Connect with:
Friday, November 24, 2017
HomeHealthNurse Anesthetists vs. Anesthesiologists: New York Times Gets It Right

Nurse Anesthetists vs. Anesthesiologists: New York Times Gets It Right

Yesterday’s editorial in the New York Times got the facts right. Research confirms that nurse anesthetists provide anesthesia as safetly as anesthesiologists and don’t need to be supervised by physicians. This is particularly crucial in rural areas where a nurse anesthetist may be the only qualified anesthesia provider for miles. Of course, the evidence doesn’t seem to matter to anesthesiologists who continue to claim that they must supervise nurse anesthetists to ensure safe care. Oh, and anesthesiologists make more than twice the annual earnings of nurse anesthetists. You can learn more about nurse anesthetists at www.aana.org.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor

Written by

djmasonrn@gmail.com

<p>Diana is a co-director of the GW Nursing Center for Health Policy and Media Engagement and founder of HealthCetera. She was previously president of the American Academy of Nursing. She is senior policy professor at George Washington University and the Rudin Professor of Nursing at Hunter-Bellevue School of Nursing. She is a health policy expert and leader. Diana tweets @djmasonrn.</p>

Latest comments

  • Wow, a nurse agreeing with a study based on billing data funded by the the AANA. I’ve emailed this Cromwell guy 5 times without a response, to discuss his “study.” What a fantastic scientist! You can bet the ASA will be countering with its own evidence, and it wouldn’t include billing data.

    Each time we read this rubbish our PAC increases exponentially. It’s about time physicians stand up for each other. Doctor of nursing practice? We need a federal law that mandates unless you are a physician (MD/DO) you can’t introduce yourself to a patient as doctor. Thank god I live in a state where we have that law.

    Regards

  • What about if you are a psychologist, physicial therapist, pharmacist, occupational therapist…all of whom either require a doctorate or a doctorate is preferred. Everyone, after going many long years of school to get a doctorate, should call themselves Billy, Susie or Harry except a physician? Where is this insecurity coming from?
    I have been a patient many times and each one of these providers, although having a doctorate, always says who they are…a psychologist, social worker, etc. Why is this an issue with nurses and no one else? All of the NPs I know, also say that they are a nurse practitioner.

  • I apologize, I meant interactions in the hospital, not as outpatients. It is misleading to introduce yourself as a doctor, with a white coat in the hospital, if you are a pharmacist, physical therapist, or a nurse. Just my opinion. Then again I have all the responsibility, and when things go wrong, I’m the one that has to face the patient or their family.

  • What’s the difference between inpatient and outpatient? Frank didn’t specify outpatient. I assumed he was talking about inpatient, too. And what data are you using to suggest that nurse anesthetists are not as safe as anesthesiologists?

  • There is no good data to suggest CRNAs aren’t as safe as MDs (and there never will be). But with statistics and study design you can support just about any assertion you want. These studies, both from the physician and nursing organizations are next to worthless. Should we study if a paralegal is as competent as a lawyer (I bet for a large number of tasks they are) or a high level technician versus an engineer? I just wish the ASA and AANA would join forces and fight the government instead of each other (because they are coming). Paying for purchased “research” and getting some nurse advocate at the New York Times to write a support piece (without even putting their name on it) is hardly an intellectually responsible thing to do.

    The issue is anesthesia care is more than safety. And to think the practice of medicine stops at the entrance to the OR and PACU, during one of the most physiologically stressful times of patients’ lives, is crazy. Should we restrict surgeries in rural areas, because there is no anesthesiologist around, absolutely not. I am simply saying physicians should have the central role in the care of the perioperative patient (physicans are most responsible for the research and development of systems that have produced such high quality care in the OR/ICU/PACU). Do I think CRNAs play an important and irreplaceable role in the care of these patients, absolutely (I am a very pro CRNA physician by the way). Do I believe they should have the ultimate responsibility (which is what the opt out is about, that the CRNA doesn’t answer to the MDA or surgeon) for the patient, no I don’t think that should be so. No offense intended, just my opinion.

  • A bit childish to say that you are more a doctor than all the other doctorate programs. So I guess only an MD or DO has earned the right to call themselves a doctor. What rubbish! At what point do MD/DO get along with nurses and help patients. Here is a tidbit on flawed studies. How about the fact that MD/DO can practice anecdotal evidence based solely on their observations which can be contrary to real science. Maybe you guys should say the world is flat or germs spontaneously appear or we are the center of the universe and everything revolves around us. Einstein was a theoretical physicist are you saying that Hawking and other physicist are not doctors. There are many doctors out there that are not MD/DO’s. What a small world you live in.

