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dynorphin t1_iupcsqx wrote

You really don't want to look into how private equity groups are buying up all the private anesthesia practices they can to cut corners, generate profits for investors, and kill patients, while actually increasing surgical costs.

These people belong in jail but we live in a corrupt system where that will never happen.

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r0botdevil t1_iuq4rv3 wrote

I recently found out that one of the clinics I work in was just sold. I wasn't given any of the details, but I can only assume the buyer is one of those private equity firms.

I'm quitting next month.

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Art-Zuron t1_iurkmnh wrote

The various Christian churches are doing it too, and then enforcing their religious dogma onto what treatments they'll use.

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dinner_is_not_ready t1_iur13e8 wrote

Do you have more information on what places to avoid? What places are bought by private equity groups?

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anthrocommunism t1_iur1z8a wrote

It would be good to have a website or something that lists ownership information about clinics, hospitals, etc.

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mokutou t1_iurrk41 wrote

PE groups are creeping into all parts of medicine, and the results are appalling.

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PlasticPaulBunyan t1_iuvyb3n wrote

Radiology groups too. It's going to get to the point where radiologist are just at home reading imaging, and PA's will be on site doing all the work. It's already close to this in many places. You're 3x more likely to see a radiology PA than one of them vampire docs.

1

Poopsandboops t1_iup9rot wrote

"We received the jury's verdict, and while we respect the civil justice
system, we believe strongly that our clinicians provided the patient
with excellent care." 

... You have GOT to be kidding me - the guy was left in a vegetative state, real excellent patient care guys!

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Greentoysoldier t1_iupjvoq wrote

More details can be found over at r/anesthesia but basically the crna left the room for 12 min and the electronic record has been “lost” and a hand written record created. Clearly an error was made an injury occurred. Implied is a coverup was attempted and there is a question if a policy is to blame more than human error.

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[deleted] t1_iuq0f6o wrote

[deleted]

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fitnessCTanesthesia t1_iur5c4j wrote

Anesthesia providers are not supposed to leave a patient without supervision even for 30 seconds, let alone 12 minutes. In my residency it was a 1x offense you are let go, learned from day 1.

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SkyeSpider t1_ivln6g1 wrote

I woke up during surgery once. I couldn’t move, but my eyes were open and I was fully aware. I saw my anesthesia person happily chatting with the others in the room. It took him a few minutes to notice I was awake and turn a knob that put me back under. If I hadn’t had a nerve block done in my shoulder, I would have felt everything. I’ve had 11 surgeries and it’s a major fear of mine that another person will do this to me while not nerve blocked (like on an abdominal surgery I have coming up).

It really blows my mind how casually someone can take a job that important.

1

emrythelion t1_iuphkzu wrote

While it’s likely in this case that the issue occurred due to the fact that he didn’t seem to be getting the correct supervision from an anesthesiologist…

it’s not a guarantee this wouldn’t have happened anyways. Surgery is always dangerous. Even the simplest of surgeries could mean you never wake up again.

The absolute best of the best anesthesiologists will still likely face a death where anesthesia was the cause (or a factor) at some point in their career. Not to mention other issues, like what happened in the OP, or heart attacks, strokes, etc.

Elderly or those with pre existing conditions will always be the highest risk, but just being 27 doesn’t mean there are no risk factors. At that age, pre existing conditions may still be unknown; especially if the person in question has never been put under anesthesia before. Some people are more (or less) susceptible to the affects of anesthesia, which can make a huge difference. Some people are born with heart defects that only become known when specific situations occur. There’s a million and one different factors involved with anesthesia and while the anesthesiologists best judgement will be correct in the vast majority of cases, there’s always a possibility it’s wrong or something goes wrong during the process.

The family was awarded money correctly, and it’s very likely that this situation would never have occurred if it wasn’t a distracted doctor supervising CRNAs who were also busy. That, or it would have been caught earlier, meaning no or little longterm impairment. The fact that private companies are trying to cheap out by pushing overworked CRNAs instead of fully trained anesthesiologists is absolutely disgusting and shouldn’t be allowed.

