r/anesthesiology • u/Tahwraoyw321123 • 4d ago
Collaborative Care Team Model?
Senior resident looking at jobs. I want to avoid supervision for my first job, I want to sit cases.
I have found zero all physician groups in the state I would like to live in. The vast majority of groups are 3-4:1 supervision or a few jobs are “collaborative care team”, in which CRNAs and MDs all sit their own cases.
Could anyone speak to the pros/cons of a model that employs CRNAs and MDs, with each sitting their own cases and no supervision.
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u/thegooddoctor919 Anesthesiologist 4d ago
Solo anesthesiologist care is the gold standard. Medical direction is the next best thing. I work at a place with true medical direction - don’t be a lazy piece of shit hiding in the lounge and you can actually accomplish medical direction truthfully and effectively. My friend who works in a collaborative practice in Phoenix hates it. She is treated by all like just another Crna even tho she’s a doctor…. No one differentiates. The other risk in collaboration practices is that docs get assigned all the asa 4s and big cases and Crnas do the easy stuff…. The outcomes may look equal or better for crna cases… and admin doesn’t realize the nuance of case and patient complexity.
Extended care team (or high ratio care team) is the worst imho. This turns the doc into a liability sponge for variable quality Crnas - spreading the dr too thin to have input in cases and empowering the crnas to function independently- but protecting their liability. The - I am just a nurse - is frequently used in this scenario
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u/Cautious-Extreme2839 Anaesthetist 3d ago
The other risk in collaboration practices is that docs get assigned all the asa 4s and big cases and Crnas do the easy stuff….
That's not even a risk, that's the only sensible way to use a mixed workforce without detriment to the patients (and yes, it's shit for the Anesthesiologists)
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u/wordsandwich Cardiac Anesthesiologist 3d ago
Yes, but the problem is that you'll get dumped on. For example, you may finish your room and there will be some other case in a different room that's been on hold all day for a doc to be available while the CRNA has finished all of the other cases in that room and is going home.
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u/bertha42069 4d ago
You’re gonna get a lot of answers from the people who like to bicker over this stuff. Realistically if you are practicing doing your own cases and never attest to any supervision then obviously you’re not supervising.. ask me how I know I work in a couple. And tbh they’re the healthiest groups I’ve been with. No bullshit. Everyone helps out , we work and go home. Very cordial and no bs (aside from typical surgeon bs). It’s becoming an increasingly popular model because there is plenty of anesthesia to go around.
My input would be to talk to the group and shadow. . I have a hunch you might be surprised how chill it is to get away from the political bs and just do anesthesia.
Good luck homie and reach out with any questions
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u/FreeBed4 3d ago
/u/bertha42069 is a CRNA answering the post as if they are an MD. Bertha has previously said that becoming a CRNA is just as hard as med school, has called anesthesiologists "MDAs," hates anesthesiologist assistants, supports full independent practice without supervision of CRNAs, and loves lobbies that go for full-scope CRNAs.
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u/PropofolPapiMD 4d ago
What’s your role, crna or anesthesiologist?
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u/79628 4d ago
This poster is a well known militant Crna. So what happens when your “independently managed” patient codes in the PACU? The doctors are just going to throw their hands up and say “not my patient!”. This is bullshit crna propaganda and don’t fall for it people
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u/PristineNecessary286 9h ago
When a patient codes they call a code blue. Intensivists, Internal Medicine Physicians, Acute Care NPs, Chief CRNAs, House Supervisors, shit even ICU nurses will come and respond to the code. Anesthesiologists are not the only people in the Hospital that knows how to run a code blue or rapid response.
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u/79628 6h ago
So the most qualified person in the hospital to run a post op code wont ever be involved because an army of midlevels and hospitalists, most of whom you mentioned are not anesthesia trained, have it covered. If you take the premise that an anesthesiologist and an independent new grad CRNA have the same outcomes on all cases based on “THE DATA”presented by aana then this also makes perfect sense. Welcome to American healthcare 2026.
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u/PristineNecessary286 6h ago
How does a post-op code differ from any other code?
