by Allison Womack
(Hernando, MS, USA)
I understand why an Anesthesiologist may be upset about this; however, they have the option to go to med school or to go to nursing school.
Although a nurse may not have to go to school for as long as an anesthesiologist, a CRNA also makes about a third of what an anesthesiologist makes. I do not really see the problem. If you are making more for doing the same job as someone else, be happy that you have an increased income and do not worry about the other person. If a CRNA is capable of their job, then just let it go.
The only problem I have with this change to a “DNP” is that I have yet to hear anything about an increase in salary for CRNA’s with a DNP. If you become a CRNA DNP, that makes you a Doctor of Nurse Anesthesia Practice. As a doctor in anesthesia, you should be paid like a doctor. Of course that is not the concern here. “Fairness” is the concern. Clearly more parents should use the phrase “life is not fair” with their children; this way people will stop growing up thinking that if something is unfair, then something must be done about it. Nothing is fair; live your life the best you can and deal with it.
Comments for CRNA vs. Anesthesiologist
May 01, 2016
DNP ? NEW
by: Anonymous
I think there is a flaw in your reasoning . And dnp doesn’t give you a doctor in nurse anathema practise or whatever you call it . It gives you a doctor in nursing . By that logic a phd could fill the void and make you a doctor (phd ) of anaesthesia ( from your crna degree) . Doesn’t make sense . The reason they are anesthesiologist is because the have a doctorate and residency geared toward anesthesia specifically , you don’t, you have a masters geared to anesthesia. The dnp is mostly likely for ppl who want to be in academics . I find it troubling that degree is allowed to be used in a clinical health care setting as it is EXTREMELY misleading to the patient . If you wanted be called a doctor in a clinical setting a MD , DMD DO or something other terminal degree would serve you better.
Apr 27, 2016
valuable NEW
by: Anonymous
The last comment was well said regarding the significant difference in training, knowledge and skill. That being said, both anesthesiologist and anesthetic nurses are very different but both valuable members of the medical community.
I think everyone would agree that dentist and hygienists are not equal, but both are valuable.
What about pilots and flight attendants? again, both important.
Lets get back to medicine… Surgeons and Scrub nurses?
All valuable….not necessarily equally valuable from a monetary standpoint and i don’t think that anyone in their right mind would argue that all of these people should be paid the same, but they should all be respected for the good work that they do.
Obviously the education, knowledge, breath and depth as well as skill of an anesthesiologist and an anesthetic nurse are VERY different, but we can all get along and work together to provide safe care.
Apr 27, 2016
CRNA not the same as MD-Anestheiologist NEW
by: Anonymous
The best opinion to this long time debate is to ask the CRNAs who went through Medical School and became board certified Anesthesiologist. I’m sure they will all agree with the depth of knowledge and experience gained doing residency in Anesthesia as well as the very basic foundation of medical knowledge gained doing medical school.
Going through Medical School entails an applicant to be at the top 1-5% in high school education, to be at 1-5% top Pre-Medical Colleges/Universities, and with the current highly limited and competitive Anesthesia residency positions available requiring to be at the top 1-5% of the medical school. Also, it involves lots of time, lots of tuition and boarding, miss countless family events, pressures, unwavering dedication to the art and science of healing, etc. It’s like going through a sifter or sieve, the applicants undergo filtering to obtain the best product. Anybody disagree? Then challenge yourself to apply through the process.
The “experience gained” by the CRNA working as an ICU nurse is always directed and supervised by the ICU intensivist, either by the Anesthesiologist with Critical Care Fellowship or Internal Medicine with Fellowship in Critical Care medicine, and “at NO TIME” that the ICU nurse initiate or administer pharmaceutical or medical intervention or procedure WITHOUT the knowledge or order from the supervising MD involved. Then how does these differ from the the practice of Anesthesia……
This comment is NOT to belittle but to acknowledge the contributions of the competent CRNAs in the providing anesthetic care to the countless healthy patients, but also to expound further that the difference and extend of level of education, training and experience between the CRNAs and MD-Anesthesiologists as mentioned in the earlier post of this forum is NOT EQUAL or AT THE SAME LEVEL. The in-depth knowledge and understanding of co-morbidities as applies to anesthetic effect as well as the trauma inflicted by the surgery to the healthy and sick patient, to maintain homeostasis and prevent catastrophic outcome requires interplay of “IN-DEPTH” knowledge and understanding of Applied Anatomy, Physiology (molecular and Cellular), Biochemistry, Genetics, Pharmacology, Pharmacokinetics, Pharmacodynamics, Pathology, Surgery, Neurology, Urology, and many more medical disciplines that contributes to the core knowledge of becoming a physician.