But I think it’s still important to point out that what they said is not necessarily false. He may very well have gotten the best care possible, and this could have happened regardless of who was supervising him. It’s just not the most likely situation.

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DylanHate t1_iupoma5 wrote

I think the issue here was electronic medical records were “lost” and there is the appearance of a coverup by the hospital.

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dinner_is_not_ready t1_iur0hxa wrote

So how does one avoid this? Should we just avoid private hospitals or should we avoid treatment where anesthesia is done by CRNA?

10

rchart1010 t1_iuuwnul wrote

I have specifically asked. I used to date a CRNA and he seemed good at his job. But, I'd like an anesthesiologist. So I've asked specifically if the anesthesiologist is an MD or CRNA. It's always been an MD.

5

dinner_is_not_ready t1_iuvo9tx wrote

Oh so in your case it was MD. I don’t know if I can make hospital get an MD to do anesthesia just for me but I can avoid places if they only offer CRNA. On that, what other things you avoid? Any other tips?

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emrythelion t1_iuzv2me wrote

Avoiding a CRNA is ideal, yes. It’s unfortunate, because there are absolutely CRNAs who are incredibly experienced and as knowledgeable as actual Anesthesiologists. But the reality is, it’s mostly shitty private hospitals and clinics that use CRNAs because they’re too cheap to pay for someone with actual experience. Capable CRNAs are the exception, not the rule (or even common) in this situation.

It’s just greedy fucks being greedy.

3

rchart1010 t1_iuuwbr9 wrote

Are you an anesthesiologist?

Prior to my most recent surgery my anesthesiologist said that nearly all anesthesia complications/deaths are in unplanned anesthesia situations such as when someone has an accident and needs immediate/emergency surgery.

Is there a specific reason you have that leads you to a different conclusion?

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emrythelion t1_iuzurx5 wrote

Nearly all. That’s the caveat.

Not every anesthesiologist will see a death due to anesthesia, but most will. Based on current numbers at least (and even a decade ago it was much worse.). Most deaths they face will be due to people with extreme risk factors or unplanned situations, but that doesn’t change the fact that most anesthesiologists will face at least one death they absolutely didn’t expect.

I’d also bring up that unplanned anesthesia really doesn’t matter; because the people that die unexpectedly in those situations are those with no risk factors at all. You never expect a young person, in good shape, with no known health issues to suddenly go into cardiac arrest, because it turns out they have a faulty valve in their heart. It doesn’t really matter whether it was a planned surgery or not. The majority of people who die in unplanned anesthesia situations have known or very obvious risk factors.

It is improving. Better imaging makes a HUGE difference. Issues that wouldn’t have even been caught 10 years ago, let alone longer, are being seen far in advance and can be planned around.

I’m not an anesthesiologist. But I’ve been put under almost 20 times, the majority of which have been in the last 10 years. I’m 29, just to clarify. I also carpooled with a child of an anesthesiologist the majority of highschool. I‘ve had this discussion with every single anesthesiologist besides the first, since it was my tonsils when I was 2 years old.

I’m not a doctor, but what I’m saying is what every single experienced anesthesiologists have told me. Every time before I’ve been put under. It’s always a risk. And I was probably in a better position, because i was generally healthy and had “good“ experiences with anesthesia.

1

rchart1010 t1_iv0pumz wrote

Okay, so, it sounds like you're basing your statement on the fact that you've been told there is a risk of death and maybe some CYA statements from your anesthesiologists. Oh, and carpooling with the child of an anesthesiologist? Which seems like a pretty big reach.

However, even 20 years ago it appears there were only 315 anesthesia related deaths a year in the US so I'm not sure how that led you to a conclusion that most anesthesiologists experiencing an unplanned anesthesia death.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/

>First, our results indicate that the numbers of anesthesia-related deaths in the United States averaged about 315 deaths per year from 1999 to 2005.

Also, unless you have another data source I'm not sure how you'd know that emergency situations aren't the setting in which most complications occur, serine as how there is no time to get a history, perhaps limited access to different drugs and a person who may have wildly fluctuating vital signs due to being in distress.

