20:00 Seems like perspective of being an outlier, could also be viewed and leading by example and finding a new path? AMA looking out for their own interests more than the Veterans IMO. The delays in care caused by a lack of personnel within the system surely lead to more harm than letting an Optometrist perform a YAG laser procedure. They are presenting it like a PA is going to start doing neurosurgery. Let's start having Refracting Opticians at the VA also!!
I don’t see how waiting for YAG would put patients at greater risks than a retinal detachment or severe inflammation or dislocated/broken IOL as a result of YAG done by poorly trained optometrists
@@Mang20023 Opening access to care it the part that matters, so the ophthalmologist are able to focus on more complicated procedures. Optometrists performing YAGs for 30 years have very similar results to those done by ophthalmologists. Refracting opticians though, perform better than most ophthalmologist and could also open up access to care. Delays in care = lower quality of life = harm to patients.
Studies have shown that access of care is the same even for optometry. Not sure if expansion scope of practice will benefit patients/veterans or the few greedy optom
As an Active Duty Navy CRNA, I find Dr. Ehrenfield’s comments full of lies and honestly offensive. CRNAs provide independent care to Active duty members, their families, and many others at Navy hospitals, on ships such as Air Craft Carriers, and on deployment around the world. By the way… Please know - physician Care Team model the way he describes it means the Dr talks to the patient while the CRNAs are the ones in the operating rooms providing hands on care. He is just here to protect his paycheck!
You say that until you are over your head. Then you call for the anesthesiologist. You are just trying to get more money for yourself with no regard for patient safety.
Primarily because an anesthesiologist must practice anesthesia under their own medical license for the better part of a year after graduating residency before they can take oral boards and become board certified. It is the minority of doctors who aren't board certified because they can't pass the exam sequence. "Board certification" for CRNAs isn't even in the same universe in terms of rigor / standards. Sorry
What a lie, you can't get a job these days without being board certified or eligible with the condition of becoming certified within a couple of years if you are fresh out of residency. I remember when I was in training, I had the opportunity to witness a SRNA mock board exam for nurses close to graduating, and it was a joke, there is no way any SRNA could pass our board exam.
@@carlson767 I actually agree with you (and him) on that point. I actually wish the AMA president would have just stated the fact that while one can undergo sexual assignment surgery, it is not possible at this time to genetically transform a male into a female or vice versa. But beyond that point, I felt that Mr. Van Orden was a loose cannon just trying to look like Perry Mason. In a way, he was playing politics just like everyone else was.
CRNAs were the first anesthesia providers and we're proud to be able to serve our Veterans on the front lines and at home. We will gladly provide care wherever our Veterans may be with or without a physician present, because we are experts in anesthesia care. It's understandable that physicians fear losing power and control. However, veterans shouldn't suffer due to their greed, ego, pridefulness, or arrogance.
Anesthesia is not the reason why veterans have to wait for care, if that is even true. There are no rural VA hospitals, there are no rural VA facilities where invasive procedures requiring anesthesia are being performed.
Greed and arrogance is the reason why CRNAs want to practice unsupervised and mislead patients naming themselves doctors, anesthesiologists, physicians, etc
@@nicolascrescimone They have to wait because the MD refuses to do the case and needs a CRNA to do it for them. MDs don't do cases. They sit in the lounge at 2 CRNA to 1 ratios making twice as much money and trading stocks on their phones while drinking coffee. #Tell the #truth.
Yes and barbers were the first surgeons...really an irrelevant fact to bring up. Anesthesiologists developed the field into what it is today, have much more comprehensive training and rigorous standards for board certification, and have a much greater depth and breadth of medical knowledge. CRNAs have their place in modern anesthesia care but it is a disservice to patients to claim equivalency. Has nothing to do with power, control, greed, ego, pridefulness or arrogance.
@@stratmartin it has to do with their ego, greed and jealousy, just like when they want to be called Anesthesiologist, doctor or physician. Reminds me of the time when podiatrists started calling themselves foot Doctors. A complete misrepresentation and a lie to the patient they say they care about.
