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Message
re: Wisconsin Hospital Replaces All Anesthesiologists with CRNAs
Posted on 4/7/21 at 11:49 am to Hangover Haven
Posted on 4/7/21 at 11:49 am to Hangover Haven
quote:
There maybe 3 Anesthesiologist on during a day of surgeries.. and one of those are probably in L&D..
Only downside to this is I've seen CRNA's scream for the anesthesiologist when the shite hits the fan...
Why do you think that is? CRNAs can provide adequate care in most anesthesia scenarios, but even they know who the experts in anesthesia are.
Y’all better get ready. The NP independent practice bill is going through the LA state legislature soon. And despite what the AANP (and some misguided posters here) says, NP care has not been shown to be equivalent to physician care. They order more unnecessary biopsies, make more unnecessary referrals, and prescribe more addictive narcotics. This all increases time, cost, and invasive procedures to the patient, and the health systems love it because it means $$$. That doctor may only spend 10 minutes with you but they bring expertise that no online degree NP who shadowed a doc for 500 hours could ever hope to match. Patients don’t realize this difference in quality of care though.
I can go to mechanic A and mechanic B and think they did the same job for my car, but since I know little about cars I can’t rightly judge the quality of their work.
1
Posted on 4/7/21 at 11:51 am to 1BamaRTR
quote:
The level of schooling, training, and certification required to become an NP is still significantly less compared to a physician.
I don't think anyone is denying that. But comparing a psych iatric NP vs a psychiatrist is just ignorant
Posted on 4/7/21 at 11:51 am to ProjectP2294
quote:
Which one has the ridiculously high suicide and drug addiction rate? Anesthesiologists or CRNAs?
The Trannys
Posted on 4/7/21 at 11:51 am to LSUfanNkaty
quote:
Those are completely different things/skill sets. WTF are you talking about.
This is the entire point of the thread, allowing lower level care providers to do the same job as higher level providers, can you read?
Posted on 4/7/21 at 11:51 am to Cs
Just ask my wife what they do at her hospital. She is a CT surgeon. She said a CV anesthesiologist will make the plan, be there for induction, come back to do the TEE if needed, and be there when they come off pump the rest of the time it is just a CRNA in the heart room. She pointed out a lot of her cases require an anesthesiologist since a CRNA can't do a TEE which is needed for a lot of heart surgeries.
Overall she has no issue with the proper use of the CRNAs it is just a fact in basically every hospital and procedure. The MDAs that want to overutilize them are a different story. Like most things, it is about proper balance and having the proper support when shite hits the fan. Like most things in life an OR is generally pretty straight forward and you are paying the big bucks in case things get far from straight forward.
Overall she has no issue with the proper use of the CRNAs it is just a fact in basically every hospital and procedure. The MDAs that want to overutilize them are a different story. Like most things, it is about proper balance and having the proper support when shite hits the fan. Like most things in life an OR is generally pretty straight forward and you are paying the big bucks in case things get far from straight forward.
Posted on 4/7/21 at 11:57 am to LSUfanNkaty
quote:
I don't think anyone is denying that. But comparing a psych iatric NP vs a psychiatrist is just ignorant
It is just one example. But the basic premise still applies. NPs can become NPs right after their BSN is finished. It is a 2 year program (quite a few programs are mostly online) with one major board exam. That’s it.
Meanwhile medical school is 4 years and cover significantly more content and have far more training. It’s also much harder to get into unlike many NP programs. It’s basically a full time job for the students. It features two main board exams, and is followed by residency which can be 3-4 years. For some people, there can also be several more years of for the fellowship.
That psych example applies to many fields. Not sure why you think it doesn’t.
Posted on 4/7/21 at 11:57 am to PropofolPapi
quote:
In regards to this Wisconsin Hospital’s decision, a CRNA’s salary is generally $170,000-200,000 versus $300,000-450,000 for an anesthesiologist. May have something to do with the decision.
Something?
Posted on 4/7/21 at 11:58 am to 1BamaRTR
quote:
It is a 2 year program (quite a few programs are mostly online) with one major board exam. That’s it.
This is incorrect. There are clinicals, etc.
Posted on 4/7/21 at 12:00 pm to Mid Iowa Tiger
quote:
Mid-level providers (NPs and PAs) are undoubtedly a critical part of the healthcare system
Agreed, and they function well when part of a physician-led team.
quote:
Agreed, but they require the sign off of a supervising doctor. What doctor is signing off for them? That is who is assuming the legal risk.
It depends on the state. In independent practice states, the nurse practitioner or PA assumes the risk. In non-independent practice states, the doctor assumes the legal risk.
What few people realize, however, is that while NPs claim equivalency and say they do the same thing as a doctor, they are not held to a physician standard in a court of law. This means doctors cannot testify against nurses. They also carry much less malpractice insurance, which means if an NP kills your family member you may be left with a pittance. Thankfully for patients, plaintiffs attorneys are starting to catch on to the poor standard of these practitioners and going after the healthcare systems that employ them.
