Ditch the "physician anesthesiologist" expression

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Carbocation1 said:
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Won't settle for less...right up to the point of having to attend medical school and go through an actual residency to become the best anesthesia provider they can be. But yea, won't settle for less. Close enough.
 
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GravelRider said:
I read this as even more of an insult. "Advanced practice nurses who won't settle for less?" What is "less?" Is "less" an MD with a full residency?
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It's us who are settling for less by allowing them to do this. If you want to be mad, direct it towards the ASA and the legislators who've allowed this to happen. If you didn't have to go to medical school or complete a residency and a group fought for you to make more money and do whatever you wanted and call yourself a doctor you would be happy. These people will take as much as you allow them to take. It's up to you to punch them in the face.
 
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Are there no regulation? seeing that DNP online thing is just horrible. then after a 2 year online bs degree, they start introducing themselves as doctor. how can this be allowed? ridiculous. it can only harm patients. Are any doctor organizations pushing for only MD/DOs be called doctors in clinical areas?? If not the ASA needs to get on top of this.
 
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anbuitachi said:
Are there no regulation? seeing that DNP online thing is just horrible. then after a 2 year online bs degree, they start introducing themselves as doctor. how can this be allowed? ridiculous. it can only harm patients. Are any doctor organizations pushing for only MD/DOs be called doctors in clinical areas?? If not the ASA needs to get on top of this.
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This is a hospital level problem. The solution is for anesthesiology departments to take an active role outside the OR and start sitting on hospital committees which are responsible for setting policy on scope of practice and how providers introduce themselves to patients. Every individual hospital should mandate that only MD/DO can introduce themselves to pts as Dr.
 
anbuitachi said:
Are there no regulation? seeing that DNP online thing is just horrible. then after a 2 year online bs degree, they start introducing themselves as doctor. how can this be allowed? ridiculous. it can only harm patients. Are any doctor organizations pushing for only MD/DOs be called doctors in clinical areas?? If not the ASA needs to get on top of this.
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What the absolute hell is going on there? Doctor of nurse anaestheist!?!
 
vector2 said:
This is a hospital level problem. The solution is for anesthesiology departments to take an active role outside the OR and start sitting on hospital committees which are responsible for setting policy on scope of practice and how providers introduce themselves to patients. Every individual hospital should mandate that only MD/DO can introduce themselves to pts as Dr.
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Why can't this be higher up? Like pass a bill banning this from happening
 
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A few states introduced legislation limiting the use of the term "doctor" in health care facilities to be limited to physicians, dentists, and podiatrists. They were all shot down and never became law. I THINK that one or two states limit the term PHYSICIAN to medical doctors as a matter of state law.
I would think that there are many institutions that limit the term as a matter of institutional policy.


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It still mystifies me why we haven't blown this whole deal up by advocating for AAs
 
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The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
 
Iraheatbeat said:
The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
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Yeaaa, I'm sure right after a nurse introduces themselves as Dr to the patient they spend the next 5 minutes explaining how they're only technically a doctor because they spent two years doing online classes and submitted some poorly written "thesis" about how mid levels bring down US healthcare costs. It matters because patients have a (reasonable) expectation that if they meet someone named Doctor in the hospital then that person is a physician. PharmDs and PhDs have the good sense to realize this simple fact, DNPs on the other hand have such a monumental chip on their shoulder that they don't realize the idiocy of their actions. Those that do realize are acting out of malicious intent in an attempt to blur the lines between mid levels and physicians and somehow claim "equivalency." I couldn't care less whether a patient knows how much or how little debt I have- what I do care about is whether they know their hefty premiums ensured that they received care from someone with the maximal education, training, and ability to respond to emergencies, aka a board-certified anesthesiologist.
 
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Iraheatbeat said:
The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
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ISIS has finally taken over anesthesiology too, damn they're good!

I have always found that the people with biggest attitude and inferiority complex are usually mid levels, while physicians relatively aren't as such. If you want to be a doctor, go to medical school, plain and simple. An online degree about nonsense doesn't make you a physician. It really is mind boggling how these DNPs think they are at the same level.
 
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2Fast2Des said:
ISIS has finally taken over anesthesiology too, damn they're good!

I have always found that the people with biggest attitude and inferiority complex are usually mid levels, while physicians relatively aren't as such. If you want to be a doctor, go to medical school, plain and simple. An online degree about nonsense doesn't make you a physician. It really is mind boggling how these DNPs think they are at the same level.
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But they've put in 2,000 hours of work into writing those essays about Socrates, for their DNP! :p

These people just don't get it: imitating what doctors do, even for the same number of hours, doesn't make one a doctor. Otherwise, we would have a lot of toddlers with Dr. in front of their names.
 