Why is it Always the case that health insurance actuaries information Never are required to submit analyzed data concerning actual healthcare outcomes? What we observe here are biased opinions and educated guesses. We need to know exactly where the cow ate the cabbage....not which field. Over blown Congressional testimony is allowed and far too common. This jabber would Not be allowed in trial testimony.
The truth is there’s no difference in outcomes or safety whether the anesthetic is provided by a CRNA or an MD. We all support a collaborative team, it’s a team where everyone provides high quality safe care. We need teams where CRNAs and MDs both sit their own respective cases and provide independent, full scope, safe patient care to put the patient needs first. Please stop this false narrative, it’s disingenuous and is misleading at best!
I do not know the history of the AMA and its behavior but for Veterans who served our country, i want them to have the best care that they can get. So if you could get an Anesthesiologist but the government chooses a CNRA which has different education time span, I would be upset. Yes they need each other, no they are not getting rid of CNRA as a whole, they just want the best care for their veterans. CNRAs chose a path with less time in education, not saying they are dumber, but there's a difference in education and experience. They don't want CRNA to be alone in the OR. Same goes with opthalmologist and optometrist. You can't be upset if you chose a shorter path than your counterpart.
@@nicolascrescimone as a CRNA, I can tell you that I've had multiple MDs and MDAs request me or another CRNA for their own or a family member's anesthetic. Something about experience and care......
Being an MD does not automatically give you the best care. For example, would you really want an MD straight out of residency, having only 3 years of actual anesthesia experience, or the CRNA that has years of experience. And just as they are not getting rid of the CRNAs with this initiative, they are not getting rid of the MDAs nor the other MDs. No anesthesia provider is alone in an OR during a procedure - MDA or CRNA - there are always multiple people around.
@@amyforrester4427 yes absolutely, I would totally take a CA3 resident or a good CAA over any CRNA, they know their limitations, they are not as cocky as CRNAs that think they can provide the same care as Drs. Every single complication including one that ended up in a lawsuit happened when I was supervising a CRNA. And I worked with several experienced ones that scares me the lack of knowledge and interest. Granted, there are bad Drs too or I should say lazy, but those are the exception.
@@amyforrester4427 I agree with you on that example, but the basic fact is that MD anesthesiologist and CRNAs went on different paths. Their choice. You can be good at your job as well as others. People can be bad anesthesiologists and bad CRNAs. The structure is that it should be team based. But based on the hearing, it sounds like they want Veterans to be cared by CRNAs only, removing MD anesthesiologists
I love how CRNAs say they can provide anesthesia to the healthiest men on earth (American soldiers) on their own overseas. I really don't understand their brains, if you wanted to be a Dr why didn't you go that route....
We also provide independent care overseas to the contractors (frequently having multiple co-morbidities) and foreign nationals - including peds. I did multiple independent anesthetics on pediatric patients downrange, at one of the Army FSTs during OEF. And no, we don't want to be MDs, we love being CRNAs doing the exact same anesthetics and procedures as MDAs and held to the same standard of care.
@@amyforrester4427 really? Can you do fellowships in pediatric, cardiac, transplant, ICU, regional, OB, neuro, etc? You don't provide the same level of care, you don't have the same level of training or education.
@@amyforrester4427 and I was talking about overseas traumas because those are the BS studies you guys base your argument on. If there would be studies with ASA 3, 4 or 5 ongoing complex surgeries the difference in M&M would be evident. But thank good you guys don't do enough of those type of patients unsupervised. Plus the reporting of complication in this country is pretty bad.
![Wolfram Physics Project: Working Session Wednesday, Apr. 29, 2020 [Finding Black Hole Structures]](http://i.ytimg.com/vi/SbDzqlOLIZA/mqdefault.jpg)
Mr. Van Orden --- I love your interactions with members. Thank you for your care and concern and challenging questions.
20:00 Seems like perspective of being an outlier, could also be viewed and leading by example and finding a new path? AMA looking out for their own interests more than the Veterans IMO. The delays in care caused by a lack of personnel within the system surely lead to more harm than letting an Optometrist perform a YAG laser procedure. They are presenting it like a PA is going to start doing neurosurgery. Let's start having Refracting Opticians at the VA also!!
