Sunday, July 1, 2012

A Reader Sent Me This; "Interesting" Indeed!

An anonymous reader sent me a quote from here;  Are anesthesiologists the last true generalists?

Here's the quote sent to me in the e-mail;  by a Jason Simpson
"Man, so anesthesiologists don't know how to use telephones and fax machines?  That's some self-righteous vitriol down there.
Anesthesiologists aren't the last true generalists, we're the last true critical care generalists -- because that's what we are, intensivists.  Every day, I render my previously healthy 25-year-old lap chole patient defenseless and critically, critically ill by giving him midazolam so he can't remember me pushing propofol and burning his veins prior to paralyzing him with vecuronium, the latter two of which would literally kill him were I not to provide him with ventilatory support.   I can't claim that I remember all about ATP III levels for cholesterol treatment or when Grandma needs a colonoscopy or immunization dates or when proper fundal height of the uterus is reached, but I sure do know about pretty much everything else."

So of course I went searching for this person and I found him on facebook. 
Here's the mystery man, author of the quotes in this piece.

Jason Simpson posted a comment in Why the physician shortage is worse than you think · 2 months ago

"Karen talks a big game about fixing the doc shortage, yet she ignores the reality of CRNAs infiltrating anesthesia.  One day her job is going to be done by a midlevel.  Absolutely amazing that something as fancy/sophisticated as giving gas can be done equally well by a person who has less than one third the training of an anesthesiologist"

 What to make of all this?  First, I think that 'Jason' is probably a crna "infiltrating anesthesia" lol!  Here's what he says about using Versed/Midazolam;  "Every day I render my previously healthy ... patient defenseless and critically, critically ill by giving him midazolam..."  So does that sound like the definition of a harmless or safe drug?  In whose vernacular?  He's giving Versed to make his healthy patient "critically, critically ill" in order to save the patient from some burning sensations in his vein?  Does this make sense?  Wouldn't it be more efficient to prevent the burning instead of making the patient "critically, critically ill" with Midazolam instead? 

My crna tried to charge me and my insurance carrier 300 dollars for "electronic transmittal of data."  For 300 bucks a pop, I'm thinking that an anesthesiologist will totally "know how to use telephones or fax machines."  Or an e-mail for that matter!  (PS We did NOT pay that outrageous surcharge for "electronic transmittal of data."  Nice try Mr. Crna of mine, but no cigar!)

 Jason points out in the second quote above, something which is DENIED CATAGORICALLY by most crna's, that being "something as fancy/sophisticated as giving gas can be done equally well by a person who has LESS THAN ONE THIRD THE TRAINING OF AN ANESTHESIOLOGIST"  (emphasis mine) The crna's that I have run across absolutely feel that their training is as good, or far superior to that of an anesthesiologist, an MDA if you will.  These midlevel providers feel that they are most definitely worth as much as doctors.  Yerp!  Thanks to Jason for having the emotional fortitude to call a spade a spade.  "Midlevel" is exactly the term I use to portray the ACTUAL job description of a crna.  As far as the "equally well" part, not so much, in my opinion!

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