The line should be drawn………to practice Medicine, go to Medical School and gain in-depth knowledge of the chosen art. “Primum non nocere” (First do no Harm).
Mar 28, 2016
Re; confusing titles NEW
by: Anonymous
Taking the time to do a little research on anesthesia history would clear up the confusion about the term “nurse anesthetist”. Beginning in the late 1800s, the delivery of anesthesia was a task originally given to specially trained nurses, which marked the first specialty practice in nursing. In the following decades, even as physicians also began to specialize in it, ALL anesthesia providers were referred to as “anesthetists” – regardless of being a nurse or physician. Eventually semantic differentiation became “nurse anesthetist” and “MD anesthetist”, then “CRNA” and “MDA”; MDAs subsequently coined the term “anesthesiologist” as a way to try to distance themselves from the generic “anesthetist” term. Bottom line: nurse specializing in anesthesia delivery were the first profession to do so – even before physicians – and have been referred to as (nurse) anesthetists for well over 125 years. Again, the information & history are well-documented and readily available – please take the time to educate yourself before posting an ill-informed opinion on a public site.
Oct 17, 2015
Confusing Titles NEW
by: Anonymous
Titles in healthcare continue to become more and more confusing to patients. With a trend towards everyone wanting the word “doctor” in their educational degree/diploma, many patients are confused by who is actually a doctor (aka physician aka doctorate in medicine) and who has a doctoral degree (doctorate in nursing, doctorate in pharmacy, doctorate in physical therapy, doctorate in custodial engineering).
I’ve always thought that CRNA’s should be CRAN’s, Anesthesia Nurses, rather than nurse anesthetists. This would be more in line with the rest of specialty nurses.
Surgical nurses are not known as nurse surgeons. ICU nurses are not nurse intensivists etc so why is it that anesthesia nurses are called nurse anesthetists?
As the profession becomes more an more specialized, each medical specialty will have specialist physicians and specialty nurses. We need both, but it needs to be clear to patients who is directing care.
Oct 17, 2015
DNP vs CRNA NEW
by: Anonymous
The title “DNP” will not and should not make any difference to payment.
Just because it is a doctorate in nursing, doesn’t mean that the person will be a “doctor or physician” by the traditional sense.
Physiotherapists in the USA now have DPT’s this hasn’t affected their salaries, nor does it entitle them to introduce themselves at Dr. X in a clinical setting. Pharmacists, chiropractors, optometrists, pediatrists all have the word “doctor” in their degree’s but they are no more physicians than someone with a PhD in Literature.
Many nursing instructors also have doctorates in nursing, and as people continue to have desire to inflate their training, pretty soon the janitors will have doctorates in custodial engineering. It is all a bit silly, but I don’t expect it will have any impact on salary or scope of practice.
Oct 17, 2015
Untitled NEW
by: Anonymous
My hat goes off to both Anesthesiologist and CRNA’s. Anesthesiologists have to sacrifice their lives, family, social life, etc. They have completed many, many years of school. I feel that if they get to relax a little at work, they deserve it. They have worked hard, sacrificed, and endured the stress that it takes to get were they are!
Sep 29, 2015
Background “primary care knowledge” NEW
by: Anonymous
Not having background (or primary care) knowledge is exactly the problem. If you don’t understand the pathophysiology and treatment of comorbid conditions you do not have the ability to make critical decisions about their acute management intraoperatively.
I do not question crnas ability to perform procedural tasks with the same or perhaps at times even better proficiency but what the general public doesn’t understand is that anesthesiologist a have to quickly diagnose and treat acute conditions and it is the decision making that is more challenging than the procedural aspect.