I don’t see how waiting for YAG would put patients at greater risks than a retinal detachment or severe inflammation or dislocated/broken IOL as a result of YAG done by poorly trained optometrists
@@Mang20023 Opening access to care it the part that matters, so the ophthalmologist are able to focus on more complicated procedures. Optometrists performing YAGs for 30 years have very similar results to those done by ophthalmologists. Refracting opticians though, perform better than most ophthalmologist and could also open up access to care. Delays in care = lower quality of life = harm to patients.
Studies have shown that access of care is the same even for optometry. Not sure if expansion scope of practice will benefit patients/veterans or the few greedy optom
As an Active Duty Navy CRNA, I find Dr. Ehrenfield’s comments full of lies and honestly offensive. CRNAs provide independent care to Active duty members, their families, and many others at Navy hospitals, on ships such as Air Craft Carriers, and on deployment around the world.
By the way… Please know - physician Care Team model the way he describes it means the Dr talks to the patient while the CRNAs are the ones in the operating rooms providing hands on care. He is just here to protect his paycheck!
You say that until you are over your head. Then you call for the anesthesiologist. You are just trying to get more money for yourself with no regard for patient safety.
All CRNAs ARE Board certified… not all physicians can say that!!
Primarily because an anesthesiologist must practice anesthesia under their own medical license for the better part of a year after graduating residency before they can take oral boards and become board certified. It is the minority of doctors who aren't board certified because they can't pass the exam sequence. "Board certification" for CRNAs isn't even in the same universe in terms of rigor / standards. Sorry
What a lie, you can't get a job these days without being board certified or eligible with the condition of becoming certified within a couple of years if you are fresh out of residency. I remember when I was in training, I had the opportunity to witness a SRNA mock board exam for nurses close to graduating, and it was a joke, there is no way any SRNA could pass our board exam.
1:00:00 This Mr. Van Orden is extremely unreasonable!
What the heck did I just watched? Who let him in the chair!!!
Also Mr. Scott was amazing too!
He can barely speak. Term limits. @@acexsketches
I thought he was on point! Admit you are there for politics and that you are biased!!
@@carlson767 I actually agree with you (and him) on that point. I actually wish the AMA president would have just stated the fact that while one can undergo sexual assignment surgery, it is not possible at this time to genetically transform a male into a female or vice versa. But beyond that point, I felt that Mr. Van Orden was a loose cannon just trying to look like Perry Mason. In a way, he was playing politics just like everyone else was.
Barney is dangerous.
54:00 Dr. Murphy is dead on!
CRNAs were the first anesthesia providers and we're proud to be able to serve our Veterans on the front lines and at home. We will gladly provide care wherever our Veterans may be with or without a physician present, because we are experts in anesthesia care. It's understandable that physicians fear losing power and control. However, veterans shouldn't suffer due to their greed, ego, pridefulness, or arrogance.
Anesthesia is not the reason why veterans have to wait for care, if that is even true. There are no rural VA hospitals, there are no rural VA facilities where invasive procedures requiring anesthesia are being performed.
Greed and arrogance is the reason why CRNAs want to practice unsupervised and mislead patients naming themselves doctors, anesthesiologists, physicians, etc
@@nicolascrescimone They have to wait because the MD refuses to do the case and needs a CRNA to do it for them. MDs don't do cases. They sit in the lounge at 2 CRNA to 1 ratios making twice as much money and trading stocks on their phones while drinking coffee. #Tell the #truth.
Yes and barbers were the first surgeons...really an irrelevant fact to bring up. Anesthesiologists developed the field into what it is today, have much more comprehensive training and rigorous standards for board certification, and have a much greater depth and breadth of medical knowledge. CRNAs have their place in modern anesthesia care but it is a disservice to patients to claim equivalency. Has nothing to do with power, control, greed, ego, pridefulness or arrogance.
