Eventually anesthesiologists will take over for nurse anesthetists?

Question

Hopefully Pangolin will answer this, but anyways, i keep hearing that CRNA's can do just about anything Anesthesiologists can do, and not only will the pay for Anesthesiologists go down, but Anesthetists will soon be able to do nearly (maybe not nearly but many things) everything Anesthesiologists can do. There will also be a less demand for anesthesiologists.

Can someone tell me what is so different between the 2 professions?

Answer 1

The first two answers refer to some common misconceptions about CRNAs.

1) "A CRNA ... is well trained for mundane anesthesia." Yes, they are. But they're also well trained in what to do when the fecal matter hits the fan.

2) CRNAs do everything from gallbladder surgery to open hearts.

3) If something goes wrong, though, get the h**l out of the way and let the anesthesiologist work.

- I've been in cases and seen a patient go down the tubes.By the time the anesthesiologist gets there, the CRNA already has the patient stabilized.

I've also seen anesthesiologists just stand there with a "Oh, %@, what do I do now look?" on their face.

Most CRNAs (and PAs) know their limitations. There's a lot of MDs/DOs that don't know theirs.

Answer 2

Pangolin has answered this about fifty times in my own memory.

Malachi has put it quite well, and much the way Pangolin has responded.  There is a big difference between a fully-qualified, board-certified anesthesiologist and a nurse-anesthetist, and if you don't believe that, I very much hope you never need one.  Heck, even a dumb fourth year medical student just doing an anesthesiology rotation can "do anything an anesthesiologist can do" (under careful supervision and direction, of course) under non-emergency circumstances when nothing is going wrong.  If something goes wrong, though, get the h**l out of the way and let the anesthesiologist work.  When someone's life is on the line, give me an anesthesiologist or an ICU specialist in the room and I will thank my lucky stars every time.

There is no particular sign that there is any trend towards less demand for anesthesiologists.  The opposite, if anything, is true.

Answer 3

Thanks, Malachi & Marie!  Well said.

The difference is, the CRNA calls the anesthesiologist when things go bad, not the other way around.

I bail out CRNA's probably once a week, usually in small ways, but sometimes in very big ways.  Usually it's getting an ET tube or spinal in, but I've had to remove drugs from a very experienced CRNA's hand that would have killed a very sick patient.

Most CRNA's are excellent, and do very good work, and those that know their limitations and call us early are the best.  I don't claim to know it all - I'll call in my colleagues when I need help, and we all need help at times - but I'm calling in another physician.

Answer 4

A big part of a traditional anesthesiologists time was "wasted" on routine, uneventful anesthesia. A CRNA only needs a master's degree and is well trained for mundane anesthesia, but they almost always work under a certified anesthesiologist who has M.D. level training, clinical experience and continuing education. When anesthesia goes wrong, it does quickly and needs an M.D to take over. CRNAs allow M.D.s to concentrate on the more difficult cases for which there is no shortage of demand.

It sort of reminds me of airplane pilots. When everything is normal, many liken their profession to being a bus driver. But in about 1/100 flights their years of training and experience are called upon to handle unexpected problems. Unlike Anesthesiologists though, you can't call another pilot onto the plane in case of an emergency.