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[Dogruffle01]

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[Dogruffle01]

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[pamac]

I think your concerns are valid and have reasonable foresight. You also seem to be comfortable with the very real geographic limitations. The only thing you might be wrong about is some of the raw costs of CRNA school, but you also could be on to something given that working during CRNA school isn’t feasable like how RNs do while pursuing Np. Living on loans is likely. So even though a CRNA school might be a lot cheaper that what you listed, the entire package of cost may be near what you said. But overall,I actually think CRNA school is at least about as expensive as AA if not less. I just don’t quite think that the side by side cost puts AA ahead than CRNA. But you would likely come out better financially with AA given that you could start tomorrow vs potentially several years more moving through the nursing route.

Overriding concerns I would have beyond what you stated, and touching upon what you mentioned as far as income, is the issue of where they stand with being dependent providers. In states where NPs are dependent providers, they tend to make less because of having less leverage. I think being a dependent provider carries less control over circumstances. So far, I hear reports that AAs tend to make as much as CRNAs, but I don’t think there is much to compel that situation to continue. If there’s not current evidence that will change, what is the proof that it won’t next year if a physician wants to keep more and pay less. Same goes for a health system, or a medical group. When your geography is limited, and you are required to be attatched to a supervisor, you have to go with the flow. Makes me nervous.

 

[Dogruffle01]

I think your concerns are valid and have reasonable foresight. You also seem to be comfortable with the very real geographic limitations. The only thing you might be wrong about is some of the raw costs of CRNA school, but you also could be on to something given that working during CRNA school isn’t feasable like how RNs do while pursuing Np. Living on loans is likely. So even though a CRNA school might be a lot cheaper that what you listed, the entire package of cost may be near what you said. But overall,I actually think CRNA school is at least about as expensive as AA if not less. I just don’t quite think that the side by side cost puts AA ahead than CRNA. But you would likely come out better financially with AA given that you could start tomorrow vs potentially several years more moving through the nursing route.

Overriding concerns I would have beyond what you stated, and touching upon what you mentioned as far as income is the issue of where they stand with being dependent providers. Why I know is that NPs in stres where NPs are dependent provides, they tend to make less because of having less leverage. I think being a dependent provider carries less control over circumstances. So far, I hear reports that AAs tend to make as much as CRNAs, but I don’t think there is much to compel that situation to continue. If there’s not current evidence that will change, what is the proof that it won’t next year if a physician wants to keep more and pay less. Same goes for a health system, or a medical group. When your geography is limited, and you are required to be attatched to a supervisor, you have to go with the flow. Makes me nervous.

Thank you very much for your response. In my particular case, CRNA school would be more expensive. Living costs are virtually nil due to my partner supporting both of us on her salary, ( also one AA school is near my parents' house which would be a massive plus). I was also factoring the cost of an accelerating BSN program when speaking of the cost of CRNA school.

 

[Dogruffle01]

Bump

 

[precisiongraphic]

I think as long as you're ok with the geographical limitations, being tied to an MD and the possibility that AAs might be in less demand in the future due to CRNA advancements, you'll be fine. Similar to PAs, AAs probably aren't going away any time soon.

 

[pamac]

CRNAs are more influential as a group, which is nice. But overall, cost eventually catches up to everyone. If CRNAs become too big for their britches, it could be AAs that ride to the rescue and replace them. The downside of that would be that they would do so because AAs would be cheaper, and I don’t think AAs want to be AAs for <$100k. Administrators and anesthesia groups would love that, but that’s not what any AA has in mind. They want to make the big CRNA money. If CRNAs get iced out, AAs will wish they were still around. Interestingly, AA wages tend to match CRNA wages state by state where they practice. CRNAs are pretty much independent everywhere, so one could only guess what wages would be like for AAs and CRNAs in states where CRNAs weren’t independent, but what you’d probably see is that their wage would be lower, and so would AA wages.

The canary in the coal mine for me as far as AA goes (and I once looked into it) was what kind of job would I want to take that only allowed me a future in a handful of states. They exist and do well where they practice, but what kind of leverage does being in so few locations give AAs as a body? Just the optics of that seem to impart a sense of risk there. I think that they probably won’t lose ground where they have settled in, but gaining ground is harder than holding it. I don’t know of how many careers are limited to certain states like that either. For me, if I’m explaining what I do to someone from another state, they all know what NPs, physicians, CRNAs, and for the most part PAs do. If you explain AA to someone, it is something along the lines of “I’m part of a small and obscure body of providers that exist in a few states that does what CRNAs do, but if I want to move and find a job in my field, I can only move to a handful of certain states”. I love the state I’m in, but I’m also glad that I could pick up and work anywhere else in the country.