Anesthesiologist Assistant ::: CRNA vs Anesthesiologist Assistant Jobs

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Dave "J" - CRNA's Random Thoughts on Anesthesiologist Assistant's

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by: Dave J.

About the author:
Dave J. is a CRNA who is posting insightful Q & A's on AAMessageBoard.com. Please visit and ask questions about AA's and CRNA's. Dave shares his clear nonbiased views about Anesthesiologist Assistants and CRNA's and how they might work as team players in the near future. Ask Dave J!

went to AnesthesiologistAssistant.com and looked at the salaries listed for Anesthesiologist Assistants, CRNAs and anesthesiologists.

As of August 10, 2006, there were TWELVE (12) jobs posted for AAs in five states. Of those 12 jobs, the average bottom figure was $125,833. The average top figure was $137,500.

There were 2104 jobs posted for CRNAs in almost all the states. I used the lowest figure from the minimum income column and the highest figure from the maximim income column for the first 12 jobs listed. The average minimum income figure was $162,500. The average maximum income figure was $204,166. As of this date there were 1525 jobs posted for anesthesiologists in almost all the states. I used the same method to calculate averages for the anesthesiologists as for the CRNAs. The average bottom figure was $322,500. The average top figure was "Greater than" $354,166.

"Medicare is making a 13.7% CUT in payments come Jan 1, 2007. In light of that, we all may see either no pay raise in the next 2-3 years or we may even be asked to take a pay cut. One thing to watch out for though is stretching the staff to keep the same bottom line."

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If you are hired by the MDA group or by the hospital, an hourly wage is very common. Years ago (1970s) if your room finished early, you got to go home and still got paid for a full 8 hours of work. But as case load increased, you ended up more and more often working the full 8 hours. Because of the way overtime worked, it was cheaper for the group or hospital to pay you time and half for over time than it was to hire enough staff to cover for late cases. So it got to be expected that you would work until your cases were finished. Putting in 12 hour days five days a week became more common and was not worth the extra money. I once pulled out the "crew rest" rules mandated by federal agencies for truck drivers, airline pilots and nuclear power plant staff and got looked at like I was nuts to even suggest that hospital people should also pay attention to "crew rest" issues.

Based upon personal experience and the experience of three other family members who are CRNAs, (total of 90 years of practice) the trend seems to be more like you get a good salary when you first get hired but then the case load picks up without an increase in pay to match the increased work load. Expecting a pay raise to keep up with inflation is not unreasonable however in the past 20 years that does not seem to be the case.

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Rather than reposting "this is straight off the ASA website" why does not an AA do the comparison for himself? (The ASA is not "AAs" and it is not "CRNAs" so why use their listing?) Take a number of criteria.

Compare the AA and the CRNA.

Can each do the item listed? How about this for a start?
Can they administer gas anesthetics, raising and reducing the concentration as necessary, turning it off near the end of the case?

Can they administer narcotics?
Can they administer Propofol? (This may seem minor but propofol is one drug the anesthesia people would like to keep out of the hands of non-anesthesia people, so if AAs can administer it, it goes a long way to show that AAs are qualified anesthesia people. Check out the nurse practice acts in some states to see what I mean.)

Can they do the intubations?
Can they do the spinals?
Can they do epidurals?
Can they do bier blocks?
Can they do ACLS protocols?
Can they do peripheral blocks?

If both are working at the same facility under the supervision of MDAs, can they relieve each other on cases without a major hassle?

Same question, can they relieve each other on ALL cases or is the relief limited?
If limited, which way is the limitation?

Can they work without MDA supervision?

Just a suggestion. I (as a CRNA) would believe a well thought out and researched study done by an AA working on his masters degree than just some info from the ASA website. Anything can be posted on the internet but it takes quality research to get something into a medical journal.

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QUOTE FROM HERMAN: "My point is that the insurance companies have not recognized the increased liability of CRNA's doing their own cases without supervision."

#1. CRNAs have been doing their "own cases" without MDA supervision for years. The "OP OUT" is just a Medicare issue and has not changed the practice, just the payment.

#2. Do you really believe that insurance companies are so far behind the times that they have missed an opportunity to jack up the rates?

#3. CRNAs have never said they are "equal" to a MDA. What has been said is that CLOSED CLAIMS reviews show that solo vs team practice has the same percentage of "bad" outcomes. What I proposed is a concurrent study of the various anesthesia modalities to see if one type is better than another. I also said I bet AAs and CRNAs are equally safe. But until someone does a valid study, we (you and I) can make all the claims we want.

Anesthesiologist Assistant or Nurse Anesthetist?

Dave "J" the CRNA's random thoughts....

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