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FFP said:
This is all very nice in a market where one can just hire another CRNA tomorrow. Actually, in most parts of the country, one has a higher chance of hiring a good anesthesiologist than a good CRNA. A per diem CRNA can make more than a salaried anesthesiologist, so many good ones don't take more than a part-time W-2 position, if any, and work per diem in multiple places (so they can leave any single group if needed). Both employed and per diem CRNAs know this, so they feel free to ignore your "suggestions", if they disagree with them. Good luck making a fuss, especially if you are not a partner, and they have been there forever. It's easy to talk as a CA-0.

Also, let's not forget the pack mentality. Many ACT practices cannot afford pissing off their CRNAs as a group. Money, money, money!

The CRNA militancy has gotten to a level where I have had a millennial SRNA talk back to me. That did not go well, but still nothing major happened to the SRNA, since money talks. ;)
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Man such truth in this statement. Can't like this one enough.
 
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Iraheatbeat said:
The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
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Let's get something straight here, nurse.

Having a doctoral degree and being a doctor are not the same thing. Doctors are considered to be experts and authorities in their respective fields. No one considers DNPs to be anything other than the mid-levels they are (with bloated degrees).
 
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Iraheatbeat said:
The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
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I think you are the one who needs to "live" with the fact that you are a nurse and that your role in the health care field is to assist a physician with ancillary tasks, not to impersonate one.
 
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FollowTheMoney said:
I think you are the one who needs to "live" with the fact that you are a nurse and that your role in the health care field is to assist a physician with ancillary tasks, not to impersonate one.
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Ouch! That ship has almost sailed.

Good luck suggesting to any nurse holding an advanced degree that her role is to assist you. As long as we don't take back the governance of our healthcare organizations, the nurses at the top will keep protecting the ones at the bottom, and pushing for the practice of medicine by nurses. What do you think this whole "healthcare team" concept is about, just political correctness? Nope, it's about eroding the practice of medicine by physicians only. ;)
 
ASA Priorities on Out of Network Billing and the APRN Compact Recognized at AMA 2017 Annual Meeting
06.16.17

"In addition to ASA promoting Resolution 115 and helping protect it from harmful amendments, ASA President Jeffrey S. Plagenhoef, M.D. presented on the APRN Compact at the AMA’s 2017 Scope of Practice Summit. His presentation, entitled “APRN Compact: The latest tool in the independent practice toolbox” provided an important opportunity to educate physician leaders and staff from a number of specialty and state medical organizations on this dangerous legislative initiative. Dr. Plagenhoef reminded the audience that this is not a scope battle, it is a patient safety/quality of care battle. Dr. Plagenhoef’s presentation aligned with the ASA Delegation’s APRN Compact Resolution which calls on the AMA to convene an in-person meeting of relevant stakeholders to initiate a national strategy to address the APRN Compact. This resolution will be considered at the AMA’s Interim Meeting of the House of Delegates in November."

American Society of Anesthesiologists - ASA Priorities on Out of Network Billing and the APRN Compact at AMA 2017 Annual Meeting
 
Dr. Plagenhoef is usually very inspiring. I'm almost sorry for him, and all the work he puts into his presidency.
 
We need more alphas like Plagenhoef in anesthesia imo. Too many weak betas in this field who are letting nurses take over.
 
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Carbocation1 said:
We need more alphas like Plagenhoef in anesthesia imo. Too many weak betas in this field who are letting nurses take over.
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He's the rare ASA leader who doesn't come from academia or an AMC.
 
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BLADEMDA said:
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What. In. The. World.

Where did you even find this crap?

I'm not in anesthesia, but I feel terrible for you guys. Unfortunately, anesthesia is just canary in the coal mine... the encroachment into IM specialties is happening, but hasn't hit critical threshold just yet. Maybe in another 5 years, we'll all be looking up at our DNP/BSN/RN/PHD/CCRN/CRNA overlords.
 
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bronx43 said:
What. In. The. World.

Where did you even find this crap?

I'm not in anesthesia, but I feel terrible for you guys. Unfortunately, anesthesia is just canary in the coal mine... the encroachment into IM specialties is happening, but hasn't hit critical threshold just yet. Maybe in another 5 years, we'll all be looking up at our DNP/BSN/RN/PHD/CCRN/CRNA overlords.
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This man has a point. Don't think gas is the only group being probed. EM, FM and IM are all on the chopping block.

