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    James Sid

    Hi Dr.Kumar,
    I was wondering what your view is on CRNA’s in the clinical setting. Also your experience in collaborating with them as an anesthesiologist.



    Hi James! This is easily the most common question I’m asked!

    First, there’s a shortage of anesthesia providers in this country, and for that reason, I’ll always admit that we need CRNAs and AAs in addition to anesthesiologists. Furthermore, the number of individuals I know who went straight from nursing school into ICU just to get the minimum experience required for CRNA school is rather disconcerting and alarming. I’m a firm believer that there are NO shortcuts in medicine and providing quality patient care, and experience takes time to garner.

    I’m obviously biased, but I’d argue that pre-med undergraduate studies, medical school, residency, +/- fellowship with all the responsibilities, liabilities, board/entrance exams, fees and rigorous training inherent to the physician path… well… there’s no comparison. And patients need to know this.

    I’ve trained alongside SRNAs as a resident and supervise CRNAs as well as residents in my current role, there’s a night-and-day difference in knowledge base and procedural skills. From what I’ve seen, there’s a lot of “pattern recognition” without understanding the underlying pathophysiology. As an intensivist and cardiothoracic anesthesiologist, I don’t really work with CRNAs (very rarely I’ll supervise them if I’m moonlighting) nor do I foresee them replacing me as an attending physician rounding in the ICU or doing complex cardiothoracic cases.

    With all that in mind, I’ve always had wonderful interactions with my CRNA colleagues when I was a resident. While there are a vocal minority who like to comment on their “MDAs” (as they say) with significant attempts at political lobbying for more autonomy, patients need to understand the difference in our training paths and responsibilities.

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