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'PA anesthetist'?

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by HillaryC HillaryC, RN, CRNA (Member) Member

HillaryC is a RN, CRNA and specializes in Adult SICU; open heart recovery.

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My patient's daughter the other day said "my daughter's an anesthetist." So I say, "oh, a nurse anesthetist?" and she replies, "no, a PA anesthetist." I'm pretty sure there's no such thing and this woman just had the title a little confused, but she insisted her daughter was a "PAA". She said her daughter went to Emory so I'm assuming she's an AA, and maybe was a PA-C before going to AA school? I just thought the whole thing was curious, as this woman seemed insistent that PA anesthetist was her daughter's title. She then said "the CRNAs hated the AAs in her practice", not knowing of course that I am about to start NA school. I just replied that I think a lot of the disagreements among the different types of anesthesia providers are probably blown out of proportion. I am not trying to start any fights here; I was just curious if anyone else had heard this term.

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My patient's daughter the other day said "my daughter's an anesthetist." So I say, "oh, a nurse anesthetist?" and she replies, "no, a PA anesthetist." I'm pretty sure there's no such thing and this woman just had the title a little confused, but she insisted her daughter was a "PAA". She said her daughter went to Emory so I'm assuming she's an AA, and maybe was a PA-C before going to AA school? I just thought the whole thing was curious, as this woman seemed insistent that PA anesthetist was her daughter's title. She then said "the CRNAs hated the AAs in her practice", not knowing of course that I am about to start NA school. I just replied that I think a lot of the disagreements among the different types of anesthesia providers are probably blown out of proportion. I am not trying to start any fights here; I was just curious if anyone else had heard this term.

There are a few PAs doing anesthesia. Most of these were trained before the anesthesia assistant existed. Other jobs in anesthesia include pre and post op assessment as well as critical care management. Some also work in pain management (although there is a seperate PA specialty organization for that). In states that license AAs they usually do not allow PAs to provide anesthesia. There are around 100 PAs that identify themselves as working in anesthesia. I would guess that the ones that actually do anesthesia is less than 20.

Here is there website (although I will have to say I don't agree with everything that is on it):

http://www.paanesthesiaworld.us/

David Carpenter, PA-C

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jwk has 32 years experience.

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My patient's daughter the other day said "my daughter's an anesthetist." So I say, "oh, a nurse anesthetist?" and she replies, "no, a PA anesthetist." I'm pretty sure there's no such thing and this woman just had the title a little confused, but she insisted her daughter was a "PAA". She said her daughter went to Emory so I'm assuming she's an AA, and maybe was a PA-C before going to AA school? I just thought the whole thing was curious, as this woman seemed insistent that PA anesthetist was her daughter's title. She then said "the CRNAs hated the AAs in her practice", not knowing of course that I am about to start NA school. I just replied that I think a lot of the disagreements among the different types of anesthesia providers are probably blown out of proportion. I am not trying to start any fights here; I was just curious if anyone else had heard this term.

Emory indeed has an AA program. Due to the way the PA laws are written in Georgia, AA's there hold a PA license, but one that is restricted to the practice of anesthesiology only. The original concept of a PA about 40 years ago actually had a delineation between general practice (type A) and specialty practice (type B) PA's. Georgia was one of the first states to have PA laws, and went forward with this concept in mind.

Although there are a tiny number of PA's administering anesthesia, they cannot bill or be reimbursed for their services. The only recognized anesthesia providers are anesthesiologists, CRNA's, and AA's. The article that David linked to above talks about PA's giving sedation for endoscopy. I'm guessing that is perfectly legal, but it can't be billed as an anesthesia charge - it would have to be billed similarly to nurse-provided sedation as is often done in GI clinics, etc.

As far as CRNA's hating the the AA's in her practice - That's rarely the case except when AA's first start in a practice. And for all the threats that CRNA's make that they'll quit if a practice hires AA's, they rarely if ever actually leave.

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When a rn provides moderate sedation it is billed as anesthesia provided by surgeon. In the cpt codes this year there is a new set of codes that are for sedation provided my physician other than operating provider. With this I thin that a PA or NP could bill for providing sedation rather than anesthesia.Jeremy

Emory indeed has an AA program. Due to the way the PA laws are written in Georgia, AA's there hold a PA license, but one that is restricted to the practice of anesthesiology only. The original concept of a PA about 40 years ago actually had a delineation between general practice (type A) and specialty practice (type B) PA's. Georgia was one of the first states to have PA laws, and went forward with this concept in mind.

Although there are a tiny number of PA's administering anesthesia, they cannot bill or be reimbursed for their services. The only recognized anesthesia providers are anesthesiologists, CRNA's, and AA's. The article that David linked to above talks about PA's giving sedation for endoscopy. I'm guessing that is perfectly legal, but it can't be billed as an anesthesia charge - it would have to be billed similarly to nurse-provided sedation as is often done in GI clinics, etc.

As far as CRNA's hating the the AA's in her practice - That's rarely the case except when AA's first start in a practice. And for all the threats that CRNA's make that they'll quit if a practice hires AA's, they rarely if ever actually leave.

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deepz specializes in Anesthesia.

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....... for all the threats that CRNA's make that they'll quit if a practice hires AA's, they rarely if ever actually leave.

Q -- how many CRNAs still work at the UNM Hospital in ABQ after faculty hard-core A$A types brought in AAs?

A -- They left.

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jwk has 32 years experience.

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Q -- how many CRNAs still work at the UNM Hospital in ABQ after faculty hard-core A$A types brought in AAs?

A -- They left.

And who got hurt with that? Isn't that a classic "cutting off your nose to spite your face" kind of thing?

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Q -- how many CRNAs still work at the UNM Hospital in ABQ after faculty hard-core A$A types brought in AAs?

A -- They left.

Actually I'm kind of confused. Who left, the CRNAs, the AAs, or the Anesthesiologists?

David Carpenter, PA-C

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deepz specializes in Anesthesia.

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And who got hurt with that?.......

Of course, the answer is: quality of patient care was hurt.

!

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jwk has 32 years experience.

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Of course, the answer is: quality of patient care was hurt.

!

Really? Explain.

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Ventjock has 11 years experience and specializes in ECMO.

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Of course, the answer is: quality of patient care was hurt.

!

b/c CRNAs left and there was a shortage of providers?

or b/c AAs are less qualified?

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deepz specializes in Anesthesia.

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b/c CRNAs left and there was a shortage of providers?

or b/c AAs are less qualified?

b

d

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thezman has 18 years experience and specializes in Anesthesia.

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There are two fully qualified anesthesia provider types accross the entire spectrum of clinical anesthesia delivery, CRNAs and Anesthesiologists. AAs by design and legislative mandates are fully dependent on anesthesiologist supervision. In many areas of the US CRNAs are autonomous providers that work in cooperation with their sugeon colleagues without anesthesiologist involvement of any sort. This includes full service pain services including interventional and implantables.

Contary to the propagana espoused by many in organized medicine there is no federal standard of care that requires anesthesiologist supervision of CRNAs. All there is a CMS regulation pertaining to billing Medicare! To date I believe 12 or so states have opted out of this requirement. Hopefully the remaining 38 will follow.

Best,

Art

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