Kevin, M.D. - Medical Weblog

This is very interesting.I am an FMG US resident & this route does not sound too bad.
 

This post is misleading. To get into any CRNA program you have to be an RN with at least 1 year of critical care ICU experience. So you start out with 4-6 years of traiing before you take your 2 year CRNA course. Yes there may be CRNA's around who trained years ago that have been grandfathered in but that is not the case today. Most programs are very competative and it usually takes much more than 1 year critical care experience to get in.
 

A "mere" RN degree huh....nice.
Anyway, for those of you who haven't bothered to ask or educate yourself, purely from my point of view- the lowly, mere RN degree I received didn't take 2 years. Yes, it's only an Associates degree, but I had 2 years of pre req's ONLY before I even started the 2 year "nursing" degree.
Apparently there must be a high call for anesthesia. Do you think it's really the most efficient use of limited resources (i.e. money, personnel) to limit even the most simple procedures to MD's only?
I'd wager many of those CRNA's are on a par with many MD's as far as intelligence, experience and common sense.
 

Did you not get the memo? MDieties are akin to the lords of Mount Olympus when compared with mere RNs. That is, unless a level of responsibility commensurate with their societal status and after expense compensation is required. Then, of course, the RNs serve as a good scapegoat.
 

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"I'd wager many of those CRNA's are on a par with many MD's as far as intelligence, experience and common sense."

My wife, an anesthesiologist, would tell you if she had to do it again she would have become a CRNA rather than an M.D.. "They are a lot smarter than doctors, let me tell you" she says. Less training, better hours, high pay, and the doctors kiss a** because there is high CRNA demand relative to supply. Criminallo. should know that the CRNA profession is very good at limiting their numbers, much better than the medical profession. And they keep the foreigners out, unlike the medical profession that insources competition from other countries. You are much more likely to have an American born and trained CRNA than an American born and raised anesthesiologist, for better or worse.
 

Anesthesia is an overpriced and overvalued service for both MDs and CRNAs. The only thing floating this sinking ship is the fact that private insurers pay 300-700% of Medicare rates to MDs and CRNAs.

When the finally open their eyes and figure out that passing gas is a nurse level job, they will eliminate those fat payments and you can say goodbye to the high paying field of anesthesiology.

ONce this market correction kicks in, I predict CRNAs make about 100k per year, which is still more than the average NP (70k) but nowwhere near their bloated figure at more than twice an NPs income.

After all, what are the CRNAs going to do? ARe they going to go to working as an NP at 70k? Hell no, they'll take hte CRNA wages at 100k.

Their salary is going to fall like a rock, and it will drag the MD anesthesiologists down with them.
 

Anon 5:03 is obviously ignorant of the current situation regarding anesthesiology. I cannot get MD's to cover the Medicare or Medicare cases at my surgery center; reimbursement is absurdly low. A hairstylist makes more for their time. I WILL NOT accept the liability of supervising a CRNA as a surgeon; this is a fool's game.

Do you work 36 hours straight making life-or-death decisions? Do you get perpetually sued for millions of dollars for adverse outcomes in patients who would be left to die instead of coming to surgery in any other country? Do you want a slug of whiskey and a bullet to bite? That is where things are heading with public sector reimbursements.
 

"Passing gas" is what Crim and some others do on this blog. Do you know what an anesthesiologist actually does?

Hemodynamic and airway management are particularly involved areas of practice; both underlying pathology and surgically induced blood loss, fluid shifts, etc. can make for a lot of excitement. I have great respect for these professionals. I chose not to pursue this career as I consider it too stressful, unappreciated, overlitigated, and undercompensated. And that was 18 years ago, when times were "good".
 

What my understanding was that CRNA's were RN's with a Masters degree, or a post Masters if their previous Masters was in another area of advanced practice nursing.

My understanding is that CRNA's do not have the same level of responsibility as anesthesiologists do. They can't take complicated cases. Many hospitals use them to staff obstetric anesthesia as most patients are low risk. CRNA's are cost efficient, much like other advanced practice nursing fields.

And if hospitals and insurance companies are willing to pay them that 6 figure salary, then why not take it? As much as I would like that sort of salary, I wouldn't be a CRNA. But great for those who are.
 

I may be a little biased (my wife is a CRNA) but they deserve everything they get and then some. My wife had a BSN (4 years, private), 2 years of critical care experience, and then 2 years of CRNA school.

She gets paid 1/3 - 1/4 of what an MD anesthesiologist makes for the same work.

Given what I've experienced having worked in an anesthesia department for 3 years, I'd rather have my wife do my anesthesia than just about anyone else. She delivers technically excellent care with the compassion of a nurse.

If the American Soceity for Anesthesiology came to its senses, they'd see than antagonizing CRNAs is going to be non-productive.
 

"She gets paid 1/3 - 1/4 of what an MD anesthesiologist makes for the same work."

My wife is an anesthesiologist. She supervises and is responsible for 3 or 4 CRNA's (when she isn't doing her own room) and has 13 years of training beyond high school. Her training, experience, and practice capabilities (regional, cardiac, liver) far surpass those of the CRNA's. She teaches residents, runs the schedules, participates in reseach, serves as a liason with very demanding hospital adminstrators, serves on multiple hospital committees, and mainly tries to keep everybody happy.

