Wisconsin Hospital Replaces All Anesthesiologists with CRNAs.

I have experience looking at heathcare deals, this has a lot less to do with power grabs from conspiring nursing cabals and a lot more to do with doctors being far more expensive. If I’m a hospital and can pay a CRNA $120k-$150k to do most of what I’d pay an anesthesiologist $500k to do, that’s a lot better for everyone economically.
 

You typically still need the physician for more specialized work (this is the first I’ve seen of going all nurses), but it usually lets you cut down the total number of docs you need. This hospital may just have low need for the specialized skillset and just end up using locums when they need it. 

This is all increasingly relevant as we move from fee-for-service care to value-based payments. They can’t pass the cost along? Then they cut the cost

I have no knowledge in this field my only experience to share is the on surgery I've ever had the nurse failed three times to start my IV and the anesthesiologist had to come and got it started in like two seconds so there's that.

Simply, PE firms.  That is what is causing this. 

Good, as long as the quality of care stays about the same, then these measures are needed to lower HC costs. And honestly, fuck the new crop of doctors. All those pre-med kids in undergrad were the most cutthroat, brown nosing, anti-social dopes imaginable who made prestige hungry bankers look like saints, so job cuts and hopefully pay decreases couldn't happen to a better group of people.

I totally agree with your opinion. I am an anesthesiologist and a nurse and anesthesiologist can never do the same job.

I know a doctor who f'd up very badly and lost his license. The patient he hurt is living with the consequences.

I have doctors in my family too but this is kind of a lazy take because the doctors are already overworked. Ancillary staff and mid-level clinicians are needed to handle the clinical workload.

So I don't fully agree with this but you have solid points.

Know plenty of both as well. Spend 20 minutes talking with a nurse, spend 20 minutes talking with a doctor.

The difference would be the same as talking finance with a bank teller or mortgage lender and someone in IB.

My school is top 10 for nursing. I would not trust those coke snorting sorority girls as my anesthesiologist. 

Anyway, this probably means the surgeon will have to act as a supervisor to the CRNAs. I wonder if that means that they are liable if the nurse makes a mistake? Hospitals usually try to cover-up anesthesia mistakes anyway as it's a very high bar to prove malpractice on the part of the patient. 

Patients will never see these cost-cutting measures reflected in their bill

I guarantee not a single patient will see any savings from this. The hospital will keep all the additional profit. This isn't to say our for-profit system is entirely bad, it does help in attracting top talent globally, but hospitals certainly should not be PE owned

A physician oversees them and would be covered under med mal.

"Also, we might see medicine move more towards a specialist model where there are more specialists and less GPs.  Nurses and PAs will fill in the gaps and direct patients to specialists."

Yeah, this is already happening in the states. Kind of nice for GPs/primary care docs though, I've heard their pay has gone up quite a bit during the pandemic. Some undesirable locations will pay these guys 350K+ starting out - working 35 hour work weeks.

CRNAs have a doctorate in the way that lawyers do… it’s not comparable to a MD/DO degree in rigor.

But what matters even more-so is that CRNAs do not have to complete a rigorous 4 year long post grad apprenticeship in the way that anesthesiologists do (residency).   CRNAs have a small fraction of the proctored anesthesia clinical hours that an anesthesiologist obtains. We’re comparing 2000 to well over 10,000….. And it’s not just nominal hour count… There are also stricter case acuity requirements for an anesthesiology residency than there is for CRNA programs. Anesthesiologists are far better trained to administer anesthesia 
 

source: a student anesthetist that knows no CRNA should be working outside of the ACT model (anesthesiologist supervision). 

Very true. Many young Gen Z/Millennial doctors are motivated by their income more than they'll say publicly. Grew up around a lot of people in the field and that's all they often talked about after a few drinks - reimbursements/pay/complaints about lost of autonomy (a lot of boomer docs straight up quit during the pandemic).