You've been talking like an authority and I just don't think you are one, even if you carpooled with someone whose parent was an anestheologist and have been under anesthesia multiple times.

Anymore than I'm an authority in the field of endocrinology because I've seen an endocrinologist hundreds of times or an expert in eye injections even though my doctor tells me there is a risk of blindness or complication. Or an expert in gastroenterology even though I went out on a date with a gastroenterologist.

Unless of course there is an outside data source that backs your claims that most doctors have experienced x, y or z and the causes, I don't think your experience or even your conversations make you any better situated to speak authoritively in this area.

ETA: there is some evidence to suggest increased anesthesia risk in emergency situations which is also counter to your post.

>Difficult intubation is far more likely to occur in suboptimal environments outside of the OR such as in the emergency department, the intensive care unit (ICU), patient wards and even outside of the hospital.

https://tsaco.bmj.com/content/2/1/e000113

1

gardenpartytime t1_iup7s96 wrote

A 4:1 ratio of CRNA’s:MD might fly for a colonoscopy clinic but this young man was having a two-hour surgery. Clear negligence.

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OldTammyTwoToes t1_iupjx9c wrote

all about $$$ for the medical execs. Hire cheaper CRNAs with less training over MDs. Happening everywhere in medicine.

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thecaits t1_iuptcst wrote

Healthcare should never be for profit. It's crazy to me that people think our system is the best, when really it's just a race to the bottom.

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Drift_Life t1_iur1u6p wrote

Everything is the “best” when you have no experience or knowledge of how other systems work. I don’t understand how Americans are so scared of a national healthcare plan that will take care of all of its citizens for a fraction of the cost and with standard care. I mean, the system we have now really isn’t working well for the majority of us, and if you lose your job… well best get on dyin then!

23

Fenrils t1_ius0u88 wrote

"Americans" aren't scared though; much like marijuana legalization, the vast majority of Americans support nationalized healthcare. Our system is just broken and corrupt so our leaders don't need to give a shit about what the majority wants.

7

ComradeMoneybags t1_iurdzt7 wrote

It’s best if you have so much money that handing over a pile money for procedures is like buying groceries. Yeah, there’s technically ‘access’ to the best medical care on the planet, but that’s like saying nothing’s stopping me from eating wagyu beef and caviar every meal, except, well money.

4

[deleted] t1_iuq0bkf wrote

[deleted]

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rchart1010 t1_iuuwust wrote

Yeah, I think if you kinda make a fuss about it ahead of time they make sure to have an anesthesiologist there. I know I've made a fuss.

2

dinner_is_not_ready t1_iuvoqt0 wrote

Yeah I’d want the facility to sign a contract with me that they’d have an MD present. Like what the hell

2

PlasticPaulBunyan t1_iuvyv2g wrote

It's probably cheaper to cancel your surgery than bring another MD on for the case. Sad, but true. One MD can supervise a handful of CRNAs, vs an MD who can do one case.

1

gnfknr t1_iur0cu4 wrote

It’s the other way around. Supervising 4 CRNAs in endoscopies is significantly more dangerous than Longer surgeries, especially on healthy people.

The most likely scenario is that they don’t have a medical record easily accessible on a terminal so the doc can check the vitals in the OR from any terminal.

The CRNA likely saw the low blood pressure and decided that he/she didn’t need to treat it because the patient is healthy.

As an anesthesiologist I see this all the time. I tell the CRNA to increase the blood pressure and there response is that the patient can tolerate it. 99.9% they are probably right but the. You get that 0.1% of a patient who won’t tolerate it. I’ve seen this issue so many times.

It’s hard to say what happened here but I can almost guarantee you it’s the situation above. Crna’s just being stupid and not listening to the docs.

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dinner_is_not_ready t1_iur0ldp wrote

What’s a safe ratio? Should CRNA be banned?

5

DBM t1_ius1ge3 wrote

4:1 ratios are defined for medical direction practice models. This model is not the same as independent practice or medical supervision.