Certainly you do not require an MD to learn hiow to follow a recipe and put to sleep relatively healthy patients.
Sep 29, 2015
Education levels NEW
by: Anonymous
I am intrigued that so many people refer to how much over-all schooling an anesthesiologist has as an indicator that they are more qualified to administer anesthesia. I had 4 level of business statistics. I can only recall the parts that I use on the job. Prior to my business degree, I took 2 years of Anatomy and Physiology, Microbiology and Chemistry, along with many other classes in a medical direction before changing my major. I had a 3.64 GPA so I must have learned something:) However, having not used that material in quite some time I am very rusty to say the least. Administering anesthesia is not primary care. Physicians learn a lot of primary care medicine in medical school. It is post 1st year residency that they, like CRNA’s focus on anesthesia. This is very different from primary care. From this point on not much primary care is done and, therefore, much of that training is unfortunately lost. When we talk about anesthesia itself, Anesthesiologist and CRNA’s alike eat, sleep and breathe it. This makes them both experts in their field. CRNA’s, however, actually administer anesthesia itself many more times in their careers than do many Anesthesiologist. Supervising is not hands-on experience. I personally prefer to have someone administer my anesthesia who has administered it time and time and time again with success than someone who merely observed as a means of “supervising” the job well done. Let me clarify that there are still, thankfully, Anesthesiologists out there who are hands-on. In that case, I would happily have either.
Aug 22, 2015
Teamwork NEW
by: RNstar
I’m an RN (interested in becoming a CRNA) and I am married to an anesthesiologist (went through the whole medical school journey together). All I can say is that I will always feel more comfortable having a Physician around (knowing the the amount of training they go through). A physician understands the pharmacodynamic and pharmacokinetic and how patients with different diseases are affected by anesthesia down to the cellular level. Ask yourself, if you were getting brain surgery, would you be comfortable having only CRNAs as your anesthesia care provider or a physician? Now add hypertension, seizure disorder, and congestive heart failure to your medical history. We need teamwork. Without CRNAs, the cost would be ridiculous.
Feb 09, 2015
Teamwork NEW
by: Anonymous
It takes a team to provide world class care.
You wouldn’t have a very good dental clinic without a dentist, dental hygienist or dental assistant and the up front staff
Surgeons can’t operate without their scrub nurses.
Same can be said for anesthesia. Anesthesiologists working together with CRNAs and AAs is the best model and the skills and resources that each have should compliment the other.
I love having an AA in the OR with me. They help make care more efficient and safer!
A team with well defined roles and responsibilities is the key to world class care!
Feb 09, 2015
Anesthesia Tech NEW
by: Anonymous
I’ve been an anesthesia tech in the operating room for over a year now and can give you a true 3rd person point of view here. CRNA’s and MDS are definitely different in many levels. My goal is to actually become a CRNA after my final 3 years of nursing school and 1 or 2 years in the SICU. Anyway, CRNA’s are great at what they do and I would definitely trust any of the ones I work with to provide my care. However I do believe that MDS do need to be in the building as supervision because yes anything can happen even with the most routine care. EVERY CRNA I have worked with has had to page a doctor at least once or twice in this year’s span for extra help and advice. MDS are there as that second assurance that can guide CRNA’s to make better decisions and become better anesthesia care providers. When CRNA’s and MDs work together it is remarkably better than any CRNA or MD working alone. They truly feed off each other and help provide care based on their different perspectives and experience. So yes MDS and CRNAS are different and but should both be considered medical professionals who as a team provide excellent care. The reason I’m choosing to become a CRNA is because I actually am more comfortable having that MD to call and knowing that yes I personally am capable of providing anesthesia but I also have that last resort to call in case something happens that I’ve never seen before but an MD has. Not to mention the terrible call hours and loads of liability an MD has to deal with. You can tell almost every CRNA is happy and has the opportunity to to spend a great deal of time with their families. People dont realize the great deal of added responsibility and stress an MD has over a CRNA. Just my opinion on the matter. If you dont want to spend over a decade in school and have the desire to be independently living on your own and happy sooner rather than later, then become a CRNA.
