the end of anesthesia as we know...

Started by traderx, January 07, 2007, 10:33:41 PM

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 Hello, I am posting this new topic because I would like to find what other believe about the future of anesthesia. As you know, in US we are facing a new trend (the CRNA-s ) and cuts in payment. Also I believe that an imminent conflict will appear betwen the new trained anesthesiologists and surgeons. We are less and less ready to take any abuse. We also know that the "old school" (without to diminish their merits) is at fault regarding the attitude of the public regarding anesthesia and also the appearance of CRNA plague.
Please give me a moment of your time and your thoughts ,
Thank you a lot


In Australia, all anaesthetics are given by doctors, the vast majority specialist-trained anaesthetists (in some country areas, there are still a few General Practitioners with a Diploma in Anaesthesia giving anaesthetics).

There are no nurse anaesthetists, or techs.

The Government is trying to institute nurse anaesthetists and our college is strongly opposed. Of course we are defending our territory, but also the extremely high safety record (Australia has the safest published anaesthesia record in the world).

Its all about money - it would certainly cheaper for the Govt to bring in nurse anaesthetists, but at what cost? Increased morbidity? Mortality? As is often stated by our college, "Would (insert politician's name) prefer to have their mother anaesthetised by a nurse or a medical specialist"?


You are correct in that the trend toward nurse anesthetists is growing. We manage our surgeries with a group of four anesthetists (CRNA) and a supervising MD (MDA). This has been demonstrated time and time again as an economical and astoundingly safe arrangement. Dialogue concerning the safety and efficacy of the CRNA is becoming a moot subject which only demonstrates our hunger for money and control and a loss of concern to advocate for patients' access to quality care. Discussions to the threat of anesthetic practice in the US must now be directed towards medicare reimbursement which increasingly threaten to diminish (and has recently diminished); once again a money and control issue. Anesthetic practice as we know it is not ending, but augmenting options in what we can do and offer for our patients. Change can be good....


I'm new to the forum and practice in Texas.. CRNA's at least here in south texas are not cheap and some are practice the same way they did in the 70's. Just as an example starting salaries are 180 with little or no call. The hospitals have gotten into wage wars due to low supply; there's crnas at one place making over 300 on hourly pay with no hearts and no call. There's even one MDA who hired all crnas to cover 12 ORs and was using them to cover two rooms at a time supervised..the kicker is he still hasn't been caught. I won't consider working at that place for anything. I hope the australians are able to steer clear of crnas; they start out willing to work cheap and follow direction but only for a while.


Hi E'body!
This is really disheartening to know that we anesthesiologists are facing the same kind of problems around the world, that too because the lack of self respact in our ancestors. We must work together to win general public confidence and to increase the awareness about our speciality. We have to teach them that we are the ones who take care of their lives during any operation and not the surgeons, because they always have a second times to rectify their mistakes but we rarely have! Or  we should be ready to become and lead our lives as an upgraded technicians , not as a respacted Doc inspite of all our really hard work and effort in every case.