3

dinner_is_not_ready t1_iusa9wl wrote

What does this mean? What is a good ratio?

2

DBM t1_iusfa1x wrote

4 CRNAs : 1 anesthesiologist. It’s a ratio set by law at the state legislative level

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dinner_is_not_ready t1_iut1mz5 wrote

So they had compliant ratio and still messed up someone’s life. Is it possible to request a hospital does not use any CRNAs?

1

[deleted] t1_iups3w6 wrote

[deleted]

−19

fitnessCTanesthesia t1_iur50jp wrote

A lot of changes in the last 5-10 years. There’s medical direction vs supervision. I think supervision can be up to 10:1. The doc just signs charts and is around to put out fires but doesn’t know the patients very well.

5

TrunksTheMighty t1_iuoxxu1 wrote

It's really bothersome to me that some families would rather care for someone that is clearly not there anymore. It's sad and I hope it never happens to me, I think if I ever go into surgery, I'm going to stipulate dnr and give instructions on not to be kept alive on life support.

Condolences to this family and the poor guy this happened to.

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Thetruthislikepoetry t1_iupb839 wrote

Every place I’ve worked you are required to be a full code when going to OR. Why? No surgeon wants a patient to die on the OR table.

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LoverlyRails t1_iupryh6 wrote

For about a year, I received botox treatments for migraines. Every single time I came in to the neurologist's office for the treatment, I had to sign paperwork stating I wanted to be receive everything possible (the full code) if neccessary or they would not do the botox.

I'm guessing it's similar. A small, but slight risk of something going terribly wrong.

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coreyman317 t1_iuqvsqx wrote

So why would you risk that for Botox? Just bizarre.

−32

ravingriven t1_iuqwlfs wrote

Did you skip over the part where they said it was for migraines?

Botox has many uses far beyond just cosmetic

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coreyman317 t1_iur1lg9 wrote

So take poison for migraines? You’d have to be stupid to do that lol

−48

zanraptora t1_iuri7b4 wrote

We use purified toxins all the time in medicine. Botox specifically was cleared by the FDA in 2010. Turns out a paralytic compound is pretty great at stopping headaches caused by misfiring musculature that doesn't have much practical use.

7

craznazn247 t1_iuro1fr wrote

Warfarin is the primary ingredient in rat poison, but we do controlled microdoses with frequent monitoring, and that has been the gold standard for blood clot prevention for decades. Factor Xi drugs are now the gold standard but only due to slightly less bleeding risk than warfarin. Last I checked the clot prevention is still considered equal to warfarin, but those new drugs are expensive as hell at over $500/month if your insurance doesn’t cover it.

Besides, some of us get migraines so painful and enduring that in the moment, that being prescribed a bullet starts to sound reasonable. Botox is safely used for wrinkles and overactive sweat glands - things that people can easily live without. So why not use it in situations where it can alleviate chronic pain and suffering with minimal (or even desired) side effects if done right? Other than the localized effects, it can have a lot fewer systemic effects than some of the drugs used.

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LoverlyRails t1_iur1ypy wrote

I have severe migraines that have neurological symptoms (like I have had a stroke). For example- I have briefly forgotten my children's names, how to tie my shoes, how to use a phone. I still have memory loss and other neurological issues (like a severe inability to do math and aphasia) even despite treatment.

Before treatment, I was getting migraines most days a month (over 25).

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GreyFoxLemonGrass t1_iuph5bi wrote

You can write a living will with that info! That way if you ever get in an accident your family and doctors will know your wishes.

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HIM_Darling t1_iuqvqso wrote

If you are in possession of a uterus make sure to specify that your wishes are the same if you are found to be pregnant. And be super specific. If I’m coma wishes are xyz, even if pregnant, if I’m vegetative state wishes are abc, even if pregnant, if declared brain dead wishes are xyz, even if pregnant, etc.