Oct 22, 2014
Prof Title NEW
by: Jen
I’m sorry but I remember calling my Ph.D titled professor in nursing school Doctor. If someone earns a Doctorate of any kind then they deserve to be called Doctor in the professional setting. If you have to go to medical school to use the title of doctor then maybe we should start discouraging all undergrads from obtaining any doctorate other than the M.D. or the D.O.
Sep 06, 2014
Why can’t we all just get along? NEW
by: SRNA
I am an RN with 21 years exp. I have worked in the OR, PACU, and ICU. I recently started school to become a CRNA. My decision came about because of a few excellent MDA’s that I worked with. My anesthesia school places us in the OR environment immediately. The CRNA’s and MDA’s are awesome at teaching and being patient with the SRNA’s. At this time, I can’t imagine practicing without some MDA coverage. Yes, delivering an anesthetic is the same by a CRNA or MDA, but you cannot deny that an MDA has more medical knowledge than a nurse. However, what is getting missed in this argument is the fact of how many anesthetics are being performed each year by CRNA’s (some 38 million I believe). The usual argument between MDA and CRNA has to do with training, education, safety, etc. The real question to the MDA’s should be what their plan would be to cover all of these cases (especially rural areas) without CRNA’s.
New to anesthesia and very pleased that I am in a mutually respected practice by all.
Sep 06, 2014
Why can’t we all just get along? NEW
by: SRNA
I am an RN with 21 years exp. I have worked in the OR, PACU, and ICU. I recently started school to become a CRNA. My decision came about because of a few excellent MDA’s that I worked with. My anesthesia school places us in the OR environment immediately. The CRNA’s and MDA’s are awesome at teaching and being patient with the SRNA’s. At this time, I can’t imagine practicing without some MDA coverage. Yes, delivering an anesthetic is the same by a CRNA or MDA, but you cannot deny that an MDA has more medical knowledge than a nurse. However, what is getting missed in this argument is the fact of how many anesthetics are being performed each year by CRNA’s (some 38 million I believe). The usual argument between MDA and CRNA has to do with training, education, safety, etc. The real question to the MDA’s should be what their plan would be to cover all of these cases (especially rural areas) without CRNA’s.
New to anesthesia and very pleased that I am in a mutually respected practice by all.
Apr 17, 2014
Training time NEW
by: Anonymous
People seem to be talking about an MD’s training in med school not being specifically anesthesia focused, and it’s not. It does however lay the ground work for understanding of all the medical problems and how anesthesia effects them. This doesn’t take into account the 4 years of residency, 3 of which are 100% anesthesia, q3-4 overnight call. The levels of experience don’t compare. That being said, there are some great CRNA’s and some bad MDs but on the whole if there is a sick complicated patient that needs lines, epidural, nerve blocks ect, I’d take the MD every time.
Mar 12, 2014
NEW
by: Anonymous
I have a few questions for the CRNAs that think that they have the equivalent training an proficiency of practice.
1. Are nurses so much smarter than physicians that they are somehow able to learn all that is needed to be an independent anesthesiologist in 2 years x 40hrs/wk ~ 4000 hours as compared to physicians who do a 4 yr x ~70hrs/wk or 14,000 hours of training?
2. Are the standards to get into nursing school the same as getting into medical school? Is some random community college equivalent to an ivy league or top tier university?
3. If you are awarded a doctorate in nursing – do you think it is deceiving to your patients to introduce yourself as “Doctor X”? What if the janitor gets a Doctorate in Custodial Engineering – is it fair for them to introduce themselves as Doctor Y?
4. If you have never managed (not just taken care of as a nurse) patients with the medical conditions that the patients that you are anesthetizing, then do you really think you have the same level of understanding as the anesthesiologist who prior to the 14,000 hours of anesthesia training had 10-12,000 hours of medical training during medical school?