Her hours are unpredictable, frequently dragging into the evening even when not on call, and often dragging on toward noon the day after when she is on call. Her practice is a business engaged in providing high quality anesthesia services while meeting the demands of surgeons and hospital administrators. Multiple federal, state, and insuror mandates must be met.

The most demanding employees in the practice are the CRNA's. They don't/won't take call and have a better lifestyle than the MD's. When their shift is up, they are out the door. Their husbands and children know when they will be home for dinner. They love independence until the next lawsuit comes around, then being a subordinate is not such a bad thing.

I would never chose to do what my wife does, as I consider her compensation inferior relative to mine for what she does.

So pardon me if I disagree with your statement.
 

Ir's very interesting how much inaccurate information is floating around on a blog such as this. Of all the comments on this blog, my favorite of all, is the following:

"My understanding is that CRNA's do not have the same level of responsibility as anesthesiologists do. They can't take complicated cases. Many hospitals use them to staff obstetric anesthesia as most patients are low risk"

Whoever submiitted this comment is quite obviously clueless. At the institution I am employed, CRNA's routinely undertake such cases as AAA's, craniotomies, complicated vascular procedures, hearts, and level one traumas. It's a glorious day whenever a ASA 1 or 2 patient comes rolling into my OR.

Another sign of your obvious lack of information is classifying OB anesthesia as low risk. OB is never low risk. Anyone knows that these patients can go south on you in a hurry.

I have been a practicing CRNA for 15 years. I went to a diploma nursing school, followed by 2 1/2 years of education to receive my BSN. Having obtained 3 years of ICU experience, I spent 2 1/2 years in a Masters Degree program. I am a highly educated health care professional, who works hard to provide outstanding anesthesia care to every patient presented to me. And yes, I feel I deserve every penny I get.
 

It is funny how your wife complains of "CRNA's" being the first one out the door and also accuses them of being the most demanding EMPLOYEES. If it were not for these employees her salary would be 1/2 to 1/4 of what it is and she knows it. Did you ever think that maybe if her group gave CRNA's ownership in the company as group members rather then employees they might get a change in attitude and hours? Until then your wife has no business complaining about an employee leaving after their time is up. Without ownership overtime is an option.
 

I'm thinking about trying to become a CRNA. Do you all think the salaries are sustainable over the next 20-30 years?
Thanks
 

Yes- the damand for surgery is high and the aging baby boomers will further fuel the demand. CRNAs have consistently shown to be as safe if not safer than anesthesiologist- see research done by cardiologist Dr.Pine.
CRNAs are safe practitioners and are more cost effective for hospitals and surgeons to employ.
 

For the Anesthesiologist that complain about their CRNA employees having a better life. Well, thats because they are paying your income. I wont repeat a previous post. But, I will say that I am an completeley independent CRNA (no MDA's) in a group of four CRNA's. We are their till the cases are done...and there at 4am if needed. Granted, I make twice what an employeed CRNA makes. But I work more and have no vacation time. I absolutely refuse to hand over my provider ID# so someone can bill for my work and give me only a fraction.
 

Yes there are typos...but who cares...I dont proof read. Im a man... Besides, I dont mind admitting that I suck at spelling...thats what spell check is for. :)
 

CRNAs are highly qualified, clinically competent practitioners. The upcoming transition to Doctor of Nursing Practice (DNP) for advanced practice NPs and CRNAs would better reflect their education and responsibilties. A case could be made that FMG Docs are, well, over paid for their foreign medical training. I agree that this can be corrected with further training in the United States after their graduation as, FMGs. To the person expounding on what a CRNA's salary should really be, your lack of knowledge of reimbursement by insurance carriers and your dire prediction of anesthesia practitioner salaries is uninformed and just plain rambling at best.
 

You reap what you sow! You make the decisions for yourself, too bad yoiu didn't make a smart one
 

Dear Dr. Kevin
It's amazing to me that you can post such false information in your blog. To be able to graduate from an accredited CRNA program applicants must hava a bachelor degrees in nursing, at least 2 years of ICU experience,and score highly in the GRE exam. Getting into the programs is very competitive so most applicants are opting to do observation in the OR, following a CRNA or Anesthesiologist. The Nurse anesthesia program at Columbia University, which I attended, requires you to have a B+ average. I did clinical rotation at the most prestigious hospitals in NY and took call just like the residents did. We also did open heart, high risk obstetrics, and trauma rotations just like the anesthesia residents did. The programwas extremely hard , but I graduated and have been practicing as a CRNA for 3 years now. All CRNA programs are Master degree programs, and in the next 15 years all CRNAs will be required to have a Doctorate degree. All together is 4 years for a bachelor degree and 2 years and 10 months of anesthesia school. That adds up to 6 years and 10 months, plus the 2 months you spend studying for state boards= 7 years. The doctorate degree is 2 more years, so I will have 9 years of training under my belt, not a mere nursing degree, is it??
I work with anesthesiologist and we do the same cases, same acuity, and our patients have the same outcome. CRNA's like my self give up their billing rights to the group we practice with. So they collect from insurance companies and pay us a salary. So, lets say they collected $1200 for general anesthesia for a gastric bypass case, I get $95 an hour and it is a 2 hour case, that equals $190. The anesthesia group keeps the rest!!! ($1010) I am getting paid, but the group is collecting 12 times more than what they are paying me!!
Dr. Pho where is the hate comming from??? Could it be that in reality it all comes down to money?? Do not question our training , profesionalism and ability to provide safe anesthesia, just because you are mad and think we make too much money to be "mere" nurses. We are not taking that money from you, we work hard and we are qualified and highgly educated health practioners!!!!!
 

