The Lazy, Lackadaisical MDAs

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In what clinical setting, do you see MDAs administering the anesthesia, sitting alongside the patient monitoring him or her during the case?

I've shadowed in 6 hospitals and 1 surgery center and not once have I seen an MDA doing the case in the OR, always the CRNA. Is Florida just wacky like that? Where must I go to see the MDA doing the case?

Thanks

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Specializes in ICU, SICU, Burns, ED, Cath lab, and EMS.

I work in Seattle at a teaching hospital. I see MDAs providing anesthesia to individual TAVR and EP patients(EP as break for CRNA).

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Specializes in OR, Nursing Professional Development.

Very much going to vary by facility. Mine requires MDAs for all heart surgeries, AAAs, and other complicated surgeries. I wouldn't call the circulating anesthesiologists (those who are carrying a phone and are in the OR during induction and emergence alongside the CRNA) lazy- there is a lot going on behind the scenes. They may also be responsible for pain rounds (consulting on patients with unrelieved pain regardless of medications given or other interventions tried), rounding on patients on the floors who have epidurals, starting invasive lines, starting epidurals, doing blood patches, seeing patients prior to surgery (either for consent right before or as a consult a few days before due to history of difficult airway or other factors affecting anesthesia plan of care), rounding on patients in PACU to determine who is ready for discharge to the floor or postop area, running offsite locations (MRI, imaging areas, etc.), responding to traumas, responding to codes, the list goes on.

Your profile lists you as a pre-nursing student. I would strongly advise not going into any work situation with the preconceived notion that any medical/nursing/other professional is lazy based on their credentials. Your experience as a nursing student will be eye-opening, and your first nursing position will be even more eye-opening.

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You're right, lazy wasn't the best word to use. Rather I feel some are unworthy of such high compensations relative to their counterparts, that's all.

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Specializes in Reproductive & Public Health.

I don't think you will find much support from the APRNs here for such a dismissive attitude about our physician colleagues.

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Specializes in ICU, SICU, Burns, ED, Cath lab, and EMS.

Not to defend them, but after 4yr of undergrad, 4 yrs of medical school, and 4 yrs of residence, they deserve high compensation.

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Specializes in Anesthesia.

What you are seeing is the product of how anesthesia billing is done. It is more profitable for anesthesiologists to "supervise" than it is for him or her to actually do the case. An MDA will "supervise" up to 4 CRNAs and be paid 50% for each case essentially allowing an MDA to double what they could make by doing their own case.

Florida and Pennsylvania are both oversaturated with CRNA schools. You are always going to see more ACT practices where there is an oversaturation of NA schools and in more "desirable" areas to live in. It also helps to understand that anesthesia practices almost always are owned by MDAs.

CRNAs that work in restrictive ACT practices are often bitter about the way they are treated, but you should take that into perspective and not condemn all anesthesiologists right off the bat. You should just need to realize that you don't want in that kind of environment when and if you become a CRNA.

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Skip, my point is not whether MDAs deserve high compensation. Of course they do.

But if i'm supervising you to mow several thousand lawns, shouldn't we be getting paid equally?

If the national annual income averages for the two professions was off by $50,000, I wouldn't be having this conversion, but it's not, it's off by $150,000. Compensation should correlate with contribution. The majority of MDAs aren't working twice as hard, it's just the doctor title that entitles them to more, supposedly.

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Specializes in ICU, SICU, Burns, ED, Cath lab, and EMS.

What about a CEO of hospital? They don't work very hard and make 2-3x what MDAs make?

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I know some choose to practice independently without the ACT but why do others need to be supervised in the first place?

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"Pre-nursing" and you're worried about CRNA vs MD compensation? Seriously?

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But we have no person to compare the CEO to, he is at the top all by himself, rightfully so. CRNAs and MDAs perform the same function, more or less. Not sure why you are defending MDAs so strongly.

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