• Mitch Keamy Photo Mitch Keamy is an anesthesiologist in Las Vegas Nevada Andy Kofke Photo Andy Kofke is a Professor of Neuro-anesthesiology and Critical Care at the University of Pennslvania Mike O'Connor Mike O'Connor is Professor of Anesthesiology and Critical Care at the University of Chicago Rob Dean Photo Rob Dean is a cardiac anesthesiologist in Grand Rapids Michigan, with extensive experience in O.R. administration.

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"This continues their theme, promulgated to legislators, that nurse anesthetists, despite not having undergone the rigors of premedical education, medical school, and residency, are equivalent to anesthesiologists."

Aaaawwwwwww pooor baby. News flash, those things don't matter as much as you think. Sorry you wasted so much time.


They don't matter to technicians (CRNAs) but do matter to physician anesthesiologists.


Here we have both ends of the spectrum in both specialties. A CRNA who resorts to name calling instead of outlining the fundamentals of CRNA's, and a MDA who belittles the training and expertise of CRNA's by calling them technicians. I take offense to that statement as I'm sure most of my collegues do.
As for the original post, I do see merit in what the author says. It is vitally important for the funding to be there to continue on the training for MDA's.
As a side note, I have worked with Dr. Bacon and believe he is a wonderful instructor who has a vast amt of knowledge, teaching CRNA's, SRNA's and residents with kindness and compassion. I do not feel that he would take a position that would hurt CRNA's just for the sake of improving MDA income.
Lets face it, there is a fundamental difference between both specialties. MDA's do have a point that they do go to medical school, residency, and fellowship. They have a vast amt of knowledge that is very beneficial in our profession.
We both provide excellent anesthesia, and one withouth the other would be a shame in our specialty.
I for one would like to see both working together to improve anesthesia as a whole, and move forward.


CRNAs beleive that the administration of anesthesia does not require a medical degree or four years of residency - its just not that tuff (medical degrees are for real doctors like psychiatrists). And they're right in the majority of cases.
So I'm curious, why not turn over simple surgeries to PAs? Maybe PAs should be doing the inguinal hernia repairs in 20 year old males. Let's start training mid-level practioners in simple surgery with the goal of independent practice - who's with me?
Maybe you haven't heard about the 50 trilion in unfunded liabilites? A PA could do a surgery for half the price. There is a real demand in the rural areas for these mid-level surgeons as well. Surely, after two years of training, a person could learn the ins and outs of a hernia repair. And what about ear tubes? - those poor families in the country wouldn't have to drive three hours for a 5 minute surgery by some overpaid ENT surgeon. Or if that's too radical, think of the advantages that will come with the Surgery Care Team approach - like they say, there is a reason for having two pilots in the airplane.


Brahms' suggestion for an increased role for less well trained providers has some merit in the context of finite resources. However, we have to understand that I think that it does represent a decrement in quality of care and a decision is made to accept this a quality decrement driven by cost containment considerations. The sorts of cases described are low risk patients with low risk surgery so it is likely that most of the time things will be OK. The issue is what happens when an unexpected event arises that requires real medical training to prevent morbidity or mortality. It very well may be that this is an acceptable decrement in quality if the saved resources translate to more people getting medical care or other sorts of things that may in fact save lives in excess of what my be lost.

perhaps the happy medium is to maintain medical assessment and prescription with ongoing MD availability as he /she is multi tasking and ensuring that his/her medical training is optimally used.....

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