  • To think all these doctoral trained people here and the issue of who is called what, please. Ignorance should not be bliss for patients. People should know that “doctor” is not the position but the level of education. They hear doctor they should think highest level of training for that person, not medicine man. When a person introduces themselves, it should be there title (lasted I check if you had a doctoral degree you could use doctor) your name and what you do. That goes for physicians, physician assistants, advance practice nurses, the door man, etc. If more people on the heath care team have doctorates, this should make the patient feel they have an extraordinarily educated crew looking after them. The sooner the health care team stop putting time and money into lobbying for turf and focus on patience care, the better this place would be. It will show people you got into medicine to help, not to be praise on a high horse.

  • Wow , to the reply above. Like a ASA study that is in favor of the anesthesiologist never happens. And what gives MD’s the right to have the lock on the word Doctor!! I am a CRNA with a PhD I went to school for a long time and earned my degree no different then you earned yours. Pharmacist, physical therapist, Or any other professional that earned a doctorate are………yes you got it Doctors… It is a degree you self absorbed, egotistical….. I will stop there. And what makes you think we are trying to be like you!! All health care professionals doctorate degree or not are proud of what they are. Since when does doctorate degree=physician only. It is a degree, A doctorate degree only. I never seen a healthcare professional with a Phd, DNP, PharmD try to pass as a physician… I am proud to be a CRNA I did not need the PhD I just wanted it. You could address me how ever you want (just be carefull). I will put my skills against yours any day of the week.

  • I’m a 55 year-old guy who just returned from overseas on active duty; unfortunately I need some surgery and procedures that require anethesia. No big deal (or so I had thought); I have a great CP and she set me up with the best ortho surgeon and GI doc to do the surgeries/procedures. As a dumb pilot (Ph.D. in aeronautical engineering, second degree particle physics from a decent university), I assumed that my anesthesia would be performed by an anesthesiologist MD/DO I could not believe that I was expected to allow a nurse to provide my anesthesia; sorry. “supervised” or not, a CRNA is not a qualified anesthesia provider….calling someone “doctor” means nothing..hey, I’m a “doctor” too! so is my pharmacist, my dentist, my podiatrist. heck even my PT had a “doctorate”……..I want my anesthesia delivered by an anesthesiologist only, no nurses (CRNA) or AA or anyone else. I put this on the consent and have the anesthesiologist sign. Recently, for my colonoscopy (my wife says it was a brain scan), the promised anesthesiologist turned out to be a nurse/CRNA……myGI doc was mad when I refused the sedation from a nurse..but when she asked why I refused (the CRNA kept calling propofol sedation “propranolol sedation”) and she basically had a nurse’s limited knowledge of pharmacology..

    • I am in total agreement with you that every patient has the right to know who the clinical practitioner is that is providing their care. That information should be clearly stated by name and their credentials. This allows patients to make informed choices. Howevery, there is solid research supporting the quality, safety and efficacy of CRNA’s. This site lists some of those studies from peer-reviewed journals http://www.aana.com/resources2/research/Pages/Research-Topics.aspx
      Respectfully,
      Barbara Glickstein, RN, MPH, MS
      Co-director,
      CHMP

  • To the response above. I am a CRNA, PhD. I own and operate a small practice with 3 other CRNA’s. we work independently with surgeons that rather work with us. That is a quote straight from all 5 of our surgeons mouth. The reason I say that is there is no cap on how smart or how good someone can be. You think there is some kind of Celing on how educated one can become. Speaking for myself, I have no problem with Anesthesiologist. That being said before I went out on my own I worked with some. Let me tell you most were horrible and were the laughing stock of the OR! Now I know that is one hospital in one state and one city. Point being you are good or your not. That is in all professions. As far as the “Doctor” thing, it is a degree and nothing more. When people see my PhD and ask if I’m a Doctor I say yes I have a doctorate but I am not a physican I am a CRNA. Make no mistake about, I also tell them they are in very safe and well trained hands. I do not feel more then my MD colleges and certainly I don’t feel less. I can be as good and as intelligent as I want to be. I will not be told otherwise. God created all men equally. It is what you do with your talents that matter. To the person who made the statement above it is easy to make statements like that behind a keyboard. Let me know next time your in a large forum and then make those statements. I have only one favor to ask, let me know where it is so I can be there!

leave a comment