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AA's, CRNA's And The Economy

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    Posted: 31 Aug 2009 at 11:07am
AA's, CRNA's And The Economy

CRNAs are making anywhere from $90,000 working for a federal agency to $300,000 if they do not mind busting a gut. I know one who is making $400,000 on a 1099 contract working solo. If he wants time off he has to pay for all relief services himself. Not too bad if the place is not busy.

The potential is there for a big drop in income secondary to the economy. People lose jobs so do not get elective surgery done. The Plastic Surgeons are already feeling the impact and it will not be too long before other "elective" intensive specialties feel it as well. People lose their benefits so only get non-elective stuff done as emergencies.

I can also see with health care reform, AKA, medical people get paid less, Medicare and Medicaid and all the insurance companies gang up and cut payment substantially. I even see them saying anesthesia (Propofol) is not needed for things like endoscopies so anesthesia providers who do nothing but that kind of stuff will suddenly be out of work. A lot of CRNAs who were doing nothing but locums are now looking for a full time job to ensure some security in these times. The worst has not arrived and the next few years are going to be very painful regardless of your specialty. (Except gold miners. They are working a ton of over time.)

Let me clear it up for you...

Is getting your gallbladder out an elective procedure or is it an emergency?

With loss of insurance, if you can not pay you are not going to get a doctor to take out your gallbladder unless you are sicker than a dog with liver problems and pancreatitis.

You will be able to get it done if you walk into the ER and it is an emergency.

But if all you have are some recurrent gallbladder attacks, you are out of luck.

With the drop in income, loss of jobs and insurance we are going to see a drop in "elective" procedures. And that is going to impact us all.

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Good points. Also, wouldn't the income of the anesthetist fluctuate with income of the anesthesiologist he/she works for?

For example, if the average anesthesiologist income plummets to $150k (whether spurred by economic woes, healthcare reform, or any other cause), won't the average anesthetist income be adjusted to a figure that is more congruent with the average family practice PA income (since family practitioners earn around $150k on average)?

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Actually I see this...

Picture this. An MDA group has 3 CRNAs/AAs per MDA. The case load drops a lot.  Are the MDAs going to let MDAs go and increase the ratio to 4 to one? Of course not. They will let CRNAs/AAs go. Perhaps going to a 2 to 1 ratio. Or if it gets really bad, they could let the ratio go even lower or just get rid of the CRNAs/AAs and do the cases themselves. There are some cities in the USA that have absolutely no CRNAs/AAs and all anesthesia is provided by Anesthesiologists.

So in that situation, both the CRNAs and Anesthesiologist Assistants would be the first to go. However the advantage of the CRNA is they can practice independently. Just as there are towns that are all MDAs, there are some that are all CRNAs. The Anesthesiologist Assistants do not have that advantage.

Besides the recession issues, we need to keep a close eye on "health care reform" because nine times out of ten that means the same work load with less money being paid for it.



This is only one scenario...CRNA's and AA's will prevail. 


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