This post may come off as condescending and it is not the intention. Nurses do a wonderful job as nurses and are EXTREMELY valuable and healthchare could not be delivered without them but the foundational training is VERY different and based on a different model with different objectives and goals. CRNAs do a wonderful job of delivering safe anesthetics to certain patients with adequate supervision but to say they are the “same” as an anesthesiologist is way off base – it is like saying that a dental hygienist is the same as a dentist because they can both clean teeth and do some other basic procedures. The Good CRNAs know enough to know what they don’t know and these CRNAs respect the differences between anesthesiologists and CRNAs. The scary CRNAs are the ones that don’t even know what they don’t know.
The best opinions on the issue come from anesthesiologists who were CRNAs before. They are the only ones that have truly experienced both fields.
Mar 12, 2014
reply NEW
by: Anonymous
The difference is that anesthesiologists do a lot more than just provide anesthetics. They have done years of internal medicine, intensive care as well as rotations in sub-specialty anesthesia, respirology, pediatrics etc.
Being a nurse in the ICU is VERY different from being a doctor in the ICU.
Nurses provide excellent care and are capable of providing a basic anesthetic but an anesthesiologist is so much more….
I don’t think any real anesthesiologists are concerned for their jobs they are just concerned for the patients and want to make sure that patient safety remains a priority, not whatever is cheaper.
Mar 11, 2014
Pro CRNA NEW
by: Anonymous
So instead of reading about disease is a book, (which I did in nursing school for 2 years) I worked on an intensive care unit for 3 years taking care of different diseases and medical conditions. But honestly, so many hospital are getting rid of anesthesiologist and going to CRNA’s that I do not blame anesthesiologist for hating CRNAs! Studies support the fact that Nurse anesthetist are equally competent to provide safe anesthesia, so why would hospitals at half the cost. 17 states have chosen to “op-out” meaning that nurse anesthetist can provide anesthesia without an MD present at all. This tread is thought to continues. Long story short, haters gonna hate.
Oct 21, 2013
Perpetuating the misconceptions
by: Anonymous
What I find so frustrating about this debate is the nursing professions unabashed willingness to sweep the glaring (and germane) facts under the rug and instead repeat the same nonsensical arguments over and over.
Nurse-anesthetists do not have medical educations. Yes, they spend 28 months in CRNA programs learning to deliver anesthetics, but the years spent by an anesthesiologist studying in-depth all aspects of human physiology and human diseases ranging from cardiovascular to metabolic disorders as part of medical school and residency is simply not possible as part of a 28-month CRNA program. Contrary to the argument perpetuated by CRNAs, this medical training DOES matter in the clinical setting. CRNAs, put simply, are not educated enough to know what they don’t know, much the same way a pilot of a Cessna would be oblivious to the fact that fuel on larger planes often must be redistributed to keep the weight balanced. They simply lack the formal medical “experience” that anesthesiologists do. And one year or even twenty years working in an ICU as a nurse is no substitute for the formal medical training under an amesthesiologist’s belt.
There may be very few, if any, studies demonstrating the number of lives saved or morbities averted by an anesthesiologist’s input in the delivery of an anesthetic, but this is probably attributable to the fact that hospitals caring for the sickest patients wouldn’t risk going it without us.
Oct 08, 2013
CRNA vs. MDA
by: Anonymous
There is nothing that shows that an MDA is a safer provider than a CRNA. CRNAs may only have 28month programs but it is focused on anesthesia(something MDA’s basically learn as they go in residency). The CRNA also has a 16mo residency built in. CRNA’s also spent at least 1 year, often more, taking care of critically ill patients in an ICU. They do a great job and are better when it comes to lowering health care cost.
Supervision is something misunderstood by the public. They say they are but really if they were concerned about CRNA practice they would. In truth most do not supervise, they surf the internet. The public often pays 2 people to do a one man job. The person who does the work makes half of what the person surfing the internet.
Every anesthesia provider should perform the anesthetic. Let the facility board decide what they want to pay ie what you pay. If you want to pay more for a name, you can. If you want to pay less for the same result than you can.
oh and if an Anesthesia Assistant (AA) is going to deliver the anesthetic you might want to walk out.
Aug 27, 2013
Both are Good but different
by: Anonymous
These two jobs are very different. Yes both professions deal with the same population the roles are very quite different.
The general public seem to understand the differences between a a mid-wife and an obstetrician so I’ll use that as the example of differences.
