable...they had anesthesiologists take over...the ASA is a very wealthy, very high powered troup...so you see how the struggle began..and how it continues...