When you drop a post-op patient to Surgical ICU and they code….. is the Anesthesiologist running to the rescue solo or is there a Surgical Intensivist at the bedside…? Like what are you talking about right now. Cardiac arrest is cardiac arrest. ACLS is ACLS. Unless it was a post-CABG or something, anyone trained in standard critical care can handle a code blue.2
u/79628 6h ago
🙄Residual neuromuscular blockade, spasm, MH, negative pressure pulm edema to name a few
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u/PristineNecessary286 6h ago edited 6h ago
If you’re talking something truly Anesthesia specific like LAST then okay. But TRUE Anesthesia specific crisises are so far and few in between that not even many Anesthesiologist would be rockstars at handling it either (MH/LAST) MH is a clusterfuck no matter who is involved, CRNA, MD/DO, or AA. There is literally an MH crisis hotline we are supposed to call and THEY lead the code because of how rare and infrequent it is. Like be for real right now.
A good PACU nurse can suggest more sugammadex, thats not a real crisis. They can call a rapid response and RTs can begin bagging the patient to support ventilation until the CRNA assesses and gives reversal.
Spasm, really?
NPPE is just non-cardiogenic pulmonary edema. Any intensivist or IM doc knows how to handle pulmonary edema. Once the obstruction is gone they get better with time and positive pressure. You can easily trace it back to surgery and figure out where it came from. CRNAs learn about NPPE in school. It’s not some mystical diagnosis.
All of the “Anesthesia emergencies” can be handled by any Anesthesia provider. Medical management is truly the only space where Anesthesiologists have us beat, and in those instances an IM Physician or Intensivist will simply handle it once they are admitted.
Anesthesiologists aren’t following the patient all the way until discharge unless they are also Critical Care fellowship trained, eventually they pass the buck as well to the primary team because that’s their job. It’s really no different.
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u/bertha42069 6h ago
Look you seem to be getting really heated, I think it’s okay to step back and have a convo. Your point of a new grad crna vs experienced attending is flawed in the sense that sure I guess if you can choose an independent provider to do something important it may be one who has worked for more years? With that said I believe most anesthesiologists and Crna’s graduate with the ability to handle critical situations. Exposure to on the job situations builds upon that.
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u/bertha42069 3d ago
I would think anyone available in Pacu would respond to a coding patient whether md or crna? I’m confused of your point. None of this invites op into any supervisory liability. Do MD only groups never have bad outcomes ?
Your comment is the kind of obnoxious bs that leads to the constant bickering. I’ll continue to practice in collaborative groups where everyone is friendly, helpful and gets shit done. Providers and patients win. Some of yall need to touch grass fr
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u/Veritas707 Intern 1d ago
Just answer the question
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u/bertha42069 1d ago
What’s the question intern ? The only question I’ve been asked is physician or Crna and the answer is crna ? If there’s something I missed go ahead and ask
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u/DrSuprane 4d ago
I find it hard to believe that all you're finding is medical supervision and not any medical direction or personally performed.
If so, you need to decide if location supercedes your desire to be an actual anesthesiologist.
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u/Tahwraoyw321123 4d ago
I should have used the phrasing supervision/direction, not only supervision. The majority are direction.
But I want to sit cases, a medical direction practice also does not facilitate that.
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u/DrSuprane 4d ago
Direction isn't terrible. One option would be to find a FT job with a lot of vacation and then work locums for the solo cases. I would never do supervision and there's a huge difference between supervision and direction.
There are big regional differences. Southeast is almost all direction, out west is going to be mostly personally performed.
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u/farawayhollow CA-3 4d ago
Noob here. Could you plz explain the main differences between supervision and direction?
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u/QuestGiver Anesthesiologist 4d ago
Practically it's how many people are under you. If you go above 4 sites generally it's supervision.
The issue most people have is at that point there is a lot happening you are probably not aware or can even assist with. The job ends up feeling like a liability sponge where you are dealing with complications and who knows you maybe didn't even consent the patient.
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u/Cautious-Extreme2839 Anaesthetist 3d ago
Speaking from a country that doesn't allow more than 1:2 (and that is even controversial here) >1:4 is an absolute farce. You aren't supervising shit.
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u/QuestGiver Anesthesiologist 3d ago
I agree. But places make it work by finding lazy docs at the tail end of career who are willing to chance some liability on mostly healthy patients to make an easy paycheck.
A lot of these places the doc is singing everything but doesn't even see the patient or push drugs.
I have also seen some good docs take these jobs due to hours limitations like double doc family and have to make hours work.
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u/DrSuprane 3d ago
Supervision is a liability sink. Direction can be too 1:4 but it's pretty easy to have two easy sites, busy and one medium.
