GASping

Actually, I don't understand all the details to the Medicare mess that exists right now. BUT, if we all the did the same cases, meaning just Medicare, we would all actually earn pretty much the same. The difference would be negligible. Surprised. Why do anesthesiologists make more? Hospital subsidy. Why do CRNAs make more than regular nurses? Hospital subsidy. Gas overall makes nothing compared to cardiology from public funding. Surprised again. We are paid well FOR NOW because we keep ORs running, and ORs are a great revenue for hospitals in terms of facility billing. We are in demand FOR NOW. It will change within 10 years. Gas will be worth nothing and all the MDs and RNs will not go through the training. The problem overall is Medicare/Aid. They have systematically F'ed all healthcare providers. We are at their mercy. Message of the day: If you are thinking of investing in healthcare training (med school, nursing school, whatever), the debt and training time may not be worth it later on. Start paying that debt NOW. And eBear, you sound like one of the "over-confidents." I hope you don't carry that attitude around work where probably behind your back, they are talking about how charming your personality is. Or do you bow to surgeons and then vent here? You must be that nurse who flogs interns because somehow that makes you feel better about yourself. and

Hi, I'm one of those non-all mighty MDs. A lot of people here seem to think that CRNAs and MDs are equal. Agree in the matter of technical aspects. I however could even teach a high school kid how to intubate. So this point has no need to be addressed for claims of superiority. But there is more to that in gas. When to do what requires good old critical thinking. Critical thinking about someone's disease is something that is not emphasized as much in nursing school based on my sis; however, I agree the whole patient comfort thing is emphasized. As much as people disregard the extra training, it does help in the way you approach things. I could never imagine being a resident without ever being a 3rd year medical student who could never imagine not knowing basic physiology and anatomy in the first 2 years. Everything does build. Other few myths to fix up here that shouldn't be spread. First, dentists were the first ones to give anesthesia. Not doctors, not nurses. Second, anesthesia specialty amongst physicians was formed more or less in the 1950s. Anesthesia made a lot of gains in patient safety by doing the research clinically and non-clinically. Who spearheaded that mostly in 70-80s? MDs, which is why anesthesia has become safer today. CRNAs cannot take whole credit in shaping anesthesia. And MD contribution cannot be ignored b/c I had an attending who had to watch out for things blowing up in the OR 35 years ago; that's not the case now. Third, everyone works with jerks. I work with jerk surgeons and also nice ones. I don't label them all as bad. I don't label all CRNAs as lazy and stupid because the ones that I know do 7-3 shifts and need to go home after that (shift mentality vs. pickup extra slack) or are in a heart case and just don't get it why we have to watch out for certain things ahead of time. It's personality. Please join a group that cares about that. Even junior docs have to deal with the "stiffing" from the senior ones. I personally don't mind CRNAs. I however do mind the conflict that is arising in this field as well as others because it doesn't help any of us. I only envision the following for gas: in-fighting MD vs CRNA will only lead to lesser gains down the road. I also see why hospitals are getting involved in this too. It gives them leverage to order around nurses versus docs so right now they will let this keep going until they can essentially enslave their gas departments. It actually hurts long-term. An odd truth: higher MD salaries/reimbursement do translate into better CRNA salaries from a strictly political purpose. If they think MD gas is not important, they won't find CRNA gas to be important as well. We both go down together. The strive for a so-called independence will not make a CRNA necessarily independent from the system. HMOs, PPOs, WashDC still run the show. Then, the RVU for gas will decrease and reimbursement goes down. If you are a good CRNA who is willing to do the work and be part of the team, I'm coool with that. Nurses who constantly think that should be granted the power of doctor needing to fulfill their ego or doctors who think nurses can't be part of the team just don't work. It doesn't work in internal medicine, gastro, cardio, etc. No one in a good setting likes these attitudes. By the way, I work with CRNAs just fine. They do the bread and butter that I don't care to do. And I actually show up to see what's going on. I'm not playing Tetris on my computer. I'm managing the ORs. If I'm not in one room, doesn't mean I get to sit around because I have to make sure the rooms keep going. Or Dr. Ortho will throw a fit. Somehow, there is a common misperception that I don't earn my living.

Why are CRNAs so much up in arms about AAs? I assume the same reason anesthesiologists don't like CRNAs. I am not convinced with the type of arguments being made by both sides since really either side can't claim superiority or equality in patient care without any real studies. I think everything is on an individual basis. For example, I have seen a CRNA do a great job taking care of patients, but at the same time, I have seen an anesthesiologist figure out things that the CRNA had never seen before. So, I assume that both have their role in different situations. I just wish that CRNAs wouldn't try to move toward being independent so hastily because I see this as shooting yourself in the foot. Who is going to pay our malpractice or liability? I assume we will be forced into this position sooner or later. Having docs around to fork that part of bill is kind of nice. I don't see how all this will help in the end. I just don't believe Democrats will be looking out for all of us since they will just try to make us work harder in the end. Universal health care doesn't help nurses either. Politicians will find a way to abuse us too. Docs are not the only ones who shouldn't be worried. These politicians are just coaxing us for now to only turn their backs on us. Look at England. They are just starting to think of paying nurses more, especially working in more dense populated settings. Just my 2 cents.