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re: Wisconsin Hospital Replaces All Anesthesiologists with CRNAs

Posted on 4/7/21 at 3:22 pm to
Posted by cwil177
Baton Rouge
Member since Jun 2011
28594 posts
Posted on 4/7/21 at 3:22 pm to
quote:

Ok so a doctor practicing independently after all schooling and training is said and done has never asked a dumb question.

This is a horrible argument for allowing less qualified practitioners to practice healthcare.
quote:

I don't see the problem.. but also I have never see an NP that works "independently"

There is a massive difference. Again to use the car analogy, I don’t understand cars so I can bring my vehicle to two mechanics and think they both did the same thing but not know the real quality of their work. Same with electricians, plumbers, etc. But laypeople understand health even less than those things.
quote:

your screen shot is stupid, and not the majority.

It doesn’t matter if it’s the majority or not, what matters is people like this are common enough after graduation from NP school that it’s not hard to find these posts. That person has no business being in medicine, and you should be angry that that person is potentially taking care of your loved ones.
quote:

I would not go to an NP for specialized care and did not know that is a thing??

Unfortunately it is. Most do not go into primary care, which I’m ok with since it’s so broad there is way more chance to frick something up. But it’s frustrating referring a patient to a cardiologist and having them see the NP/PA. I want someone who knows more than me to see this patient, not someone who knows less.
Posted by tigercross
Member since Feb 2008
4918 posts
Posted on 4/7/21 at 3:22 pm to
quote:

CRNA’s and physician anesthesiologist go through the same clinical training


CRNAs go through 2 years of clinical rotations in medical school followed by 4-5 years of 80+ hr/weeks in accredited residency programs led by physicians? That doesn't sound correct to me.
Posted by crazy4lsu
Member since May 2005
36430 posts
Posted on 4/7/21 at 3:24 pm to
quote:

I would never trust my health or wellbeing to a DO.



Why exactly? They have the same exact privileges as a MD.
Posted by greenwave
Member since Oct 2011
3878 posts
Posted on 4/7/21 at 3:25 pm to
Oh good lord ignore the dumb question then. I just have never experienced a setting like this thread is describing with an independent care NP.. I have stated I would not see one for specialized care either. So I don't understand the with problem with the physician led team model like I have always seen. Also it seems like most Physicians like their NPs/PAs and could give them the boot if they wanted.
Posted by coondaddy21
Louisiana
Member since Oct 2012
3222 posts
Posted on 4/7/21 at 3:25 pm to
quote:

Wrong again. Anesthesia residency is 4 years, plus many do a fellowship for a fifth year. So unless 1-2 = 4-5, you need to rethink this. You won’t, but you should.


My experience with residents in their third year is that they stand by, ask questions and don’t really do anything. Some places they get to intubate but to do the actual anesthetic, that wasn’t happening That might be different at other facilities but that wasn’t my experience.

I have worked with many great physician anesthesiologist, and great CRNA’s. Just because you have more years of schooling and training, doesn’t mean you are going to be better skilled provider. The letters behind the name don’t make you better provider.
Posted by AMS
Member since Apr 2016
6498 posts
Posted on 4/7/21 at 3:26 pm to
quote:

I would never trust my health or wellbeing to a DO.



but a cRNA or midlevel is just fine?

so much ignorance in this thread
Posted by windshieldman
Member since Nov 2012
12818 posts
Posted on 4/7/21 at 3:26 pm to
quote:

2 years of clinical rotations in medical school followed by 4-5 years of 80+ hr/weeks in accredited residency programs led by physicians


I’ve always wondered what the difference was between a doctor’s clinicals and residency. Is residency also pretty much clinicals but maybe just more focused on a certain specialty? Also, what is it you finish when you can actually be called a doctor? Is it residency or the actual final test or tests?
Posted by greenwave
Member since Oct 2011
3878 posts
Posted on 4/7/21 at 3:28 pm to
quote:

Unfortunately it is. Most do not go into primary care, which I’m ok with since it’s so broad there is way more chance to frick something up. But it’s frustrating referring a patient to a cardiologist and having them see the NP/PA. I want someone who knows more than me to see this patient, not someone who knows less.


I agree and I would not want this. I have never "only" seen an NP. Unless its at a doc n the box for a zpac.
Posted by greenwave
Member since Oct 2011
3878 posts
Posted on 4/7/21 at 3:28 pm to
I know a DO and she admits the DO part def carries a stigma.
Posted by Big Block Stingray
Top down on open road
Member since Feb 2009
1979 posts
Posted on 4/7/21 at 3:29 pm to
quote:

Especially when the DNP unapologetically wears a white coat, walks into the room, and introduces herself as “doctor.”



In 20 years of practice at Level 1 medical centers, I have never witnessed this nor have a heard of one actually doing this.