Dear Dr. Kevin
It's amazing to me that you can post such false information in your blog. To be able to graduate from an accredited CRNA program applicants must hava a bachelor degrees in nursing, at least 2 years of ICU experience,and score highly in the GRE exam. Getting into the programs is very competitive so most applicants are opting to do observation in the OR, following a CRNA or Anesthesiologist. The Nurse anesthesia program at Columbia University, which I attended, requires you to have a B+ average. I did clinical rotation at the most prestigious hospitals in NY and took call just like the residents did. We also did open heart, high risk obstetrics, and trauma rotations just like the anesthesia residents did. The programwas extremely hard , but I graduated and have been practicing as a CRNA for 3 years now. All CRNA programs are Master degree programs, and in the next 15 years all CRNAs will be required to have a Doctorate degree. All together is 4 years for a bachelor degree and 2 years and 10 months of anesthesia school. That adds up to 6 years and 10 months, plus the 2 months you spend studying for state boards= 7 years. The doctorate degree is 2 more years, so I will have 9 years of training under my belt, not a mere nursing degree, is it??
I work with anesthesiologist and we do the same cases, same acuity, and our patients have the same outcome. CRNA's like my self give up their billing rights to the group we practice with. So they collect from insurance companies and pay us a salary. So, lets say they collected $1200 for general anesthesia for a gastric bypass case, I get $95 an hour and it is a 2 hour case, that equals $190. The anesthesia group keeps the rest!!! ($1010) I am getting paid, but the group is collecting 12 times more than what they are paying me!!
Dr. Pho where is the hate comming from??? Could it be that in reality it all comes down to money?? Do not question our training , profesionalism and ability to provide safe anesthesia, just because you are mad and think we make too much money to be "mere" nurses. We are not taking that money from you, we work hard and we are qualified and highgly educated health practioners!!!!!
 

Dear Dr. Kevin
It's amazing to me that you can post such false information in your blog. To be able to graduate from an accredited CRNA program applicants must hava a bachelor degrees in nursing, at least 2 years of ICU experience,and score highly in the GRE exam. Getting into the programs is very competitive so most applicants are opting to do observation in the OR, following a CRNA or Anesthesiologist. The Nurse anesthesia program at Columbia University, which I attended, requires you to have a B+ average. I did clinical rotation at the most prestigious hospitals in NY and took call just like the residents did. We also did open heart, high risk obstetrics, and trauma rotations just like the anesthesia residents did. The programwas extremely hard , but I graduated and have been practicing as a CRNA for 3 years now. All CRNA programs are Master degree programs, and in the next 15 years all CRNAs will be required to have a Doctorate degree. All together is 4 years for a bachelor degree and 2 years and 10 months of anesthesia school. That adds up to 6 years and 10 months, plus the 2 months you spend studying for state boards= 7 years. The doctorate degree is 2 more years, so I will have 9 years of training under my belt, not a mere nursing degree, is it??
I work with anesthesiologist and we do the same cases, same acuity, and our patients have the same outcome. CRNA's like my self give up their billing rights to the group we practice with. So they collect from insurance companies and pay us a salary. So, lets say they collected $1200 for general anesthesia for a gastric bypass case, I get $95 an hour and it is a 2 hour case, that equals $190. The anesthesia group keeps the rest!!! ($1010) I am getting paid, but the group is collecting 12 times more than what they are paying me!!
Dr. Pho where is the hate comming from??? Could it be that in reality it all comes down to money?? Do not question our training , profesionalism and ability to provide safe anesthesia, just because you are mad and think we make too much money to be "mere" nurses. We are not taking that money from you, we work hard and we are qualified and highgly educated health practioners!!!!!
 

Kevin,

You are just jealous about us CRNAs. Until you can manage life-threatening issues in the O.R. then talk to me. I am both an NP and a CRNA so do not talk to me about your simple primary care activities passing po drugs and referring people to subspecialties. If you can manage a difficult airway sometime in your career then let's talk. Otherwise, be content with your measly salary and existence Mr. MD. Love, Harry
 

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To those who are directing their responses against me, if you read carefully you will note that I did not make any comments regarding CRNAs - they were quoted from another site.

I suggest you re-direct your rebuttal to the poster of the quote in the appropriate forum:
http://forums.studentdoctor.net/showthread.php?t=385503

Thanks,
Kevin