A*******s
发帖数: 9638 | 1 看到这么一个贴子， 让我了解到你们的对话有这么一个背景：
"Hospital where I work uses an anesthesia management company for CRNAs.
Anesthesiologists are not part of the anesthesia management group. We
medically direct. (Prefer doing my own cases, but not an option.) We have an
opening for CRNA. I am informed by our chief CRNA that the Anesth
management company has recommended a CRNA from Georgia. The applicant is
leaving his present position because said anesthesia management company
apparently talked hospital into firing all the Anesthesiologists and having
a CRNA only model! NO Anesthesiologists! At least this particular CRNA feels
"uncomfortable" without a doc, but how scary is this--on multiple levels! I
have also been told that CMMS, together with AANA, plans, very soon, to
submit a proposal that this should become the model everywhere--completely
independent CRNA practice!"
看上去是一个趋势啊。 | m*********6
发帖数: 609 | 2 小声问一下，谁是崭新啊？
an
having
feels
I
【在 A*******s 的大作中提到】
: 看到这么一个贴子， 让我了解到你们的对话有这么一个背景：
: "Hospital where I work uses an anesthesia management company for CRNAs.
: Anesthesiologists are not part of the anesthesia management group. We
: medically direct. (Prefer doing my own cases, but not an option.) We have an
: opening for CRNA. I am informed by our chief CRNA that the Anesth
: management company has recommended a CRNA from Georgia. The applicant is
: leaving his present position because said anesthesia management company
: apparently talked hospital into firing all the Anesthesiologists and having
: a CRNA only model! NO Anesthesiologists! At least this particular CRNA feels
: "uncomfortable" without a doc, but how scary is this--on multiple levels! I
| L****n
发帖数: 12932 | 3 I have seeing hospital that use CRNA only. and the surgeons are moving their
patient away. Hospital end up hiring MDA again for medical directorship,
but very hard to fill the position. Anesthesiology is much complicated than
people would think. CRNA with 2 yr of schooling, no residency, simply can
not handle anything other than healthy patient come in for minimal invasive
procedure. Legally, all CRNA, like nursing practitioners need to be
supervised by MD. Without MDA, the surgeon will be theoretically the
supervisor. No surgeon wants to do that, first of all they don't know much
about anesthesia, secondly, they don't get paid extra because of the bundled
fee structure. If one case goes wrong, 10 years of their salary might go to
the plaintiff. when things go bad during a surgery, there are usually
really bad. either death or permanent injury. No sane surgeon wants to do
that. This hospital might be going through particular difficult financial
situation. | A*******s
发帖数: 9638 | 4 那个跟Lexian探讨的未来的CRNA。
【在 m*********6 的大作中提到】
: 小声问一下，谁是崭新啊？
:
: an
: having
: feels
: I
| A*******s
发帖数: 9638 | 5 The fact is the anestheologist group also uses CRNAs. Doctors take care of
complicated case and CRNA for easy cases. But complicated cases do not
get more reimbursement.
their
than
invasive
bundled
to
【在 L****n 的大作中提到】
: I have seeing hospital that use CRNA only. and the surgeons are moving their
: patient away. Hospital end up hiring MDA again for medical directorship,
: but very hard to fill the position. Anesthesiology is much complicated than
: people would think. CRNA with 2 yr of schooling, no residency, simply can
: not handle anything other than healthy patient come in for minimal invasive
: procedure. Legally, all CRNA, like nursing practitioners need to be
: supervised by MD. Without MDA, the surgeon will be theoretically the
: supervisor. No surgeon wants to do that, first of all they don't know much
: about anesthesia, secondly, they don't get paid extra because of the bundled
: fee structure. If one case goes wrong, 10 years of their salary might go to
| g**1
发帖数: 733 | 6 10 years of their salary might go to
this is really scary. it's really a big risk.
