Stop training CRNAs. Let them loose and see what happens. Why would anyone teach any new techniques to CRNAs. We have free license to define our careers as physicians. I know I'll get flack on here for saying this but we should take every Anesthesiology resident and mandate they do either pain fellowship, CV or ICU in a 4 to 5 year program combined with their intern year - all categorical.
Within 5 years you will take over the market place of all pain and all ICUs by graduating 5000 intensivists or Interventional Pain docs. And with that base training there is an outlet valve mechanism to literally define ourselves. Not necessarily in practice where people may not practice icu or pain which is cool, as many of the members on here do not use their fellowship, but it's about the definition. The mission statement for the modern day Anesthesiologist... the optics...and I know it's a year of money loss...but when people think anesthesiology like in Europe, in the public, they think - ok Intensivist, Emergency Medicine, resucitationist, Anesthesiologists IE doctor. Instead of looking to midlevels tiers of care like anesthesia nurses and meddle with the "help" ie the bedside OR anesthesia nurse which is basically equivalent to the bedside ICU nurse, we should look to what other professional groups have done because it's not just Anesthesiology- its Emergency Medicine, it's all the medical specialties that are non procedural or procedural derm, rheum, family medicine, plastics etc that this is impacting. See ACEP reply on the EM forum about PA/NPs. This is going to be the big issue in the next 20 years. And every generation of medical professionals had quacks and in the end education, knowledge in the sciences, and trusting your training is fundamental.
We need to keep training our residents and fellows to do it all... Especially for patient safety and advancing the medical science.
You can read my other posts on here but in brief...
TTE and TEE diagnostic and therapeutic structural, REBOA, ECMO, ICE, neurophysiology, Neuromonitoring, Bronchs, trachs, vascular procedural teams, pain catheters, regional, complex blocks, regional cathters, sacral stims, complex multimodal anesthesia, ESI, rhizotomies, perc discectomies, Preprocedural testing stress imaging, pfts. We should own it all. So that our pts know that Anesthesiologists put their patients first - based on the value they provide. We can get you through any procedure you have in the hospital and hell if you don't want a procedure we can palliate you too.
What was a complex and groundbreaking scientific discovery in the 80s is now what CRNAs leach off of in practice (sevo, des, prop, precedex) all discovered on the backs of Physician scientists after CRNAs were throwing rags of ether on people's face. There is no sane person when given the option who will ever choose an RN to anesthetize them unless for the most basic case... unless they are marketed to incorrectly. Furthermore we need to remind our residents to get stronger, better, faster every day. Do you think any of these whack AANA nurses are doing complex multimodal anesthesia opioid sparing, block only anesthesia?
Hell I'm convinced the opioid epidemic is caused by CRNAs with the ****ty prop sux tube and loaded narcotic anesthesia they administer.
If they want to go head to head then let's have at it.