Texas has already tried that bullshit once. Woman was brain dead, and despite her wishes being not to remain on life support the hospital said that because she wasn’t pregnant at the time she made that decision and she didn’t specify that her wishes would be the same if she were pregnant they were going to pretend that she wanted her dead body to be used as an incubator. It took several months of her husband and her parents fighting the hospital in court before even the judge had enough of the hospitals bullshit and ordered them to check on the status of the fetus(they kept saying they couldn’t tell). Hospital finally had to admit the fetus was incompatible with life and the judge ordered them to take her off life support.

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GreyFoxLemonGrass t1_iusg9tq wrote

Wow, thank you for the heads up. What an awful thing to have to consider.

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fr3ng3r t1_iuqi40h wrote

Is it only done thru a lawyer or can one just handwrite it, leave it in a drawer somewhere, & tell someone about it prior to surgery?

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Levlove t1_iuqz9jz wrote

You can do it without a lawyer and get it notarized. Legalzoom has a really easy format that asks questions and then puts it all together for you. Then you get it notarized, make sure your POA knows where to find it, and move on.

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GreyFoxLemonGrass t1_iusfya9 wrote

It depends on your state, and either way you should make sure to give copies to friends/relatives in case they need to decide and haven’t yet gone through your desk drawers.

In my state you need to use specific forms for it to be legally binding. I made a google doc and called that good enough, because I hope my family would follow my wishes without needing to be forced legally (and also I am lazy).

2

Blu3Army73 t1_iuoztqq wrote

I'll just stipulate to put all my favorite shows and movies on shuffle in my room so at least I'm never bored

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[deleted] t1_iupbahl wrote

It would be Supernatural for me.

Except season 7. I’m haunting whoever lets season 7 air while I’m a vegetable.

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SaltyTowels t1_iupesjv wrote

True I would much prefer death to that, but in this situation the last thing I would be receptive to as a greiving family member would be an Organ Donation approach from the hospital. Call me having pride or arrogance if you must, but how would I know they wouldn't screw up the organ harvest too? And of course it's not like the hospital did it intentionally. Man I feel so bad for everyone. I'm just thankful when I was told my aunt was braindead the decision was as clear as crystal.

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Zidane62 t1_iuq6mt3 wrote

My family had to do that for my mom during the delta wave. The doctors said they could keep her alive but she’s already gone. We chose to let her go on her terms instead of hooked up to machines the rest of her life. She would have wanted that

8

shewy92 t1_iuroblc wrote

It's kinda selfish to keep someone "alive" like that IMO.

1

CritaCorn t1_iup1qlv wrote

Can you imagine going to sleep for the last time and NEVER waking…..uuuugh so sad

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deftoner42 t1_iup3cb1 wrote

Would you even know? (Obviously, yes, sad for everyone close to you)

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Rellgidkrid t1_iup4j5b wrote

That’s the big question, isn’t it.

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SnooLemons1590 t1_iupzbdg wrote

More than big, it’s frightening.

10

420ipblood t1_iur3zve wrote

That's how you'll (and I) die anyway. Car accident, heart failure, organ failure, suffocation etc. will all be a surprise when it happens. I think it's important to not fear the inevitable and hold on to the idea that you don't know how you got here to begin with so it's just another new adventure. Humans have a genetically gifted curse in our ability to fear and make concepts bigger than life. Wear your seatbelt.

4

RoyalCities t1_ius35qi wrote

Easier said than done after experiencing the whole consciousness thing lol.

3

spyder728 t1_iuqe8oj wrote

It is a crazy experience.

I had a major surgery back in July 2021. It was a 5 hours surgery to install MANY screws and 2 rods at my neck, so it requires drilling. My spine won't stop bleeding everytime they drill in (apparently that's uncommon), so they have to keep stopping and let the cell saver machine to clean my blood and put it back into me. 5 hours surgery turned into 10 hours.

Because of that, they have to keep putting anesthesia into me and it is not good to have that much anesthesia in me. I couldn't wake up afterward.

They tried to wake me up every hour after the surgery. I can hear them and I can feel the nurse smacking my face. I tried to open my eyes and I just couldn't. 5 or 6 hours later, I finally woke up because of a phone call.

