Anesthesiologists

Thanks for the clarification.

is there a vote out there for most arcane specialty?

Anesthesiologists are living high on the hog now, with average salaries at 350k. CRNAs are by far the highest paid nursing specialty, they average over six digits and its not uncommon to find one who makes 150k which is more than most primary care doctors.

In the end though, MDAs are going to see a hard fall. CRNAs have basically proven that they can handle 95% of what an MDA does at less than half the cost.

Nowadays hospitals have about 1 MDA for every 5 CRNAs on staff. That ratio will continue to decrease. Eventually you will have one or two MDAs at most and many dozens of CRNAs that handle all the day to day OR stuff.

“CRNAs have basically proven that they can handle 95% of what an MDA does at less than half the cost.”

Where’s the link to this statment proving that an RN is a competent as an MD in providing anesthesia?

I for one, would never have an RN administer anesthesia to me, during surgery. If my insurance wouldn’t pay for the MD, and would insist that I have the RN, I’d very gladly pay with my own cash to have the MD.

Those who want to die on the table, with an RN at the helm, please be my guest. I want a competent MD…

The key phrase of course being “if given the option”. The rise of midlevels is all about not giving the option. Of course everyone wants MDs for everything, but if it saves Blue Cross 40 dollars to have a midlevel do it, good luck. Proving a difference is difficult at best because just following protocols blindly works most of the time, so it’s not easy to show the couple of percent where superior training saves your ass.

An MDA told me once that his job was 90% boredom and 10% absolute terror. This may be an arbitrary saying, but it’s interesting to debate just how much money that 10% is worth. I would sure want the MDA at the table for that 10% but 90% of the time his expertise can be mimicked by someone with more basic training. Isn’t that the point of the extra training though in the first place? Can’t many basically trained people handle the vast majority of diagnosis, clinical work, anesthesia, etc. Isn’t all the hard work and ridiculousnous of med school bent toward refining your expertise for those situations that don’t fit the norm? I’m weary of putting a price tag on that.

Of course for those who’re not inclined to be too fussy, there’s always the handy plumber, ready to step in.

We certainly need good CRNAs. It’s one of the few fields where demand seems to still outweigh supply. Sites like http://www.unitedanesthesia.com/ show evidence that every state is still looking for qualified CRNAs (and willing to pay for them too). Hardly something that every industry can claim right now.