their
than
invasive
bundled
to
【在 L****n 的大作中提到】
: I have seeing hospital that use CRNA only. and the surgeons are moving their
: patient away. Hospital end up hiring MDA again for medical directorship,
: but very hard to fill the position. Anesthesiology is much complicated than
: people would think. CRNA with 2 yr of schooling, no residency, simply can
: not handle anything other than healthy patient come in for minimal invasive
: procedure. Legally, all CRNA, like nursing practitioners need to be
: supervised by MD. Without MDA, the surgeon will be theoretically the
: supervisor. No surgeon wants to do that, first of all they don't know much
: about anesthesia, secondly, they don't get paid extra because of the bundled
: fee structure. If one case goes wrong, 10 years of their salary might go to
| L****n
发帖数: 12932 | 7 there is a scale, complicated patient do get a slight bit more(1-2units),
but risk of periop complication are much much higher(100 to 1000 times more
likely to have problem per retro study), so nobody wants to take care the
sick patients. some surgeons would build their own surgical center and do
all the easy ones in their surgical center and only bring the sick patient
to the hospital, effectively patient dumping, and the hospitals hates that.
not
【在 A*******s 的大作中提到】
: The fact is the anestheologist group also uses CRNAs. Doctors take care of
: complicated case and CRNA for easy cases. But complicated cases do not
: get more reimbursement.
:
: their
: than
: invasive
: bundled
: to
| A*******s
发帖数: 9638 | 8 True.
Hospitals have to eat up bad cases and you guys are sacrificed.
more
【在 L****n 的大作中提到】
: there is a scale, complicated patient do get a slight bit more(1-2units),
: but risk of periop complication are much much higher(100 to 1000 times more
: likely to have problem per retro study), so nobody wants to take care the
: sick patients. some surgeons would build their own surgical center and do
: all the easy ones in their surgical center and only bring the sick patient
: to the hospital, effectively patient dumping, and the hospitals hates that.
:
: not
| b*****o
发帖数: 6080 | 9 呵呵，我现在连大门边都还没摸到呢，不过远远yy一下，怎么就先讨论起门内的事儿来
了？
an
having
feels
I
【在 A*******s 的大作中提到】
: 看到这么一个贴子， 让我了解到你们的对话有这么一个背景：
: "Hospital where I work uses an anesthesia management company for CRNAs.
: Anesthesiologists are not part of the anesthesia management group. We
: medically direct. (Prefer doing my own cases, but not an option.) We have an
: opening for CRNA. I am informed by our chief CRNA that the Anesth
: management company has recommended a CRNA from Georgia. The applicant is
: leaving his present position because said anesthesia management company
: apparently talked hospital into firing all the Anesthesiologists and having
: a CRNA only model! NO Anesthesiologists! At least this particular CRNA feels
: "uncomfortable" without a doc, but how scary is this--on multiple levels! I
| b*****o
发帖数: 6080 | 10 我啊。
【在 m*********6 的大作中提到】
: 小声问一下，谁是崭新啊？
:
: an
: having
: feels
: I
| b*****o
发帖数: 6080 | 11 我倒希望我哪怕入了学呢。今年去np program orientation，是个人就是这个icu那个
icu的，可以想象被crna program录取的难度了。自然大家考board不容易，可是
nursing－icu-crna读出来也有难度，因为大家都挤破头想收入高一点，既然医院工作
都很辛苦。我是换了好几分工作过来的，不想一脚踏入只是收入可以但不适合自己做起
来心不在焉的行业，而且读np可以part-time,医院可以付一部分学费，不用负债上学，
而crna要full time 读，读完了如果很容易找到工作可以，如果读完了工作需求基本饱
和或准饱和－－象如今的rn行情一样，那样不就白白浪费了时间和金钱了？我想做np是
因为它可以避免体力劳动，将心思完全用在思考治病上；另外一层，我不太爱说出来，
因为很多人会不认同：比起喜欢不喜欢，我在钱上不是特别有追求。就象你们大家不都
在说如果不是出于热爱，不会单因为收入选择医这一行。没有看过完整的麻醉过程，所
以还真不知道自己是否适合或者说喜欢。
【在 A*******s 的大作中提到】
: 那个跟Lexian探讨的未来的CRNA。
|
|
