Specialist nurse paid higher than family doctors

[jonjuan]

http://finance.yahoo.com/news/Specialist-nurses-paid-higher-hmoney-2327465018.html?x=0

Same analogy between Captain and F/O or Major and Regional pilots?

Despite the growing shortage of family doctors in the United States, medical centers last year offered higher salaries and incentives to specialist nurses than to primary care doctors, according to an annual survey of physicians' salaries.

Primary care doctors were offered an average base salary of $173,000 in 2009 compared to an average base salary of $189,000 offered to certified nurse anesthetists, or CRNAs, according to the latest numbers from Merritt Hawkins & Associates, a physician recruiting and consulting firm.

And the firm's projections for 2010 indicate that the average base salary for family physicians will be about $178,000 compared to $186,000 for CRNAs.

CRNAs are advanced practice nurses who administer anesthesia to patients. An important distinction between CRNAs and anesthesiologist is that when anesthesia is administered by a nurse anesthetist, it is still recognized as the practice of nursing rather than a practice of medicine

"It's the fourth year in a row that CRNAs were recruited at a higher pay than a family doctor," said Kurt Mosley, staffing expert with Merritt Hawkins & Associates.

CRNA salaries have trended higher as the number of surgical procedures picked up pace over the past few years, fueling demand for anesthesiologists and anesthetists.

Mosley said medical doctors and specialists, including anesthesiologists, typically have four to five years more of medical training than CRNAs. After spending a lot of time speaking with physicians around the country, he said many family doctors are starting to feel like "second-class citizens."

This type of income disparity "won't make them feel better," he said. Most primary care doctors say they're already struggling to make ends meet as their costs rise faster than what Medicare and private insurers are paying them .

Looking at these compensation trends, the biggest concern for the nation's health care system is how to encourage more medical students to pick primary care as their specialty at a time when the nation is already facing a shortage of about 60,000 primary care doctors.

"The demand for primary care doctors will increase twofold when health reform happens and millions of more Americans have access to health care," said Mosley. "Who is going to triage these patients? It's not the neurologist or pulmonologist. It has to be the primary care doctor."

The American Association of Nurse Anesthetists (AANA) maintains that CRNAs are being fairly compensated.

"From our perspective, we are fairly compensated for the level of responsibility that we shoulder," said Lisa Thiemann, senior director of professional services with the AANA.

"We are at the head of the patient's bed. We deliver anesthesia and we keep the patient safe," said Thiemann, who has been a CRNA for 14 years.

"Once nurses and physicians arrive at anesthesia training, we use the same textbooks and same cases. The training is not too different between the two groups," she said. "We all deliver anesthesia the same way."

 

[LearLove]

you couldn't pay me 5 times that to be a nurse. Most of us whiny a$$ pilots would last about 30 minutes in that job.

Back in the 80/90's before everybody became paranoid over biohazard/body fluids I remember my mom coming home with dried blood and whatever else stuck to her uniform. As a kid around 14 I took apart one of her old watches and found it filed with dry/petrified blood.

Not to mention the job related recurring injuries she has from 40 years of lifting/turning/pushing patients. Ever see a 140 pound women move a 250 pound man from one hospital bed to another?

Condescending Doctors, rude families, combative patients (in 1969 in her first month as a nurse in NE Philly my mom was punched in the face by a guy with stab wounds trying to get away from the cops who came to question him).

 

[jonjuan]

you couldn't pay me 5 times that to be a nurse. Most of us whiny a$$ pilots would last about 30 minutes in that job.

Back in the 80/90's before everybody became paranoid over biohazard/body fluids I remember my mom coming home with dried blood and whatever else stuck to her uniform. As a kid around 14 I took apart one of her old watches and found it filed with dry/petrified blood.

Not to mention the job related recurring injuries she has from 40 years of lifting/turning/pushing patients. Ever see a 140 pound women move a 250 pound man from one hospital bed to another?

Condescending Doctors, rude families, combative patients (in 1969 in her first month as a nurse in NE Philly my mom was punched in the face by a guy with stab wounds trying to get away from the cops who came to question him).

OK, so how again is this worse than being a pilot?

 

[Lear70]

OK, they don't really talk about what Nurse Anesthetists do...

