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The Future For Anesthesiologist Assistants

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Joined: 13 Aug 2009
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    Posted: 31 Aug 2009 at 9:16am
The future for Anesthesiologist Assistants looks brighter...

First, when you combine all the schools of Nurse Anesthesia, they are turning out 1000 too few new CRNAs each year to keep up with demand and the aging population.

Second, when you add to that the fact that over 50% of the currently practicing CRNAs are baby boomers and will be retiring in the next 8-15 years, there is going to be one hell of a shortage of anesthesia providers.

Third, the nursing schools, the basis of the CRNA concept, are not turning out enough nurses. It seems what expansion that is being done to get more nurses out is coming from the two year associate degree programs, which are not (at this time) acceptable for entrance to a masters degree CRNA program. In other words, the source of CRNA students is getting dried up.

If you went and got your BS degree in nursing and got into a CRNA program and graduated, you would be looking at a yearly income of up to $200,000 in just a few years in any state and any practice setting you choose. Be it a major medical center with MDAs, a private hospital with MDAs or a smaller facility with CRNAs only.  Any state, any location. That is probably the biggest advantage of being a CRNA over an Anesthesiologist this point in time.

However, with the shortage in nursing and nurse anesthesia, I think the Anesthesiologist Assistant concept is not only going to grow in the number of programs, but in the states that allow them. In the not too distant future (10+ years) I think Anesthesiologist Assistants will be accepted in all 50 states. So the advantage that the CRNAs have in regards to that will disappear.

The catch to the AA concept is that they MUST by definition work under MDAs. That means they can not work in any setting without an MDA, such as rural hospitals or doing pain management. While this will have no major negative impact on the bigger facilities, it will be a definite "killer" for the small rural hospitals as Anesthesiologist Assistants will not be able to cover those facilities.

UNLESS the practice law down the road for AAs changes so that they can work independently. I think in that case, the ASA and the MDAs would fight it tooth and nail as they do not want another group like the CRNAs around that can "compete" with them. (AANA and ASA relationships have pretty much always been antagonistic.)

If you decide to go the CRNA route, you would have to get at least an associates degree in nursing as some schools may consider that along with your current bachelors. However more likely you will need a bachelors degree in nursing as the push in on now for the CRNA programs to be doctorate level programs - Doctor of Nurse Anesthesia Practice (DNAP). Either way you will have to work 2-3 years in a critical care nursing field before you can apply for a CRNA program.

Bottom line you are looking at 4-5 years before you can even get into a CRNA program and 7-8 years before you can be working in anesthesia.


You can apply for an AA program right now and be out in 24-30 months practicing as an Anesthesiologist Assistant. In my 33 years of experience, when you work with MDAs, it is not always a bad situation. They seem much nicer in small groups than they do as the ASA.

I would say the AA future looks bright IF...

#1. AA's form some professional organization to speak for them and they do not become a subset of the ASA.

#2. AA's define their own practice laws and not let the MDAs do it for them.  If AA's do, they can bet it will always be set up that they are always under their (MDA's) thumbs.

#3. AA's should try to develop some sort of relationship with the AANA. (IMO the best move would be the AANA to rename itself the AANA + AAs and push for them to be the same and equal. But I do not see the AANA doing that as it acts more like a union set up to protect the jobs of CRNAs.)


I agree to all of those comments as to the future of the Anesthesiologist Assistant profession and to the situation AAs are in as a whole at the moment. I had read that the highest number of baby boomers would be retiring as early as 2010, where the Anesthesiologist Assistants would see a marked rise in demand for anesthesia providers (even higher than the current extremely high demand).

The biggest hurdle is to get out into all the remaining closed states. The major opposition is the docs in each state. Also, while opinions vary among CRNAs, the AANA does not generally like the idea of the Anesthesiologist Assistant profession. And you are right...the last thing MDAs want right now is another independent provider to compete against.

All in all, the AA profession is only going forward with more demand and more acceptance.

The biggest hurdle is that many providers (in the North and the West) don't even know Anesthesiologist Assistants exist!!!

Spreading the word is key!


The best way is to contact an Anesthesiologist who is interested in working with Anesthesiologist Assistant's. You can contact any of the AA programs across the country (7 of them as of now) to get the paperwork needed and start an AA rotation at any given hospital. Once AA students begin to do rotations there, the state will be known as a "teaching" state/hospital for Anesthesiologist Assistant's and can then start to allow AA's to work in that state.

------------------------------------------------------------------------------------------------------------------- = Doctorate Of Nurse Anesthesia Practice


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