'PA anesthetist'?

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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.

OP here. I was just wondering how this thread had devolved into yet another argument. All I wanted to know was if the term "PA anesthetist" is used much, as I'd never heard it before :)

Some states such as Georgia use the PA statues to license AA's. When I applied for my license I was given the choice between PA - primary care and PA - anesthesia.

There are also about 20-25 PAs that are practicing anesthesia. Most of these have been doing it for a very long time and were grandfathered in under state laws. Almost all of them practice in environments such as VA or Kaiser where billing is not an issue.

Here is a link:

http://www.paanesthesiaworld.us/

There are also about 2-300 PAs doing pain management under the direction of psyiatry or anesthesiology. There are also some PAs that work under anesthesia doing pre-op clearances and such. Hope this answers the OPs question from a PA perspective.

David Carpenter, PA-C

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I will chime in with what I know about the 'PA anesthetist'. It is true, Emory does have a PA anesthetist program, and my friend graduated in 2005. He works at an Atlanta hospital for a anesthesia group. Just last week I saw him at work, and asked if he was putting people to sleep today? He stated, "no, I'm working OB today doing epidurals." I don't know if that is part of the curriculum, didn't ask.

For those wanting to know about pay, he was making about 98 an hour, and just received raise. He receives OT for anything over eight hours in a day, not 40 per week. Like others have stated, he is not autonomous.

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I will chime in with what I know about the 'PA anesthetist'. It is true, Emory does have a PA anesthetist program, and my friend graduated in 2005. He works at an Atlanta hospital for a anesthesia group. Just last week I saw him at work, and asked if he was putting people to sleep today? He stated, "no, I'm working OB today doing epidurals." I don't know if that is part of the curriculum, didn't ask.

For those wanting to know about pay, he was making about 98 an hour, and just received raise. He receives OT for anything over eight hours in a day, not 40 per week. Like others have stated, he is not autonomous.

He is not a PA but an Anesthesia Assistant. Through a quirk in state law Georgia licenses AAs under the PA practice act. You apply for a PA license in either primary care or anesthesia. The certification and training are different and happen independent of each other. There is a PA to AA bridge program at Emory.

David Carpenter, PA-C

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Specializes in Adult SICU; open heart recovery.
He is not a PA but an Anesthesia Assistant. Through a quirk in state law Georgia licenses AAs under the PA practice act. You apply for a PA license in either primary care or anesthesia. The certification and training are different and happen independent of each other. There is a PA to AA bridge program at Emory.

David Carpenter, PA-C

Thank you! THAT is what I've been trying to understand! :nuke: For anyone else who's curious, I found the website for the Emory AA and PA-C to AA fast track (5 instead of 6 semesters) program:

http://www.emoryaaprogram.org/General%20Track/index.htm

So basically, they have two licenses -- PA-C and AA? Is there a difference in care between a 'PA anesthetist' from Emory's program and an AA from Emory's program? I'm guessing no. I guess I was just trying to figure out if there were now four types of anesthesia providers in the US, but it sounds like these people are functioning as AAs and not in some other unique role that requires the knowledge/skill set of a PA-C. Is this unique to Georgia? What about AAs in Georgia who are not PA-Cs? Do they get a PA-C license, or are they just licensed under the PA practice act?

So, David -- if someone's gone through a PA program and then the PA to AA bridge program, once they choose to have a PA anesthesia license, are they not allowed to also have a primary care license? That doesn't seem fair! Granted, once someone's gone through an entire AA program they're obviously pretty set on doing anesthesia for the rest of their careers, but I always thought one of the perks of being a PA-C was being qualified to work in any setting (especially if they move to a facility that doesn't utilize AAs). By the way, does the primary care license include PA-Cs who work in acute care? This is all so fascinating -- and a bit confusing!

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thank you! that is what i've been trying to understand! :nuke: for anyone else who's curious, i found the website for the emory aa and pa-c to aa fast track (5 instead of 6 semesters) program:

http://www.emoryaaprogram.org/general%20track/index.htm

so basically, they have two licenses -- pa-c and aa? is there a difference in care between a 'pa anesthetist' from emory's program and an aa from emory's program? i'm guessing no. i guess i was just trying to figure out if there were now four types of anesthesia providers in the us, but it sounds like these people are functioning as aas and not in some other unique role that requires the knowledge/skill set of a pa-c. is this unique to georgia? what about aas in georgia who are not pa-cs? do they get a pa-c license, or are they just licensed under the pa practice act?