The ridicule would spread with the quickness throughout the facility and the DNP would get her her shite shut down ASAP.

Posted by cwil177
Baton Rouge
Member since Jun 2011
28594 posts
Posted on 4/7/21 at 3:29 pm to
quote:

So I don't understand the with problem with the physician led team model like I have always seen. Also it seems like most Physicians like their NPs/PAs and could give them the boot if they wanted.

There isn’t a problem. With appropriate supervision it is safe and effective. The problem is that mid levels want to do away with this model for their own personal benefit disguised as “increasing access to care.” If access to doctors is a problem, make more doctors instead of pushing nurses to be subpar doctor replacements. FWIW I enjoy working with midlevels when I can appropriately supervise them.
Posted by cwil177
Baton Rouge
Member since Jun 2011
28594 posts
Posted on 4/7/21 at 3:31 pm to
quote:

The letters behind the name don’t make you better provider.

Tell that to the nurse practitioners who put the entire alphabet behind their name because they think patients will find them more qualified.
Posted by tigercross
Member since Feb 2008
4918 posts
Posted on 4/7/21 at 3:31 pm to
quote:

I’ve always wondered what the difference was between a doctor’s clinicals and residency. Is residency also pretty much clinicals but maybe just more focused on a certain specialty?


Clinicals are the final two years of medical school. Schools typically have a core set of clinical rotations students must complete, then they may choose to focus on other areas of interest for the remainder of their rotations. Once you graduate medical school you can call yourself a doctor.

Residency is 3+ yrs focusing on one area of medicine after graduating medical school.
Posted by coondaddy21
Louisiana
Member since Oct 2012
3222 posts
Posted on 4/7/21 at 3:31 pm to
quote:

Why when CRNA Steve introduces himself to a patient does he not say “Hi I’m Steve a nurse anesthetist.” But instead says “Hi I’m Steve with anesthesia.” Why try to blur lines in a professional setting? Why not be proud of the training he has?


Most non medical people can’t even pronounce anesthetist and it’s often confused with Aesthetic practice. People can introduce themselves however they feel comfortable. The acceptable terms are Nurse Anesthetist, CRNA, and in some parts of the US Nurse Anesthesiologist.
Posted by greenwave
Member since Oct 2011
3878 posts
Posted on 4/7/21 at 3:33 pm to
quote:

The problem is that mid levels want to do away with this model for their own personal benefit disguised as “increasing access to care.”


Which again is not the majority and physicians are not going away... dont worry You just seem to have a major agenda against mid levelers. More than most.
Posted by windshieldman
Member since Nov 2012
12818 posts
Posted on 4/7/21 at 3:34 pm to
quote:

Residency is 3+ yrs focusing on one area of medicine after graduating medical school.


How does that work with people who wanna do general primary care, family doctor type stuff. Instead of doing residency at a hospital they work at different doctor offices or just bounce around different specialist areas of a hospital to learn as much as possible? Like instead of being a anesthesiologist, surgeon, eye doctor, gastroenterologist etc, you just wanna do family practice
This post was edited on 4/7/21 at 3:35 pm
Posted by Jake88
Member since Apr 2005
68572 posts
Posted on 4/7/21 at 3:34 pm to
quote:

Mid-level providers (NPs and PAs) are undoubtedly a critical part of the healthcare system, yet it seems there is an ever increasing "creep" of mid-level autonomy that is slowly supplanting the roles of physicians
They are pumping NPs out haphazardly. It's a joke how little they train and know.
quote:

Would anyone honestly feel comfortable undergoing surgery knowing that the person responsible for keeping them alive during the operation is not a MD/DO?

Hell no.
Posted by crazy4lsu
Member since May 2005
36430 posts
Posted on 4/7/21 at 3:34 pm to
quote:

I know a DO and she admits the DO part def carries a stigma.



I'm sure it does, but I don't think people understand how competitive getting into medical school is now. My friends who got into DO schools but not MD schools had MCAT scores in the 90th percentiles and up, but had some other issue, either age, GPA issues when they were younger, or chose to go to DO schools in their area because they didn't want to leave their homes. Getting into medical school isn't straightforward, and I don't think people realize how intensely competitive the process is.
Posted by BeaumontBengal
Member since Feb 2005
2337 posts
Posted on 4/7/21 at 3:35 pm to
quote:

Nurse Anesthesiologist


El Oh El
Posted by YipSkiddlyDooo
Member since Apr 2013
3648 posts
Posted on 4/7/21 at 3:35 pm to
quote:

In a state where a CRNA can practice independently the liability falls on them and likely their employer who fired all the physicians. It’s not that complicated or interesting.


quote:

This is incorrect, but people here state it like it’s fact.


My med mal carrier and my state board of medicine says it is absolutely correct where I practice...but carry on
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