Both obstetricians and midwives deliver babies and perform many of the same maneuvers and share similar basic training. Both of them are able to provide direct care to patients and there are many things that midwives can do without physician supervision. This is not to say that these two professions are the same. When things get complicated and patients are high risk they often require a physician to take over their care.
Another example that some may be familiar with it that of dental hygienists and dentists. Sometimes hygienists practice safely without supervision but usually they work under a dentist and if this is done in the right setting it contributes to more efficient care.
The same can be said for CRNAs vs Aneasthsiologists – both practitioners provide excellent care to patients and are a valuable part of the healthcare system. The level of training and the complexity however is vastly different.
In many scenarios CRNAs will work under the supervision of an anesthesiologist the same way many midwives will work under an obstetrician. In other settings each group may work independently.
Changing the title of the degree to a “doctoral” degree has nothing to do with income – its simply nomenclature. You can call a janitor a custodial engineer – it does not mean that he or she should be paid like an engineer.
The most important things is that everyone works together for the best possible care of the patient and practices within the scope of their training and level of responsibility.
Jul 30, 2013
Shakes Head…..
by: Hammon CRNA
When I read some of these petty comments I just have to hang my head and shake it for at least 5 to 10 minutes. I cannot believe that educated physicians and/or educated CRNAs can act so childish. However I have been in healthcare for well over 20 years and I have seen the biggest babies come from the most educated professions. I too would love to see the studies that this obvious MDA has mentioned that say CRNAs have to be supervised or monitored or whatever the point may have been. I work in a hospital where there are no MDA’s. I know others to do is well. I also know that the studies do NOT show that MDAs are any more superior in practice to CRNA’s. But honestly, it is a shame that we lose complete focus on the patient and the patient’s care. We (MDA and CRNA’s) are more interested as a profession in bickering with each other than to see value in patient care. What a shame
Feb 16, 2013
crnas dnp are nurses not doctors
by: Anonymous
If a “doctor” crna wants to be a real doctor just go to medical school. Its that simple. Quit the whining and jealousy.
Nov 16, 2012
Future CRNA
by: Anonymous
Having read both perspectives, I feel like this is a familiar argument, like that of RNs versus LVNs. Education may be more extensive on the RNs part, but LVNs basically do the same things EXCEPT specific skilled procedures. As far as CRNAs and Anesthesiologists, CRNAs are trained in dealing with JUST anesthestics, however Anesthesiologist are doctors,and its a given that they are more educated in terms of anesthesiology. I think RNs should just stop whining and be grateful to have a great opportunity in working in a respectable profession.
Aug 06, 2012
Your facts sir?
by: Anonymous
The “team” approach is not the same as MD supervision. There are several different models that an Anesthesia group can employ.
I’m not taking anything away from MD’s, but CRNA’s spend a minimum of 28 months solely focusing on Anesthesia, the volatile agents, and drugs used in Anesthesia down to the cellular level. They do not study other topics in that time as well as going through clinical rotations at the hospitals focusing on Anesthesia.
This is not to mention any other prior education,work experience etc…etc…they have.
I am unaware of any med student who solely focuses on anesthesia during med school. Granted, they do get to scrub into surgery and so forth and don’t spend more than 2 months in an anesthesia rotation.
And I have yet to see any MDA’s do “twice” the work.
Please do not misrepresent the practice of Anesthesia from either a MDA’s perspective or a CRNA’s.
I realize there are good CRNAs and bad ones just as with MDA’s. However we are both educated and trained so that we can take care of patients in their hour of need.
As far as the statement by Anonymous who says there are studies that prove team model is best and CRNA’s should stick to getting supervised, please post a link to these studies and not make random statements.
May 16, 2012
Interesting conversation
by: Anonymous
I think that anesthesiologists do twice the training that Crnas do and there are studies not paid for by the aana that show that the team approach is safer. So I think that if Crnas wanted to be doctors then go to medical school otherwise they should stick to getting supervised by a doctor of anesthesia and get paid quite a bit.
Mar 13, 2012
BSN-Student
by: Anonymous
It all sounds childish on the doctors part to me