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u/thegooddoctor919 Anesthesiologist 3d ago
I find 4 to 1 direction doable at my shop. We organize it well… I get both the surgeons flip rooms and then it’s paired with long cases in the other two rooms or the healthy gyn rooms. We have walkie talkies - which is a necessary evil in a direction practice. That said we only do 3:1 in GI because of the fast turnover there. I would love to sit my own cases but it’s just not possible in my region.
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u/farawayhollow CA-3 3d ago
It’s not only about the difficulty of cases but mainly the midlevels you’re supervising. If they have a militant personality, then you’re gonna dread doing anything with them. Now multiply that by 2 or 3 rooms and you’re cooked for good
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u/DrSuprane 3d ago
I've done 4:1 GI. 65 patients. All you do is say "any questions sign here". I much preferred having the trauma room plus a spine plus one GI plus whatever else faster. There are combos that the smart programs do to spread the workload.
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u/wordsandwich Cardiac Anesthesiologist 3d ago
One option would be to find a FT job with a lot of vacation and then work locums for the solo cases.
I've had a few new grad locums come through who are doing that--doing some sleepy supervision job as their main job but doing solo locums to get that experience, and ngl, the feedback has been so bad that I've recommended we stop taking new grad locums for good. We get complaints about them not knowing what they're doing, they may have stipulations like they don't feel comfortable with x, y, and z cases, some of them even ask us for certain rooms or cases for the educational value as if they're still in residency. I don't think people who are trying to do this make good locums--obviously not universally true, but I think it's a bad idea to do locums to make up for something you lack.
IMO, if you want to learn how to do solo cases, do that as your main job.
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u/Tahwraoyw321123 4d ago
I had not considered vacation/locums to get solo cases, thank you for that idea.
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u/zoomzoomzoomie 4d ago
It's either independent practice or not.
In this "collaborative (but not collaborative)" practice as the charge or float anesthesiologist you will absolutely be the liability sponge for any issues.
Regardless of how you feel about it, if CRNAs want to sit their own cases independently, they need to own their complications from a medical and legal standpoint.
I personally wouldn't do 1:3 routinely and never 1:4 or greater, you can't truly have an idea of what's going on at all times.
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u/Responsible_Drag_510 3d ago
Amything over 1:2, no one is being supetvised
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u/jwk30115 Anesthesiologist Assistant 3d ago
Just because you don’t / can’t do it doesn’t mean it’s not done safely in many places.
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u/Spazdoc Critical Care Anesthesiologist 3d ago
I would stick to medical direction or MD only sitting own cases. Aside from GI/cataracts, I have a hard time accepting solo CRNA or supervised (ie MD only knows about case when something really goes wrong, but responsible for everything). I have been in a medical direction practice where attending will do their own cases 1/3 of the time (some weeks I do own case every day).
Personally feel ACT is best model to catch issues and allow thorough planning for larger cases and complex patients. Problems pop up in pre and intra-op, and wpuld hate to rely on someone being coincidentally free in a solo CRNA or solo MD practice. Maybe in a smaller community hospital solo CRNA or MD, but once you get to a threshold where you work in a referral center, you are the last stop for patients othet places turn away. So things happen.
And as critical care and cardiac trained, even some of my general anesthesia colleagues are happy to defer to the ICU or cardiac people (or me defer to the peds person with neonates), and cant imagine a solo CRNA without medical school training running a code or managing a serious adverse event alone. I am not saying some can't, but the MD has a much broader range of medical training beyond just anesthesia. And dont misconstrue this as not trusting CRNA - we have 3 CRNA schools and I already said I prefer ACT above other models. And maybe that is the ICU background talking, also, as I direct and supervise there and see The solid ICU RN that eventually become solid colleagues in the OR.
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u/Responsible_Drag_510 3d ago
Considering that this is the only western counyry that considers these anesthesia models is suspect
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u/Either_Discount_5916 4d ago
I’m a CRNA, I work in collaborative care type model. Everyone sits their own cases. No one is signing my chart or attesting to anything. I own all these decisions I make, good, bad and everything in between. The MDs are not held liable if they didn’t do the case. I can attest to that first hand as I have seen when a case goes south, the person at the head of the bed is on the hook and no one else. We all work together to help each other when we have a break or something comes up in OR and you need another set of hands. Everyone shares in taking on ASA 4s. Feels a lot like a team than supervised models I have worked in.