They're NOT regular nurses. They don't change bed pans, do sponge baths, or have to work long shift hours at stations and have 20+ patients on a floor all wanting something different and wanting it right now. That's not what a CRNA does.

The rest of my family are ALL in the medical field, 2 doctors, 2 NP's, 4 RN's, and 1 CRNA. The church that I go to also runs the CRNA school in Nashville (it's attached to our church campus about 100 yards away from the sanctuary). The people who run it are the same people I grew up and went to school with. For lack of a better term, it's outsourcing of Anesthesiologist's jobs.

This is a story that should hit close to home:

Arguably, the route to becoming an Anesthesiologist is the LONGEST medical school route of ANY specialty. 2 years longer than becoming a Cardiologist, Cardio/Thoracic surgeon, even a brain surgeon. It's also the most lucrative BASE salary position, with most Anesthesiologists making between $400k and 750k a year, depending on where they live. Only plastic surgeons in MIA/Beverly Hills tend to make more.

Because of that, hospitals lobbied for and got a certification for NURSES to go through the same first 2 years of Anesthesia school that Anesthesiologists go through after Med school and internship. They get the same, basic training in methods and practice of practical anesthesia, then go to work directly in the hospitals - all their hands-on clinicals are done while they're in CRNA school, there's no "internships" for 2 years afterwards.

Hospitals love them because instead of hiring 4 or 8 Anesthesiologists, they can hire 1 or 2 Anesthesiologists and 4 or 8 Nurse Anesthetists. Each O.R. has its own CRNA running the bed and anesthesia for that surgical patient and most hospitals employ one Anesthesiologist for every 4 CRNA's they have to supervise. The Anesthesiologist meets with the surgeon doing the surgery and the CRNA is present, the Anesthesiologist and surgeon decide on the best methodology to use for the surgery, and the Anesthesiologist moves onto the next patient/surgeon while the CRNA sets up the bed. The Anesthesiologist rotates through each OR supervising the CRNA's but the CRNA is doing the actual work.

It's a route I've considered, but would require me to go back to school for about 4 years, and I don't have any income to fall back on while doing that. 2 years in undergrad to get my Nursing degree, then 2 years CRNA training. The average income of CRNA's in Nashville is $125,000 a year straight out of school, and it goes up to $150k+ within 5 years.

This is probably the closest thing to Scope loss that the medical profession has, aside from the Nurse Technician "degrees" that are becoming prevalent to replace $40-45k a year EXPERIENCED nurses with $25-30k a year "technicians" who do the grunt work of bed pans, sponge baths, etc, and is the example I use when discussing Scope issues with my non-pilot family members.

 

[LearLove]

so its like outsourcing the mainline Doctor Anesthesiologists to the Express Nurse CRNA?

 

[MountainFreak]

so its like outsourcing the mainline Doctor Anesthesiologists to the Express Nurse CRNA?

There is some truth to this, and I agree with lots of Lear's post. A critical difference though- CRNA and NP (Nurse Practicioner) programs are already Master's programs, and most are moving to a Doctorate/PhD requirement. So if you want to make good money administering anesthesia, you will have two choices: go to med school, intern, residency, etc. Or- go to for an RN BS, then Master's, then Doctorate. Neither route is easy or short, and all are well trained.

Compare that with us; Mainline replaced with very low time pilots (OK, not as much now with the downturn) who don't even need an ATP. That is why it is so important that any pilot flying passengers in any capacity has met a real professional hurdle, and not just some very low hours minimum. The end result would be more pay for all, less whipsaw, and maybe even less outsourcing.

I know most regional pilots are competent. But as long as there is a shortcut to 121 flying, management will take advantage, and we all suffer.

 

[jonjuan]

It ultimately comes down to supply and demand. Competition/capitalism will drive the economics of scope or lack of scope in the long run. Even WN which has scope that is tighter than a 10 year old will be faced with ever mounting economic pressures from increased competition driven by these capitalist ideals fueled by the endless supply of cheap labor with very few barriers to entry. Having an ATP as a requirement won't change this. Once you better the pay/contracts at the major airlines, the more regional airline pilot supply will increase further increasing competition.

"Greg's a male nurse."