Is physician lobbying really this weak?
 
Iraheatbeat said:
The level of disrespect I just sat and read through is appalling. Every single person on this forum has no problem discrediting and bashing CRNA's and DNP's like they just woke up one day and gave themselves that title. Titles are such a big deal to you guys as if you need it to validate spending 10 years of your life to owe 200k to Sallie Mae. You are physicians, and you have a degree and immense medical knowledge to show for it whether you are a MD or DO so what does it matter if a DNP advertises themselves as a "doctor"....newsflash they are. Just as much as PHD's and PharmD's and so on and so forth. Will some patients confuse the two? sure but they also cant tell the difference between an OD and a DO..bottom line is you'll live. You have Anesthesiologist that have degrees from schools that sound like an ISIS recruitment camp somewhere in the middle east yet still you have a problem with these people who studied here in America for quite a long time just to do something they love and continued to progress in it to the point where they earn a doctorate degree in it. If you are THAT threatened by it then by all means get your student loan bill tattooed on your forehead....that'll show em you're a good ole "Physician"
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What a douche.

You want to know who is hung up on titles? Nurses. Period. How many initials come after John Smith MD? Two. How many come after John Smith, RN, BSN, MSN, DNP, CRNA, ARNP, CCRN, CEN? TNTC. Totally absurd. LMAO!
 
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Moose A Moose said:
This man has a point. Don't think gas is the only group being probed. EM, FM and IM are all on the chopping block.

Is physician lobbying really this weak?
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Not sure if physician lobbying is weak, but the nursing lobby has powerful allies like the hospital lobby. Think of the boon to hospitals if now all of a sudden you can interchange every "1.0 FTE provider" with a nurse, PA, or physician.
 
FFP said:
This is all very nice in a market where one can just hire another CRNA tomorrow. Actually, in most parts of the country, one has a higher chance of hiring a good anesthesiologist than a good CRNA. A per diem CRNA can make more than a salaried anesthesiologist, so many good ones don't take more than a part-time W-2 position, if any, and work per diem in multiple places (so they can leave any single group if needed). Both employed and per diem CRNAs know this, so they feel free to ignore your "suggestions", if they disagree with them. Good luck making a fuss, especially if you are not a partner, and they have been there forever. It's easy to talk as a CA-0.

Also, let's not forget the pack mentality. Many ACT practices cannot afford pissing off their CRNAs as a group. Money, money, money!

The CRNA militancy has gotten to a level where I have had a millennial SRNA talk back to me. That did not go well, but still nothing major happened to the SRNA, since money talks. ;)
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Ok, I understand this, but what happens if you come up with a plan of care and document that you're instructing the nurse anesthesist to carry it out? I know typically they're shielded from malpractice and anesthesiologists take the hit, but could they be at risk if it's well-documented that they deviated from your direction? At the very least, I imagine you would be shielded similarly as if an internal medicine doctor's documented orders were ignored by a floor nurse.

What I'm getting at here is that I think a large part of the reason we even have the debate of who can do the job better between us and them is that we undermine ourselves with the very language we use. Saying we "supervise" them rather than "direct" them makes it look like they are capable of making all the decisions and anesthesiologists just sit around on autopilot until they do something wrong. I know they complain about being micromanaged, but they also complain about anesthesiologists who sit in the coffee room and make the big bucks for doing nothing (their argument not mine). You can't have your cake and eat it too.
 
zizzer said:
Ok, I understand this, but what happens if you come up with a plan of care and document that you're instructing the nurse anesthesist to carry it out? I know typically they're shielded from malpractice and anesthesiologists take the hit, but could they be at risk if it's well-documented that they deviated from your direction? At the very least, I imagine you would be shielded similarly as if an internal medicine doctor's documented orders were ignored by a floor nurse.

What I'm getting at here is that I think a large part of the reason we even have the debate of who can do the job better between us and them is that we undermine ourselves with the very language we use. Saying we "supervise" them rather than "direct" them makes it look like they are capable of making all the decisions and anesthesiologists just sit around on autopilot until they do something wrong. I know they complain about being micromanaged, but they also complain about anesthesiologists who sit in the coffee room and make the big bucks for doing nothing (their argument not mine). You can't have your cake and eat it too.
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Perhaps if you work in an ACT, as part of the every preop you could write "keep vital signs +/- 10% baseline" as part of the plan.
 
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