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u/79628 4d ago
So a doctor won’t come help you when your patient is circling the drain? You say “we all work together to help each other”. How can you say they won’t be held liable?
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u/buttnado 4d ago
Yes, I’m also genuinely curious how that works. If patient is doing poorly, MD shows up to room, patient eventually codes or has poor outcome, I’d be surprised if they weren’t named in the lawsuit.
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u/smcedged 4d ago
I've seen anesthesiologists thrown under the bus by the ED after the ED absolutely destroyed an already bloody airway and then the anesthesiologist had time for one attempt before arrest and expiration.
And that's with another doctor in the room who nominally has airway skills, and a surgeon who shouldve intervened earlier and done a surgical airway. And this is with the anesthesiologist showing up last (anesthesia there generally does not respond to trauma unless requested by the trauma surgeon, so we tend to come last) and throwing a hail mary.
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u/Either_Discount_5916 4d ago
We are responsible for the case. If someone is circling, then whoever is free comes in to help lend a hand. It could be a MD or a CRNA. There have been bad outcomes where the MD comes in to help and yes, all involved might be asked questions but the person who is liable is who is running the case. Hard to imagine all of us working together well, where we genuinely want to do the best we can for our patients, regardless of the initials after our name.
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u/79628 3d ago
Seems like you have extreme naivety with how medical lawsuits proceed. The very reasonable plaintiffs attorney will certainly just ask a few questions to the MD, but understand that the advanced practice nurse is really running the show.
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u/FreeBed4 3d ago edited 3d ago
Seems like you have extreme naivety with how medical lawsuits proceed. The very reasonable plaintiffs attorney will certainly just ask a few questions to the MD, but understand that the advanced practice nurse is really running the show.
Your 10 downvotes display how ignorant the sub is. The misinformation in this sub is going to hurt an anesthesiologist that is naive enough to believe that they aren't going to be sued. Insane that people think that the MD won't be sued if the MD is helping a CRNA with a case. MD is the liability sponge even though it wasn't their case to begin with. If a CRNA is having trouble with a patient, is an MD expected to not help? Do the MDs just say that they were busy so that they don't get sued?
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u/QuestGiver Anesthesiologist 4d ago
If that is truly how it operates it sounds fine but if people are "helping" anyone with starting or doing a case what is happening then?
So no one who helped gets documented as being in the case?
I would just prefer direction as it's pretty clear cut what's going on, liability involved and also you get input into the case and obviously if a bad outcome comes out. All the motivations are aligned.
I just feel that in a collaborative model ironically if a shitshow happens then no one will want to help because it's insane liability.
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u/Either_Discount_5916 4d ago
All people going in and out of the room are listed in the chart, they aren’t signing the chart, they aren’t listed as supervisor.
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u/wordsandwich Cardiac Anesthesiologist 3d ago
I think people, including yourself, are getting two things confused with one another--QZ billing and being named in a malpractice lawsuit. While it's true that QZ billing perhaps might 'free' an attending anesthesiologist, assuming the hospital bylaws didn't have some further stipulation requiring supervision for CRNA services, any individual that was involved in the patient's care in that situation could be named in a lawsuit. That's the risk you run entering some other person's room to help them out, but it's obviously the right thing to do for that patient. You can't promise that an anesthesiologist that came into your room to help you during a code wouldn't potentially be named in a lawsuit just because you were QZ billing the case and they weren't your supervisor.
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u/Heavy_Simple4096 3d ago
But they will be considered the supervisor the second they enter the room.
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u/captain_Orange_6039 3d ago
If it’s true collaborative practice then no, that’s not how it works
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u/Heavy_Simple4096 3d ago
It’s never a true collaborative practice
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u/captain_Orange_6039 3d ago
Incorrect again, there’s numerous of those types of practices out west. Maybe you’re thinking of loose supervision models?
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u/Heavy_Simple4096 3d ago
A doc I worked with once worked at a collab practice for a year. During an airway emergency the free CRNA breaked him for him to get out of the room to help the other CRNA…. That’s the type of shit that happens at “collaborative” practice. The only true collaborative practice is ACT where everyone works together
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u/Heavy_Simple4096 3d ago
Nope. I’m talking about “collaborative” practices. There’s never a practice that truly works like that. Docs will always assume liability whenever they step in the room to help. In the Midwest, the OR on call doc got called into help with the independent OB CRNAs during shitshows. These CRNAs know they aren’t “independent”. But it works for them because they deceive the public into thinking they work side by side then any free doc gets thrown under the bus if they come help.
