TEXAS CRNA's Call to action. Stop the potential AA bill!

jwk · Mar 24, 2007

I don't think salary parity is reality. The average AA makes 90-95K after graduation while the average CRNA in these venues makes 50% more.

I'm not sure how you came up with this statement. Your estimate is low to begin with, and in practices that utilize both AA's and CRNA's, the compensation packages are identical.

Outdoor1 · Mar 24, 2007

There is a bottom line to this whole discussion. There are a million small points to argue back and forth we could go on forever. The point is....AA's are a threat to CRNA's. As so many have pointed out they can take our jobs. Will AA's decrease patient safety....not necessarily. Will they increase Physician control over anesthesia.....most definitely! This is the whole point. Ever since the position of Anesthesiologist was invented these docs have been trying to take anesthesia from nurse anesthetists. Is a CRNA not wanting AA's around similar to MD's not wanting CRNA's to exist....somewhat. The only difference is that CRNA's were delivering anesthesia before Anesthesiologists. Has patient safety improved because the almighty doctor has become involved in anesthesia? I believe it has, not because they are actually administering the anesthetics, but they have had the power to do so much more research than CRNA's. And let's not forget the contribution of science to the safety of anesthesia. Anesthesia has evolved so much in development of new and safer drugs. Just think about that for a minute. No matter what differences of opinion we all post here the AA bill is only a push for physicians to have more MONEY & POWER. Anyone who cannot see that is blind. I am sure even the AA's realize this....buy why would they care. They are controlled by medicine already.

To all the nurses on this site who are even somewhat sympathetic to this situation....you are exactly what is wrong with nursing. As Yoga put it....this "can't we just all get along mentality" is not going to work. Until you are a CRNA or in some type of advanced practice you will NEVER understand. The one difference about regular nursing and advanced practice as a CRNA is a bond. As a new grad nurse other nurses try to eat you alive and show off how little you know as a new grad. As a CRNA student....don't get me wrong you definitely have to prove yourself, but it's more like welcome to the club, we'll stand behind you. This is why nurse anesthetists have survived the attacks of the A$A for so many years. We have learned that we are stronger together, than individually trying to show eachother up.

If you have not already emailed your senator and representative about this issue please take the 5 minutes that it takes to do so. Here is the link. It's very easy. http://www.txana.org

Go to voter voice in the bottom right hand corner. Please don't think your voice doesn't count. Already thousands of emails in support of CRNA's have been sent in Texas!

jwk · Mar 25, 2007

There is a bottom line to this whole discussion. There are a million small points to argue back and forth we could go on forever. The point is....AA's are a threat to CRNA's. As so many have pointed out they can take our jobs. Will AA's decrease patient safety....not necessarily. Will they increase Physician control over anesthesia.....most definitely! This is the whole point. Ever since the position of Anesthesiologist was invented these docs have been trying to take anesthesia from nurse anesthetists. Is a CRNA not wanting AA's around similar to MD's not wanting CRNA's to exist....somewhat. The only difference is that CRNA's were delivering anesthesia before Anesthesiologists. Has patient safety improved because the almighty doctor has become involved in anesthesia? I believe it has, not because they are actually administering the anesthetics, but they have had the power to do so much more research than CRNA's. And let's not forget the contribution of science to the safety of anesthesia. Anesthesia has evolved so much in development of new and safer drugs. Just think about that for a minute. No matter what differences of opinion we all post here the AA bill is only a push for physicians to have more MONEY & POWER. Anyone who cannot see that is blind. I am sure even the AA's realize this....buy why would they care. They are controlled by medicine already.

It's not about control. The bottom line is money. Always has been - always will. Despite the thousands of job openings for anesthetists nationwide, both urban and rural, and despite the fact that the number of new anesthetists each year still doesn't keep up with attrition and expansion of services, CRNA's simply don't want to share with ANYONE. AA's are not out to take your jobs. There's plenty to go around. We've never tried to push CRNA's out of a state, a hospital, or a group practice. The majority of AA's work with CRNA's every day. You of course can't say the same.

Physicians, whether you like it or not, will always be at the top of the medical "food chain". Although we all have our little anecdotes about bad physicians and bad CRNA's and bad AA's, it really makes no difference. By and large, we all do an excellent job. The difference between AA's and CRNA's is that AA's have no illusions that we know all there is to know about anesthesia and medicine, that we are the be-all and end-all of anesthetic care. We recognize the breadth of knowledge and contributions that anesthesiologists bring to the table. We understand that even though we do excellent work, our 6 years of training, and your 6 years of training and a year in the ICU still don't equal the 12 or more years of a board-certified anesthesiologist. Unfortunately, many CRNA's think that they are the equal to physicians in everything but name only. Even those lines are attempting to be blurred to the general public, through such concepts as the DNP programs and the "Resident RNA" instead of an SRNA, as well as moving into areas outside the OR like chronic pain management (clearly never envisioned by the authors of Watchful Care).

