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AA's And CRNA's Can We Just Get Along?

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JCole View Drop Down
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Joined: 03 Oct 2007
Location: United States
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    Posted: 19 Sep 2009 at 10:51pm
AA's And CRNA's Can We Just Get Along?

Anesthesiologist Assistant's are not trying to "threaten the existence" of CRNA's (unless a free-market economy bothers you) and most of us work with CRNA's every day. There has never been an instance where individual Anesthesiologist Assistant's or our professional organizations have sought to limit the practice of CRNA's.

Unfortunately the reverse is not the case, as the expansion of Anesthesiologist Assistant practice is fought tooth and nail at every turn by both national and state nurse anesthesia organizations. Most of the arguments against us are not based in fact or even common sense. For the couple of you that have heard anecdotal horror stories about Anesthesiologist Assistant's from your best friend's 3rd cousin's next-door neighbor, please save your breath. We all have horror stories about the CRNA / orthopedist / OB / ER doc / ICU nurse / RT / anesthesiologist / and even AA's at the hospital we used to work at. In the end, it all comes down to money, one way or another.

Anesthesiologist Assistant's do not and will not seek practice autonomy. We are committed to an ACT practice model and are limited to practicing in that manner. Many of you practice independently in one way or another - more power to you. I'm not trying to stop you. I do not and will not have that opportunity, nor will I seek it. I'm perfectly happy where I am, as are many of you who also practice with anesthesiologists every day, whether in collaboration, medical direction, supervision, or whatever you'd like to call it. Depending on the state, location, or hospital policy, we do the same things you do with the exception of practicing independently and pain procedures. In hospitals that use both CRNA's and AA's, our practice and compensation are identical.

There is a TON of work to go around for all of us. We can't find enough anesthetists of either type in my group, and many others are in the same boat. The southeast US continues to grow rapidly in population across all age groups, and there simply aren't enough anesthetists around to fill the demand. Signing bonuses and tuition reimbursement abound. Compensation and benefit packages are larger than I ever thought possible. Sooner or later things will level off or the bubble will burst or Medicare will implode, but for the foreseeable future, opportunities for all of us look pretty darn good.

I'd love to see the rhetoric between all the groups tone down. It's largely unproductive, and in the end, we all want the same thing - to care for our patients the best way we know how and get paid a reasonable amount for our services considering the level of education, expertise, and medico-legal risk involved in providing those services. Some want to practice in big hospitals doing big cases. Some want to live in hunting/fishing heaven making a fine living covering several small rural hospitals. Others are perfectly happy in GI endoscopy centers (I can't explain it, but they are :) ) There's plenty of room for everyone at the table. Anyone interested in one of my call shifts next week?

I had a perfectly civil and enjoyable online chat a couple weekends ago with several of you including the former AANA president. Not a bad word about darn AA's or freakin' CRNA's from either side. Just a nice chat about a variety of things - one AA, two CRNA's plus that guy who created the website. I hated to cut my side short after an hour, but the honey-do list just wasn't getting done.

Some of you probably aren't happy I'm around, but I'm the token Anesthesiologist Assistant - there's also a token pharmacist and perhaps a couple of others. I try and stay out of the political discussions on this AA forum for the most part, but this one was a little hard to ignore totally. And of course my opinions are biased, as are yours. If we're not proud of, and willing to defend our chosen profession, something's wrong.

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


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