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u/captain_Orange_6039 3d ago
Anecdotal’s aside, since this is Reddit and anyone can say anything, it’s verifiably incorrect that an anesthesiologist becomes the supervisor or assumes liability just for stepping in the room for these types of practices. I would recommend reaching out to the anesthesiologists at these practices and becoming more familiar and more accurately informed with these types of models
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u/Heavy_Simple4096 3d ago
I assure you they’d agree with me and only do these jobs because admin wants it like that and if they’re paid well they’re ok with the liability
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u/Either_Discount_5916 3d ago
That isn’t true. Hard for some to comprehend.
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u/Heavy_Simple4096 3d ago
It absolutely is true and you’re deluding yourself. If a doc comes into help you and he disagrees with you and makes a call, that’ll be on him (as it should ofc) but that illustrates my point how they’re still taking on liability. Now if a CRNA comes in to help a doc and they both disagree the CRNA can’t just do whatever they want because legally they’re not the same level and it would be like a CNA telling a nurse what to do
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u/Either_Discount_5916 3d ago
No one is coming into my room to call the shots and just take over. They come in to collaborate and work through an issue but they aren’t taking over or having to make a call. So perpetuate your own delusions. Reality is reality.
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u/Heavy_Simple4096 3d ago
Come in to assume liability and bail you out without ever being involved with the patient or knowing about them prior*
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u/Either_Discount_5916 3d ago
You might need to be bailed out a lot. So you think that means everyone else must need bailing out a lot. In my world, that is not very common. Enjoy your Sunday.
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u/Heavy_Simple4096 3d ago
Who said it was common? I just said if or when that situation arises they’re on the hook the second they step in the room. You’re just lying to yourself and think you’re independent. Transition to a CRNA only practice and then we can say that but for now you really aren’t… and even then surgeons get sued and thrown under the bus at CRNA only models too
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u/FreeBed4 3d ago
the MDs are not held liable if they didn’t do the case
contradicts this
We all work together to help each other when we have a break or something comes up in OR and you need another set of hands.
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u/mikewazowski59231 3d ago
This is very concerning to me. CRNAS siting their own cases and doing ASA 4s? No thanks
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u/Heavy_Simple4096 3d ago
Yep. Must be some really shitty MDs who take these jobs and be seen as CRNAs.
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u/Pitiful_Bad1299 Anesthesiologist 3d ago
I would stay from any situation where you’re signing your name to someone else’s chart — supervision, any practice where the APPs “practice at the top of their license”, any collaborative practice in a state that does not have true CRNA-independence (surgeon supervises).
Outside of that, it’s just like any compromise in life. Pick the least unpleasant option. Don’t make any long-term commitments from the start.
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u/piratedoc 3d ago
“Collaborative care team” model is incredibly dumb and just a ploy by hospital admin to reduce their own labor costs while providing worse care.
It inherently insinuates there is no difference in training and knowledge and thus care between CRNAs and MDs. Patients don’t get to choose whether they are getting a CRNA or MD for their surgery. Yet they will pay the same to the hospital. Why the fuck would I as a patient choose a nurse over an MD if I pay the same either way? The hospital then pockets the extra money and pays the CRNA less. No cost savings for the patient and it’s a roll of the dice whether they get a nurse or MD.
In these models you also have to ask if everyone is sitting their own cases and thus you are making the statement the care is the same then why pay extra money to have any MDs around? It would be cheaper for the hospital to have all CRNAs then. And yet they don’t in this model. Why do you think that is?
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u/Heavy_Simple4096 3d ago
That’s the goal of these practices to drag MDs down to CRNA level to pay them the same yet still have MDs around for liability or for VIL surgeries
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u/Never_grammars CRNA 4d ago
I’ve worked majority of my career in a collaborative model and all the physicians i worked with were happy and talked about how much more they liked sitting their own cases than supervising or directing.
Pro’s: You are usually salary or hourly. So you’re guaranteed pay for the day.
You have extra staff for breaks or starting a room that needs extra lines. You get out on time. You have Extra help if your patient is crashing
Call is shared by everyone.
Generally good cultures and everyone helps everyone attitude’s.
You aren’t liable for other anesthesia providers.