Afterward, I was told I lost 3L of blood during the surgery. They were about to tell my parents to prepare I might not wake up.

Now everytime I think of it, I still can't believe it. Especially I was asking 1 of my surgeons about the possibility of that right before they roll me to the OR. I could've just slept and never wake up right there.

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redux44 t1_iuqj260 wrote

The best way to go when you're old though.

5

CaptainJackVernaise t1_iuprjk8 wrote

"the practice is allowed in Texas."

This young man's future is gone because of Republican governance. Think about that over the next week when you're considering your vote.

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Duluthian2 t1_iup8z7b wrote

There is no such thing as simple surgery. There might be less complicated surgeries but a lot of things can go wrong.

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r0botdevil t1_iuq5390 wrote

The surgeon I work for always says "the only minor surgery is something you do on someone else".

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khrak t1_iuqmhw9 wrote

Well, ya, if you're operating on yourself it has to be an emergency.

6

PlasticPaulBunyan t1_iuvz5ss wrote

We had a case in town where a very prominent cardiologist went in for "simple" oral surgery and died due to anesthesia complications. His widow is now fighting for proper supervision when anesthesia is administered during a case.

1

iBeelz t1_iuph94r wrote

Man, I hope my lawsuit with the hospital that butchered my mom goes that well.

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RaglanderNZ t1_iuqh49z wrote

Boohoo for capitalist medical systems. When hospitals and healthcare are considered for profit business, of coarse they are not about whats best for the patient.
In NZ the healthcare of the nation is paid for with tax. Rather than a bloated military.

10

WaterfallDragonCave t1_iuqq7x6 wrote

His mother says they try to get her to take him off life support - how dare they. It doesn't sound like he is at or close to "brain death." So it's his parents' choice.

As far as the claim he received excellent care, that's exactly why his family deserves this judgment by the jury. We should all be heartbroken for them.

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yourlittlebirdie t1_iupvini wrote

Doesn’t Texas have a cap on damages though? IIRC, there’s a $250k limit, no matter what the jury decides.

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thisbechris t1_iuqmkep wrote

I believe that’s for tort, not for negligence. I say this not knowing much info about the actual case as the article really didn’t specify certain things.

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Nice_Category t1_iur5otb wrote

$750k for pain and suffering. But that doesn't include actual damages.

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SmartWonderWoman t1_iuszpwi wrote

"I think patients need to be apprised up front that they have a choice to get an anesthesiologist who has 4 years of medical school, 3 years of training and board certified, rather than a CRNA who may have a nursing degree and extra year of training," he said.

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mces97 t1_iuscgki wrote

Yeah this definitely should not have happened. And with not 1, 2, 3, but 4 nurse anesthetists there. Monitoring vitals is literally one of the most basic things an anesthesiologist is supposed to do. Should have their certifications revoked. This wasn't some act of god mistake. This was negligent.

1

coreyman317 t1_iuqvkb7 wrote

Stupidity is an expression of laziness, which in this setting is an expression of evil. Change my mind.

−3

[deleted] t1_iuqrgef wrote

[removed]

−7

613codyrex t1_iuqtmgp wrote

Yeah no.

CRNAs are not MDs and there’s nothing short of CRNAs going through the same exact process MDs go through to change that.

You call the studies unbiased but they probably are.

CNRAs are being brought into to undercut MDs salaries full stop.

Most people won’t want a nurse putting them under if they’re made aware.

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fitnessCTanesthesia t1_iur67o1 wrote

Just mention AAs and see how the CRNA narratives change. The worst crnas are the ones who think they are as good or better than physicians because they don’t know what they don’t know. They think subbing nursing degree and 2 years of CRNA school makes them equivalent, even call themselves “Doctors” in a clinical setting when they have a PhD. Makes me gag.