I am so tired of hearing that nurses did anesthesia before physicians (despite the fact that neither Morton or Crawford Long were nurses). Even 500 years from now, you'll still be claiming nurses have been doing it longer. Who cares?!?!?!? Have you PERSONALLY been doing anesthesia for 100 years? NO! That's just propaganda - it means nothing. The same line of reasoning is applied to AA's - we've only been around about 36 years, so we'll always be behind CRNA's about 65 years or so, even in 2607.

Let your profession stand on it's own merits without cutting down mine in the process. Except for "they're taking our money", you really have no argument to stand on. Anything besides that is simply a lie.

TexasGas · Mar 25, 2007

Fantastic post, Outdoor.

n_g · Mar 26, 2007

It's not about control. The bottom line is money. Always has been - always will. Despite the thousands of job openings for anesthetists nationwide, both urban and rural, and despite the fact that the number of new anesthetists each year still doesn't keep up with attrition and expansion of services, CRNA's simply don't want to share with ANYONE. AA's are not out to take your jobs. There's plenty to go around. We've never tried to push CRNA's out of a state, a hospital, or a group practice. The majority of AA's work with CRNA's every day. You of course can't say the same.
Physicians, whether you like it or not, will always be at the top of the medical "food chain". Although we all have our little anecdotes about bad physicians and bad CRNA's and bad AA's, it really makes no difference. By and large, we all do an excellent job. The difference between AA's and CRNA's is that AA's have no illusions that we know all there is to know about anesthesia and medicine, that we are the be-all and end-all of anesthetic care. We recognize the breadth of knowledge and contributions that anesthesiologists bring to the table. We understand that even though we do excellent work, our 6 years of training, and your 6 years of training and a year in the ICU still don't equal the 12 or more years of a board-certified anesthesiologist. Unfortunately, many CRNA's think that they are the equal to physicians in everything but name only. Even those lines are attempting to be blurred to the general public, through such concepts as the DNP programs and the "Resident RNA" instead of an SRNA, as well as moving into areas outside the OR like chronic pain management (clearly never envisioned by the authors of Watchful Care).
I am so tired of hearing that nurses did anesthesia before physicians (despite the fact that neither Morton or Crawford Long were nurses). Even 500 years from now, you'll still be claiming nurses have been doing it longer. Who cares?!?!?!? Have you PERSONALLY been doing anesthesia for 100 years? NO! That's just propaganda - it means nothing. The same line of reasoning is applied to AA's - we've only been around about 36 years, so we'll always be behind CRNA's about 65 years or so, even in 2607.
Let your profession stand on it's own merits without cutting down mine in the process. Except for "they're taking our money", you really have no argument to stand on. Anything besides that is simply a lie.

Excellent post.

TexasGas · Mar 26, 2007

nurse god= not a nurse

Nitecap · Mar 27, 2007

It's not about control. The bottom line is money. Always has been - always will. Despite the thousands of job openings for anesthetists nationwide, both urban and rural, and despite the fact that the number of new anesthetists each year still doesn't keep up with attrition and expansion of services, CRNA's simply don't want to share with ANYONE. AA's are not out to take your jobs. There's plenty to go around. We've never tried to push CRNA's out of a state, a hospital, or a group practice. The majority of AA's work with CRNA's every day. You of course can't say the same.
Physicians, whether you like it or not, will always be at the top of the medical "food chain". Although we all have our little anecdotes about bad physicians and bad CRNA's and bad AA's, it really makes no difference. By and large, we all do an excellent job. The difference between AA's and CRNA's is that AA's have no illusions that we know all there is to know about anesthesia and medicine, that we are the be-all and end-all of anesthetic care. We recognize the breadth of knowledge and contributions that anesthesiologists bring to the table. We understand that even though we do excellent work, our 6 years of training, and your 6 years of training and a year in the ICU still don't equal the 12 or more years of a board-certified anesthesiologist. Unfortunately, many CRNA's think that they are the equal to physicians in everything but name only. Even those lines are attempting to be blurred to the general public, through such concepts as the DNP programs and the "Resident RNA" instead of an SRNA, as well as moving into areas outside the OR like chronic pain management (clearly never envisioned by the authors of Watchful Care).
I am so tired of hearing that nurses did anesthesia before physicians (despite the fact that neither Morton or Crawford Long were nurses). Even 500 years from now, you'll still be claiming nurses have been doing it longer. Who cares?!?!?!? Have you PERSONALLY been doing anesthesia for 100 years? NO! That's just propaganda - it means nothing. The same line of reasoning is applied to AA's - we've only been around about 36 years, so we'll always be behind CRNA's about 65 years or so, even in 2607.
JWK we really dont need a bunch of new grad AAs running around with education and phys ed. degrees putting people to sleep with only 12 months of patient care training. This is scary. Of course the statistics wont show this since they will always have a MD to bail them out. As AA programs proliferate they will follow the PA trend where the vast majority have no experience in the patient care arena what so ever. This may be Ok for a PA that starts out slow in a clinic or working in an office. But anethesia is different. If you think that that AAs can go from just understaning the very basic concepts of patient care such as taking and interpreting vital signs to managing a complex anesthetic you are way biases. I witnessed these inexperienced PAs myself at the CRNA program I graduated from. The first day they learned to take vitals and assess the patient was a joke. From not knowing how to assess breath sounds then 24 months later aministering anesthetics. Of course this is a money issue created by the ASA (which you belong to) to control the entire market. Its not about access or safety. Its about anesthesiologists wanting the control the market. Believe me you are in for the political battle of your life.
For all CRNAs and SRNAs out there it should be your duty to explain to your family and friends the lack of actual hands on pt care that most AAs really have. Let them know the difference between the 2 professions and how they can not serve shortage prone areas like CRNAs can. Ask them to not support the proliferation of AAs. Why dump money and time into something that will take decades to build up. About 2,000 new CRNAs a produced a year at present. It will take at least 10yrs or more for the AAAA to produce this amount of AAs while CRNA programs can meet market demand faster. JWK I do believe you are prob one of the great AAs out there, however your entire profession is a ploy by the ASA to obtain market dominance. That is greed my friend, and I will recruit all I can to fight this attempted monopolization of anesthesia care.