as far as i know the "pa anesthetist" is the same as the anesthesiologist assistant. as i stated above there, are as far as the aapa knows, about 25-40 pas practicing anesthesia as a specialty. most of them work in organizations such as kaiser or the va where reimbursement is not an issue. this is also some confusion as this is self reported and some of these pas may be doing pain management or working for an anesthesia group outside of the or. there is no particular reason why a pa could not do anesthesia. as far as i know new york is the only state that prohibits pas from doing anesthesia.

aas in georgia do get a pa license but cannot function as pas. for reasons unknown to me georgia licenses aas as physician's assistants - anesthesia and pas (the one with pa-c) as physician's assistants - primary care. note that georgia is also the only state to put a grammatical error into statute.

so, david -- if someone's gone through a pa program and then the pa to aa bridge program, once they choose to have a pa anesthesia license, are they not allowed to also have a primary care license? that doesn't seem fair! granted, once someone's gone through an entire aa program they're obviously pretty set on doing anesthesia for the rest of their careers, but i always thought one of the perks of being a pa-c was being qualified to work in any setting (especially if they move to a facility that doesn't utilize aas). by the way, does the primary care license include pa-cs who work in acute care? this is all so fascinating -- and a bit confusing!

if you go through the bridge program you are licensed as a pa and aa. in georgia you would have a license under physician assistant - anesthesia and primary care. once again georgia uses the terminology "primary care" to mean anything that isn't anesthesia. i do liver transplant and my license say "primary care". i'm sure there must be a fascinating story behind the terminology and the grammatical error in the title, i just haven't heard what it is. i would also note that the aa/pa is responsible for meeting cme and recertification requirements for both professions.

i am not sure but one advantage for an aa/pa would be that they could do anesthesia in a state that does not have it in their practice act under the pa practice act. this would still allow them to bill under the aa. i would also allow the pa to work in areas outside the or under an anesthesiologist such as critical care medicine or pain medicine (which are well established in the pa world).

the pa model is very different from the aa or crna model. the pa is broadly trained in medicine and additional training and responsibility is between the supervising physician and the pa. usually the model allows for progressive responsibility and acuity as the physician and pa become more comfortable with pa knowledge of that particular area of medicine. the pa world is dead set against specialty training programs. there are an increasing number of post graduate specialty programs. within the realm of pa programs there are also certain programs that have a particular emphasis (for example surgery or pediatrics). however, every program must have a minimum didactic and clinical content that covers a broad range of medicine.

david carpenter, pa-c

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Specializes in Anesthesia.
.......I do liver transplant ......

Oh really?

!

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Care to be specific? Or are you just here to throw dirt?

?

Well if you remember, you said that the crna's all left UNM after they hired aa's. You also said that the quality of care went down.

Specifics:

http://hsc.unm.edu/anesthesiology/crnas.shtml

You will see that there are plenty of crna's on staff at UNM.

About the quality of care I don't know b/c I am not there but do you really know that it went down or are you speculating?

So I'm not throwing dirt. I am however, correcting inaccuracies.

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Specializes in Anesthesia.
.........

You will see that there are plenty of crna's on staff at UNM.

.......

That's now. You know nothing of who left UNM. I do.

You seem to have a lot of interest in supporting AAs.

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Oh really?

!

Umm Yeah thats where I work.

David Carpenter, PA-C

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Specializes in Anesthesia.

You, as a PA, 'do' transplants..........?

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Specializes in Pain Management.

I spoke with several CRNA's and anesthesiologists today about the new UMKC AA program. As expected, most of the CRNA's were initially negative in regards to the program, but after some questioning, their concerns were mostly from the gut rather than being based on reason. They were all glad that they were able to get the law in Missouri written in a manner than excludes them from teaching or supervising any AA's...which is understandable, especially if you felt like you were training your future replacement.

The anesthesiologists I spoke with thought the AA program would mean job security in the future, but in light of the existing anesthesia shortage coupled with the retirement of many CRNA's in the next two decades, they felt the impact of the new program won't be felt until they have all retired. I know that some of the anesthesiologists on SDF seem bound and determined to replace CRNA's with AA's, but that seems about as likely as Dubyah going down as one of the top 10 presidents in history.

On a side-note, I asked the CRNA I shadowed today if she felt working as a nurse [in the ICU] actually made her better at anesthesia. Her answer was no - doing anesthesia makes you better at anesthesia. The research comparing the M/M outcomes between CRNA's and AA's is limited, but it looks like so far it follows this line of reasoning.

She also felt a RT going to AA school would probably be a better provider initially than the average ICU nurse going to CRNA school [but after a few years of practice there would be little difference].

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That's now. You know nothing of who left UNM. I do.

You seem to have a lot of interest in supporting AAs.

Don't tell me you left UNM Z !
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