 

[charlieB]

Like most complex issues, the Doc-CRNA issue doesn't easily fit the pilot "outsourcing" comparison. Suppose you had an airline with one plane that flew 2-3 times per week for just a few hours each day. Do you think the operator expects to recruit and retain the highest quality pilots when they could make much more $$ by flying more hours/bigger planes at a bigger airline? No, they'll settle for someone willing to work for less.
This is the situation at rural hospitals and out-patient clinics. They may have one operating room, and don't even use it every day. The big bucks are at the big hospitals with multiple ORs going 24/7.
Therefore, the CRNAs are doing the work that the Docs don't want. Is this analagous to what ALPA said back in the 90's? "We don't want to fly 'props' for C-scale wages...go find your own work force." So they did.

(Hey, my first post! Where do I pick up my prize?)

 

[jppt2000]

http://finance.yahoo.com/news/Specialist-nurses-paid-higher-hmoney-2327465018.html?x=0

Same analogy between Captain and F/O or Major and Regional pilots?

Despite the growing shortage of family doctors in the United States, medical centers last year offered higher salaries and incentives to specialist nurses than to primary care doctors, according to an annual survey of physicians' salaries.

Primary care doctors were offered an average base salary of $173,000 in 2009 compared to an average base salary of $189,000 offered to certified nurse anesthetists, or CRNAs, according to the latest numbers from Merritt Hawkins & Associates, a physician recruiting and consulting firm.

And the firm's projections for 2010 indicate that the average base salary for family physicians will be about $178,000 compared to $186,000 for CRNAs.

CRNAs are advanced practice nurses who administer anesthesia to patients. An important distinction between CRNAs and anesthesiologist is that when anesthesia is administered by a nurse anesthetist, it is still recognized as the practice of nursing rather than a practice of medicine

"It's the fourth year in a row that CRNAs were recruited at a higher pay than a family doctor," said Kurt Mosley, staffing expert with Merritt Hawkins & Associates.

CRNA salaries have trended higher as the number of surgical procedures picked up pace over the past few years, fueling demand for anesthesiologists and anesthetists.

Mosley said medical doctors and specialists, including anesthesiologists, typically have four to five years more of medical training than CRNAs. After spending a lot of time speaking with physicians around the country, he said many family doctors are starting to feel like "second-class citizens."

This type of income disparity "won't make them feel better," he said. Most primary care doctors say they're already struggling to make ends meet as their costs rise faster than what Medicare and private insurers are paying them .

Looking at these compensation trends, the biggest concern for the nation's health care system is how to encourage more medical students to pick primary care as their specialty at a time when the nation is already facing a shortage of about 60,000 primary care doctors.

"The demand for primary care doctors will increase twofold when health reform happens and millions of more Americans have access to health care," said Mosley. "Who is going to triage these patients? It's not the neurologist or pulmonologist. It has to be the primary care doctor."

The American Association of Nurse Anesthetists (AANA) maintains that CRNAs are being fairly compensated.

"From our perspective, we are fairly compensated for the level of responsibility that we shoulder," said Lisa Thiemann, senior director of professional services with the AANA.

"We are at the head of the patient's bed. We deliver anesthesia and we keep the patient safe," said Thiemann, who has been a CRNA for 14 years.

"Once nurses and physicians arrive at anesthesia training, we use the same textbooks and same cases. The training is not too different between the two groups," she said. "We all deliver anesthesia the same way."

Nope, not even close.
Major and Regional Captain have the same license, an ATP.
Experience level, maybe, but I've flown with many folks that started with very little total time in the early 1960's.
IMO, greed, arrogance (Gen Lee is a great example), and lack of foresight got the best of Major's labor representation, airline management won that one.

 

[Continental]

I remember before starting flying I was finishing my Pre-Med classes. Father (who is in the medical field) was trying to get me to go into nursing and told me about this new CRNA program. He said this will be in big demand before long. I was typical young kid saying I'm not going to be a nurse are you kidding. ENT (otolarnygology) was where I wanted to go. Well got burned out fairly quickly changed major, etc...

Bought a house, neighbor's wife next door was a CRNA. We were talking over beers and the subject came up. He was like she BANKS! 150 grand per year.

Told my dad and he was like told you so son! Sometimes it pays to listen. Still like flying? Told him counting down my time.. only 30 years to go.

3rd year at CAL 58 grand. I want to cry but end up laughing. Dad was right!