8

chiefkief6969 t1_iuqwzcx wrote

Full stop? I’d say some of it has to do with the fact that there are far too many surgeries for only anesthesiologists to be in the OR. It’s not like any of them are struggling to find work because CRNAs are taking their jobs. What should the alternative be? Overworking anesthesiologists to the point where they make even more mistakes? Most people don’t have time to wait for an anesthesiologist to be able to do the surgery. And if they do that time is now allocated solely to them instead of the possibility of 4 operations happening at once. Can you imagine the backlog if each anesthesiologist had to do 4 individual procedures? People would die waiting when they could have had just as safe a procedure with a CRNA.

3

Nice_Category t1_iur6a43 wrote

Not MDs, but CRNA school is a PhD equivalent now. They are typically very well trained and know what they're doing. I'd be fine having a CRNA watching over me during surgery.

I also work in surgery and very closely with anesthesia and the surgeon. Just like anything, there are certain surgeons, anesthesiologists, and CRNAs I wouldn't want on my surgical team. But I wouldn't disqualify a CRNA because of their title. They are highly trained.

2

Lacy-Elk-Undies t1_iutgohs wrote

FNP here, so take this with a grain of salt. When I looked at CRNA programs myself, they had very strict prerequisites. Most required at least 2 years of ICU experience, 3.9 or higher undergrad GPA, multiple recommendations, and rounds of interviews. The programs itself had about a quarter of the number of students than an FNP program, and had higher GPA standards to pass. So saying it’s a nursing degree with one extra year is discounting a lot of the background (which is less than an MD, but that is kind of the point of that degree).

One thing I thought was interesting was how one of the articles said that two CRNAs had administered blood pressure meds. When did the second one come in the OR? Was that before or after the 12 min break? Was there an attempt to reach the anesthesiologist and that’s why the second CRNA was there? Also, does supervising mean actively monitoring? I know I’m other specialties, supervising means that they physician may review the notes and treatment plan later, but there isn’t usually active participation on the spot.

3

Nice_Category t1_iutkiqc wrote

So I do surgical neurophysiology/neuromonitoring for brain and spine procedures and nearly all of my cases are with CRNAs. Typically, the anesthesiologist will come in with the patient (along with the CRNA) and assist with getting the patient to sleep and intubated, then positioned onto the operating table. After that they leave and go assist with other cases or do whatever it is they do, leaving the CRNA in the OR to administer the case. 99% of cases have no issues, and the anesthesiologist may pop his head in a few times throughout the case to see if the CRNA needs anything. Another CRNA may stop by to give a break. Then, at wake up after the case is finished, you might see the anesthesiologist, but maybe not. That's a typical case.

If ANYTHING goes wrong, they call the anesthesiologist immediately while trying to correct the issue. This could be something like an irregular BP, suspected issues with a leak in the airway, IV or art line issues, or something as serious as pulmonary edima during extubation.

1

precise_O t1_iuqwtj6 wrote

A CRNA is a nurse, they didn’t go to medical school, the didn’t do a residency, they didn’t pass medical boards. They are a nurse and nothing but a nurse that private companies pay to replace a more trained, more expensive doctor.

9

chiefkief6969 t1_iuqy2na wrote

How many anesthesiologists have lost jobs to a CRNA? There is no replacement happening. This isn’t your first comment belittling CRNAs.

−2

HerpToxic t1_iurv4f0 wrote

Its not that they lost jobs, its that nobody is hiring new anesthesiologists because they are hiring CNRAs instead at a lower salary.

Imagine instead of 1 anesthesiologist supervising 4 CRNAs, the hospital had 5 anesthesiologists, one for each of the 4 patients, plus a supervising anesthesiologist that oversees the 4 others.

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PlasticPaulBunyan t1_iuvzj5t wrote

This is just the way American medicine is going though. My dad is an emergency MD and "retired" to work at an urgent care. He was the only MD on site, overseeing 2-3 PAs. At the hospital I work at, radiology PA's do the majority of procedures while the Rads read the exams and pop in for more difficult cases (this does not apply to pediatric radiologists just FYI).

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chiefkief6969 t1_iutn7me wrote

You do not know what you’re talking about. New anesthesiologists are not having trouble finding jobs

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