n_g · Mar 27, 2007

New AA's, like new CRNA's, need supervision. That is indisputable. After 3 years, is there a difference between an AA and a CRNA? Nope. The reason why CRNA vs MD studies show no difference is because the CRNA's had an MD to bail them out when they get into trouble. It would be unethical to compare CRNA with no MD supervision at all vs MD. When the CRNA gets into trouble, are you gonna let the patient die? Very experienced CRNA's get into less trouble than a freshly minted CRNA.

gasmaster · Mar 27, 2007

WHY SB 1314 AND HB 3313 ARE BAD PUBLIC POLICY
THIS IS A SCOPE OF PRACTICE FIGHT!
FACTS:
With insufficient funds for critical needs in the state, why create a licensure advisory board and licensure process for fewer than 20 people in Texas?
The Texas Medical Board (TMB) already has a backlog of over 2500 applications from badly needed physicians who cannot get licensed in Texas because TMB does not have adequate staff. The problem is so severe that TMB is receiving a supplemental appropriation to begin to address the backlog.
Anesthesiologists Assistants (AAs) do not improve access to anesthesia services because AAs can only work under the supervision of a board certified Anesthesiologist.
Anesthesiologists practice in only 70 Texas counties and one-fourth are NOT board certified.
Once licensure occurs, the next move will be to start an AA school that will drain money away from the existing anesthesiology and nurse anesthetists educational programs.
This legislation increases liability of the supervising Anesthesiologist in all cases and the health care facility if it employs an AA.
This is a pocket book issue. Anesthesiologists can make twice as much supervising 4 providers than they can actually providing care to a patient.
Passage of SB 1314 and HB 3313 WILL effect YOU!
Action Required:
Call, write, e-mail or visit your State Senator
Call, write, e-mail or visit your State Representative
Ask your friends, family and co-workers to call, write, e-mail or visit their legislators, and
Visit your legislator at the Capitol in Austin or in their district office to voice your displeasure on SB 1314 and HB 3313.
Texas must focus on accessible, affordable, high quality health care by Anesthesiologists and Certified Registered Nurse Anesthetists.

Here is my fear....if you go to gas forums yo will find that the MD's are pushing for the AA program to get rid of CRNA's. They think CRNA's will cause reimbursement to become RN instead of MD driven & lower their salaries. They think that CRNA's are evil. I just applied for a CRNA program & hope I get in so I can join the fight against the AA's. :monkeydance:

urgewrx · Mar 28, 2007

They think CRNA's will cause reimbursement to become RN instead of MD driven & lower their salaries.

If anesthesia is viewed as nursing, of course thay are going to pay you like a nurse. All the private insurers would love to cut payments. The nursing issue is a big excuse for them. It does not make sense that a CRNA is making more money than the surgeon she is working with.

core0 · Mar 28, 2007

Here is my fear....if you go to gas forums yo will find that the MD's are pushing for the AA program to get rid of CRNA's. They think CRNA's will cause reimbursement to become RN instead of MD driven & lower their salaries. They think that CRNA's are evil. I just applied for a CRNA program & hope I get in so I can join the fight against the AA's. :monkeydance:

Actually if you read the SDN forums this is a direct response to opt out states and moves for independence by CRNA's. This is probably a case where winning the fight will cause the war to be lost.

David Carpenter, PA-C

jwk · Mar 28, 2007

I just applied for a CRNA program & hope I get in so I can join the fight against the AA's. :monkeydance:

And I thought most CRNA's were interested in taking care of their patients. You really have your priorities out of whack.