@@stratmartin it has to do with their ego, greed and jealousy, just like when they want to be called Anesthesiologist, doctor or physician. Reminds me of the time when podiatrists started calling themselves foot Doctors. A complete misrepresentation and a lie to the patient they say they care about.
Why is it Always the case that health insurance actuaries information Never are required to submit analyzed data concerning actual healthcare outcomes? What we observe here are biased opinions and educated guesses. We need to know exactly where the cow ate the cabbage....not which field. Over blown Congressional testimony is allowed and far too common. This jabber would Not be allowed in trial testimony.
The truth is there’s no difference in outcomes or safety whether the anesthetic is provided by a CRNA or an MD. We all support a collaborative team, it’s a team where everyone provides high quality safe care. We need teams where CRNAs and MDs both sit their own respective cases and provide independent, full scope, safe patient care to put the patient needs first. Please stop this false narrative, it’s disingenuous and is misleading at best!
Please provide 1 unbiased research study on this
Mr. Scott please stop fear-mongering.
I do not know the history of the AMA and its behavior but for Veterans who served our country, i want them to have the best care that they can get. So if you could get an Anesthesiologist but the government chooses a CNRA which has different education time span, I would be upset. Yes they need each other, no they are not getting rid of CNRA as a whole, they just want the best care for their veterans. CNRAs chose a path with less time in education, not saying they are dumber, but there's a difference in education and experience. They don't want CRNA to be alone in the OR. Same goes with opthalmologist and optometrist. You can't be upset if you chose a shorter path than your counterpart.
As an anesthesiologist, I can tell you that I would not want to have a CRNA take care of myself without the supervision of a Doctor.
@@nicolascrescimone as a CRNA, I can tell you that I've had multiple MDs and MDAs request me or another CRNA for their own or a family member's anesthetic. Something about experience and care......
Being an MD does not automatically give you the best care. For example, would you really want an MD straight out of residency, having only 3 years of actual anesthesia experience, or the CRNA that has years of experience. And just as they are not getting rid of the CRNAs with this initiative, they are not getting rid of the MDAs nor the other MDs. No anesthesia provider is alone in an OR during a procedure - MDA or CRNA - there are always multiple people around.
@@amyforrester4427 yes absolutely, I would totally take a CA3 resident or a good CAA over any CRNA, they know their limitations, they are not as cocky as CRNAs that think they can provide the same care as Drs. Every single complication including one that ended up in a lawsuit happened when I was supervising a CRNA. And I worked with several experienced ones that scares me the lack of knowledge and interest. Granted, there are bad Drs too or I should say lazy, but those are the exception.
@@amyforrester4427 I agree with you on that example, but the basic fact is that MD anesthesiologist and CRNAs went on different paths. Their choice. You can be good at your job as well as others. People can be bad anesthesiologists and bad CRNAs. The structure is that it should be team based. But based on the hearing, it sounds like they want Veterans to be cared by CRNAs only, removing MD anesthesiologists
I love how CRNAs say they can provide anesthesia to the healthiest men on earth (American soldiers) on their own overseas. I really don't understand their brains, if you wanted to be a Dr why didn't you go that route....
We also provide independent care overseas to the contractors (frequently having multiple co-morbidities) and foreign nationals - including peds. I did multiple independent anesthetics on pediatric patients downrange, at one of the Army FSTs during OEF. And no, we don't want to be MDs, we love being CRNAs doing the exact same anesthetics and procedures as MDAs and held to the same standard of care.
@@amyforrester4427 really? Can you do fellowships in pediatric, cardiac, transplant, ICU, regional, OB, neuro, etc? You don't provide the same level of care, you don't have the same level of training or education.
@@amyforrester4427 and I was talking about overseas traumas because those are the BS studies you guys base your argument on. If there would be studies with ASA 3, 4 or 5 ongoing complex surgeries the difference in M&M would be evident. But thank good you guys don't do enough of those type of patients unsupervised. Plus the reporting of complication in this country is pretty bad.
@@nicolascrescimone How about you actually do the case 🙄. You're so bad ass from the lounge.
@@GVM2024 I actually do 80% of my cases because I work in a hospital that surgeons don't like care team