re: Wisconsin Hospital Replaces All Anesthesiologists with CRNAs

Yeah this thread did make me realize it’s a sounds good doesn’t work issue.

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Yes they will. CRNA's have to be supervised by a licensed physician. In most cases, they would be the only physician to supervise. Malpractice insurance rates are reflecting this risk

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I had a surgeon tell me specifically that his rates were no more higher working with an all CRNA practice. Insurance companies assess risk and when no higher premium is paid, no extra risk exist. Risk Management at Lammico responded to a surgeon who was concerned about this by saying “in a CRNA malpractice case, the CRNA would assume responsibility and MD would be brought in but not found Liable”

My whole point to this training and number of hours of training doesn’t always equate to quality of care or skill provided. The physician community, specifically where it relates to CRNA’s, tend to use fear tactics to scare the public. Especially when a case is done without one present or when a facility opts to go all CRNA, like in the original headline.

Heck, if training and number of hours represented skill and competency, why do we have doctors or situations like Dr. Death out of Dallas. This guy was apparently well trained with many hours of clinical experience.

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You actually make the case by which it’s ridiculous. Surgeons don’t have any clue about how to provide anesthesia, so why should we bound to be supervised by them?

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It seems like an argument for limiting the scope of CRNAs, cross-training surgeons, or requiring direct supervision by a board-certified doctor.

The implicit argument is that anesthesiologists seem to be pointless and overpaid, and that anesthesiologists should take back some of the responsibilities that were delegated to nurses, rather than giving nurses independence. It seems insane given that the history of anesthesiologists establishing patterns of care that became so well-practiced that they could delegate roles to what amounts to vocational technicians works against them, and serves as an argument for relinquishing their own role, despite the far better training and their own expertise. There's a logical conclusion from this, but I don't think CRNA's or any technician would want to hear.

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Heck, if training and number of hours represented skill and competency, why do we have doctors or situations like Dr. Death out of Dallas

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You keep making very bad arguments that work against you. Dr. Death was a cokehead who represented institutional failure, as he had less than 100 surgeries to his name by the time he graduated. Avoiding his situation is a direct argument why we should make standards more stringent, not less.

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Other than the length of residency, Please enlighten me on what specific training in anesthesia do you believe is different in the training of a CRNA vs an anesthesiologist? I am referring to anesthesia and not ICU critical care training, by which, if you are, CRNA’s work and have experience in those areas too. Let me know what you think they have learned that I may have not. If you list it, I will respond to if I have been trained or schooled in the same thing

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Genuinely curious, did your curriculum ever cover the IOM's - To Err is Human, or the follow-up Crossing the Quality Chasm? And a follow-up, how much time was devoted during your training to interpreting medical literature?

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I don’t agree with what he posted cause that dude was psycho but damn you are arrogant

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I’m just sick and tired of hearing nurses claim they are on par with physicians when one of the top reasons they chose to go into NP/CRNA school is to get comparable pay with less years of training

8-9 years of training from a physician is light years ahead of CRNA training. Especially, regarding the depth of knowledge in physiology

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The implicit argument is that anesthesiologists seem to be pointless and overpaid, and that anesthesiologists should take back some of the responsibilities that were delegated to nurses, rather than giving nurses independence. It seems insane given that the history of anesthesiologists establishing patterns of care that became so well-practiced that they could delegate roles to what amounts to vocational technicians works against them, and serves as an argument for relinquishing their own role, despite the far better training and their own expertise. There's a logical conclusion from this, but I don't think CRNA's or any technician would want to hear.

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Bingo!!! For the most part, they created this environment by taking themselves out of the OR. Let’s all work to the full extent of our license. Let’s all do cases and have one or two people who float around and assist in areas where needed. That’s not the case because you can’t put the genie back in the bottle. The majority of them come out of practice and go directly into an ACT practice, where they supervise and don’t physically do the cases. So, rather than do what needs to be done, they push Anesthesia Assistant legislation. They get to create an anti trust competitive advantage that puts many CRNA’s out of jobs.

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Bottom line CRNAs are highly trained, anesthesiologists are the highest trained. Not sure what y’all are arguing about and why some of y’all are acting like CRNAs go to community college

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Well, if the scope of work has such overlap that CRNAs can do the 'same work' for less, that is an argument against physician oversight, for a specific position that would not exist if not for the fact that physicians originally delegated that role. If CRNAs, as highly trained as they are, are going to suggest they can be independent despite much less training, understanding, or general nous, that is a direct argument in taking away those responsibilities from nurses and keeping them with physicians, while at the same time expanding GME slots for interested students. If this becomes an actual problem, I would wager anesthesiologists would act in their self-interest, as they should. Given that some of these delegated positions exist primarily because of physicians, and thus do not have as much lobbying power, who do you think would win if it came to that?