This is all brushing over the fact that nurse practitioners practice medicine without a medical license. When the president of the AANP was questioned about this, she states “nurses don’t practice medicine, they practice healthcare.”
TL;DR: be careful what you wish for
Posted on 4/7/21 at 12:03 pm to Obtuse1
quote:
She said a CV anesthesiologist will make the plan, be there for induction, come back to do the TEE if needed, and be there when they come off pump the rest of the time it is just a CRNA in the heart room.
I think that’s what they do in our CV OR also. We have 5 CV surgical suites. The Anesthesiologist is there to set up the case and the CRNA monitors the patient during the case. The Anesthesiologist oversees the 5 OR’s and is there in case the CRNA in each room needs him for anything.
They don’t have an Anesthesiologist just sitting in each room for the entire case.
Posted on 4/7/21 at 12:04 pm to LSUfanNkaty
quote:
This is incorrect. There are clinicals, etc.
Their “clinical” hours are 500 hours shadowing a doctor or NP. It’s nothing like clinical hours in residency. That’s three months of a forty hour work week. It’s a joke. And most of them get their education online at schools with 100% acceptance rates. When there is no barrier to entry you end up with bottom of the barrel candidates taking care of maw maw and paw paw. Is that what you want?
Posted on 4/7/21 at 12:04 pm to LSUfanNkaty
quote:
This is incorrect. There are clinicals, etc.
I didn’t say they were completely online. But much of their schooling can be online.
How in the world do you see a 2 year program in which a lot can be online, and still possibly have enough to time to still have a job to be anywhere near as equivalent as full time highly competitive school for 4 years with multiple boards and clerkships?
Posted on 4/7/21 at 12:07 pm to Hangover Haven
quote:
Only downside to this is I've seen CRNA's scream for the anesthesiologist when the shite hits the fan...
Because they're trained in procedures, just like NPs and PAs. They can apply the diagnostic and treatment algorithms to most patients and do well, as most diseases have a standard treatment of care.
But they don't have the deeper physiological and basic science underpinnings that physicians have. They think about medicine strictly through a clinical and procedural lens - physicians understand the pathology and cellular science of what is taking place inside a patient.
So when multiple drugs, diseases, and other unknown variables are at stake, they simply don't have the background scientific knowledge that would allow them to thrive in novel situations.
This post was edited on 4/7/21 at 12:09 pm
Posted on 4/7/21 at 12:07 pm to 1BamaRTR
quote:
How in the world do you see a 2 year program in which a lot can be online, and still possibly have enough to time to still have a job to be anywhere near as equivalent as full time highly competitive school for 4 years with multiple boards and clerkships?
Never said that at all. Just said I'd be OK with some of them performing certain things. I know a few NPs and PAs that I'd trust over some of the MDs I've seen.
Posted on 4/7/21 at 12:08 pm to 1BamaRTR
Families sound alarm on medical transparency after deaths of their children | NewsNation Now
I urge you all to watch this investigative piece on the current practice of unsupervised mid-level care. To call it disturbing is an understatement. Two families will never get to hold their daughters again and it’s thanks to corporate greed and medical negligence (and things that wouldn’t have been missed by a first year Med student).
I urge you all to watch this investigative piece on the current practice of unsupervised mid-level care. To call it disturbing is an understatement. Two families will never get to hold their daughters again and it’s thanks to corporate greed and medical negligence (and things that wouldn’t have been missed by a first year Med student).
Posted on 4/7/21 at 12:10 pm to cwil177
quote:Agree completely that NP training is not sufficient for any type of independent practice without some type of physician supervision or over site. I don’t see how anyone can say otherwise to be honest.
cwil177
Posted on 4/7/21 at 12:11 pm to Big Block Stingray
quote:
If you've ever had surgery, let alone multiple surgeries in the past, the probability of a CRNA managed your care is extremely highly.
Every surgery that I have had experience with whether it be me or a family member, the anesthesiologist will come and talk to us, review the case, review the risks and has told me that they are present in the surgery. So, you may be correct about a CRNA being present but so is the doctor. I had a surgery pushed off for my son when he was a baby because the anesthesiologist found a risk. I'm so glad he did because the surgery ended up not being necessary.
Posted on 4/7/21 at 12:12 pm to LSUfanNkaty
No you didn’t say that but you were certain that example I posted can not also apply to most other specialties
Posted on 4/7/21 at 12:12 pm to Obtuse1
quote:
Just ask my wife what they do at her hospital. She is a CT surgeon
Congrats on your retirement
Posted on 4/7/21 at 12:12 pm to Cs
"mid-level provider" isn't a thing, anywhere but reddit
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