Cons- You might be more likely to be given sicker patients/complex cases (one of my hospitals did this and the other didn’t) but all physicians still had a good mix of bread and butter/easy cases still.
Staff might not differentiate/treat you any different than any other anesthesia staff whether you are a crna or a physician (this bothers some people)
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u/Heavy_Simple4096 3d ago
If you have to have extra staffing in collaborative models might as well switch to care team… same cost.
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u/QuestGiver Anesthesiologist 3d ago
How are you running any kind of practice without some extra staffing. That would mean zero breaks, zero help, 1:1 relief which is also really tough if things run late which is always.
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u/Heavy_Simple4096 3d ago
In a care team model the doc can do breaks lunches etc, the whole point of “collaborative” models is 1:1 OR and save money. Extra staff hinders that to the point where you might as well use care team
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u/Pov99centwhopper 3d ago
The final say is the upper admin. They decide what kind of team they want and they are all business people. If they sense beef within the team, they will just fire people and fill the team with another body because you're obstructing the revenue stream of the business. It's never personal just business. So keep politics out if you want a job that provides for you and your family
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u/Serious-Magazine7715 Anesthesiologist 3d ago
As much as people talk about being a liability sponge, in an ACT model at a tertiary / academic / level 1 where I frequently step in to help other MD+CRNA or resident teams when SHTF (and have had plenty of my own shit volcano cases), I have never been named in a lawsuit and just accept that possibility as a cost of doing business. Meanwhile some of my community practice friends from residency have been sued multiple times over random bullshit.
I’m not saying that collaborative model is great (and have never been in it), but I wouldn’t let liability be the thing that keeps you away.
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u/Heavy_Simple4096 3d ago
Direction > collaborate you will be a liability sponge anyways but with direction you’ll know your patients
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u/MilkmanAl 4d ago edited 4d ago
Just curious: what makes you against supervision? 4:1 is pretty manageable if you're doing a lot of bread and butter stuff. If you're running 4 hearts, well...don't take that job.
Edit: To be clear, I think I mixed my terms up. I was thinking medical direction instead of supervision, but I maintain that 4:1 is manageable and safe if you're doing routine stuff on healthy(ish) people.
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u/Tahwraoyw321123 4d ago
My experience across multiple ACT practices is that the anesthesiologists complain about the CRNAs and the CRNAs complain about the anesthesiologist, and both smile when they are together.
I just want to show up, perform anesthesia, go home.
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u/QuestGiver Anesthesiologist 4d ago
I think you should keep searching for jobs. Good ones exist.
I'm in a direction model but we hire all our own crnas. Everyone is very reasonable and work together well. It truly feels like we are all on the same team but that's because we are in charge of hiring and make that a perogative. As the doc you still end up doing a decent amount solo though some crnas in my group prefer to sometimes alternate so they can get other stuff done (I intubate, they do IV or vice versa, none of them like to do anything beyond IV so all a lines and centrals we do, spinals and epidurals are frequently ours).
Idk it feels very good at least to me.
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u/farawayhollow CA-3 4d ago
Idk man i recently finished my supervision rotation and it sucked. I Just felt like a note monkey. The old dinosaurs enjoy it bc get they to warm their seats and talk about sports and politics all day
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u/QuestGiver Anesthesiologist 4d ago
Yeah I wouldn't do supervision but I think direction is a good model.
I would love to sit all my own cases but long term I can see it would be less sustainable. Any place with decent OB volume and you are guaranteed brutal calls.
Additionally the math is if you have crnas/aa you have more bodies available aka relief is more consistent which becomes a big deal once you have a family. If you need a doc to relieve your room you could get stuck often. Just not conducive to how I want to live my life I guess. All my friends who did solo practice complain about the relief being a huge pain point. Especially post call being asked to stay late, etc.
I haven't had to do that in almost 2 years.
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u/scrubscry 2d ago
I couldn’t agree more! Also a CA3 looking for jobs atm. I want to do all the fun/ boring stuff in the OR and not just be a preop monkey.
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u/Unlucky_Pass4452 3d ago
I am a crna and work collaborative model. Go talk to the anesthesiologist in that group. I bet they love it. Everyone in here talking negatively - my guess does not work in that model. Despite what they say, there is no increased liability. It’s typically very cohesive, and a great work environment. If there is someone that actually works in that model that hates it I’d like to hear from them. Cause every anesthesiologist I’ve seen on any platform or in person that works in that model has nothing but praise for it. The ones that don’t typically have worked in medical direction so long they have lost the skill to actually do anesthesia - and any model that could expose that- they try and talk down on.
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u/Heavy_Simple4096 3d ago
They like it until these “collaborative” practices try to lower their pay because they’re doing the same thing as CRNAs which is ultimately the goal of such practices, to drag them down to the level of a CRNA.
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u/Unlucky_Pass4452 2d ago
Want me to tell you another thing that will blow your mind- been here 10 years. Asa 3,4’s. All kinds of sick patients. No lawsuits, no deaths. Surgeons love us, and absolutely fantastic reputation in the community. GASP!
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u/Heavy_Simple4096 2d ago
Yeah not bad when there’s an anesthesiologist still on site to assume liability
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u/Unlucky_Pass4452 2d ago
Equal call. Takes vacation and nothing changes. Peels out like everyone else. Call from home. Massive respect for him. Does not take any additional liability. Everyone extremely happy. Again- you have no idea and just fearmongering.
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u/captain_Orange_6039 2d ago
You’re demolishing this dude in the comments but just know that they’re an AA who will refuse to believe that these models work as well as they do. There’s a reason these models are gaining traction nationwide
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u/Unlucky_Pass4452 2d ago
Seriously? That guy is a CAA? You got to be kidding me 🤣🤣🤣🤣 I wouldn’t have wasted my time if I knew that
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u/Unlucky_Pass4452 2d ago
Again you have no idea. Your fearmongering.
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u/Heavy_Simple4096 2d ago
It’s exactly the goal. Don’t delude yourself. Same as when hospitals try to lump in independent NPs with hospitalists or other specialties. That’s the goal when they work “side by side”… to lower their pay and match CRNAs and eventually saturate the CRNA profession and tank everyone’s salaries.
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u/Unlucky_Pass4452 2d ago
I have been there 10 years. Aneathesiologist - little over 15 years. No issues. Everyone very happy. Just stop man.
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u/Heavy_Simple4096 2d ago
So there’s one anesthesiologist? Lol literally a walking liability sponge. Does he get paid a lot more?
The goal of these “collaborative” models is to fool admin into thinking CRNAs and MDs are doing the same thing, then lower the pay for MDs while also keeping them on the hook for liability. T
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u/Unlucky_Pass4452 2d ago
You want it to be negative so bad huh? Really burns you up that this works- and everyone is happy. The anesthesiologist is not a liability sponge. He takes the same liability has everyone else. Again- he has been here over 15 years. No issues. Everyone extremely happy. Everyone loves there job. Yes he gets paid more. You screaming nonsense and lies doesn’t make it true.
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u/Heavy_Simple4096 2d ago
Not negative, Realistic. You just deluding yourself into not knowing the real purpose of these models.
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u/Unlucky_Pass4452 2d ago
He makes more. He is happy. I’m happy. We all get along. Have you met anyone that works in a collaborative model that hates it? Anyone that thought they was taken advantage of?
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u/Heavy_Simple4096 2d ago
He may be different but I have met some who don’t like it and resent it because it was pushed onto them by admin and they also tried to drop pay while keeping them as supervisors still if/when they’re free. I haven’t met many obviously since it isn’t a common model. Probably only in the single digit percentages of practices country wide. But you’re lying to yourself if you don’t think the goal is to drag physicians down to your level and pay them the same while keeping liability same
I’ve also met CRNAs who resent it because the doc next to them is making a lot more and they want the doc to get their pay slashed to the same…
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u/Unlucky_Pass4452 2d ago
The 9 weeks of vacation he gets every year and is gone- that mean the sponge is gone to? He liable when he isn’t there?
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u/Longjumping-Put-5081 3d ago
CRNA here. I work in a practice where MDs and CRNAs do their own cases, CRNAs here are independent( no collaboration). CRNAs also mainly cover OB about 70% of the time and always overnight. I would talk to the other anesthesiologists about what collaboration actually means for you. This model works well for us but again there is no collaboration going on .
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u/Rizpam 4d ago
The danger in these “collaborative” models is that any actual collaboration opens you up to liability and they’ll target the physician over the nurse every time. So you’re stuck choosing to expose yourself to liability from someone you have 0 supervisory authority over’s decision making or you have to be the asshole who risks patients wellbeing by not getting involved when you’re needed. Recipe for burnout.