In the world of medicine, Doctor is an esteemed title to achieve. Yet, there are some situations with ongoing debates on whether a physician is the best candidate for a particular position of care.
This is true when it comes to anesthetics. If you have open heart surgery do you want your life managed by a nurse or a doctor?
Many hospitals and practices would rather hire a certified registered nurse anesthetist (CRNA) vs. an anesthesiologist. Other hospitals would consider an anesthesiologist a necessity to become a qualified anesthesia provider.
Why is this so? What benefits come with hiring a CRNA as opposed to a licensed anesthesiologist?
CRNA vs. Anesthesiologist: Education
One of the most significant differences between a CRNA and an anesthesiologist is the type and amount of education they must complete to earn their title.
An anesthesiologist spends many more years in college and training than a CRNA does.
First, they must attend college, pursuing a bachelor’s degree in science. This is their pre-med education and is considered nonmedical training.
After completing those four years, anesthesiologists must spend an additional four years attending medical school.
After graduation from medical school, a doctor wanting to become an anesthesiologist would then complete a four-year anesthesia residency. This is where the in-depth training takes place.
Most anesthesiologists take advantage of an optional fellowship in anesthesiology to bolster their experience.
The education of a CRNA is much shorter in comparison to an anesthesiologist, although their educational requirements have increased in recent years.
The first step to becoming a certified registered nurse anesthetist is to graduate from a nursing program.
While many nurses get a BSN, most CRNAs get a master’s degree. This makes them an official Advanced Practice Registered Nurse (APRN). However, you can become a CRNA after graduating from any nursing program ranging from one to four years.
They must then spend a year learning critical care. This experience prepares a CRNA to handle emergency anesthesiology situations. However, in an emergency, the anesthesiologist is usually the best suited professional.
After critical care, CRNAs complete three and a half years of an anesthesia program with an optional year fellowship.
When reviewing a side-to-side comparison of education, anesthesiologists spend much more time in university cumulatively. However, a CRNA would actually complete a half year more in medical training than the doctor.
It’s important not to forget that a nursing program will teach a whole different educational path of medicine than that of a doctor of medicine program.
While nurses learn to follow a set of strict protocols, doctors are trained to look at the situation and use their in-depth medical training to make the best decision.
According to the Council on Accreditation, all anesthesiologist healthcare professionals will require a doctoral degree, or DNP, by the year 2025 to complete a CRNA program.
CRNA vs. Anesthesiologist: Responsibilities
Another area in which a CRNA will often differ from an anesthesiologist is the responsibilities that come with their title.
Understandably, an anesthesiologist usually has more responsibilities. Yet, there may be times when a CRNA is all that is available and will take over the anesthesiologist’s duties.
There are certain times CRNAs would not be qualified, but in most “bread and butter” cases they most definitely can and should be used.
An anesthesiologist must meet specific qualifications to practice. They must be board certified andlicensed in any statethat they wish to practice in.
Anesthesiologists must also complete aMOCAcertification every ten years. This certification is simply a refresher, or maintenance, of the certification they passed in the beginning.
This certification will ensure that the doctor:
- Stays up to date with the newest practices
- Is still licensed and remains in good standing
- Is consistently improving in their practice
Theclinical responsibilities of an anesthesiologistare to lead the anesthesia care team and oversee their work.
There are a variety of anesthesia types that must be learned and practiced by an anesthesiologist:
- General Anesthesia – anesthesia that puts the patient into complete unconsciousness used during major surgeries.
- Monitored Anesthesia – can cause a variety of levels of sedation depending on the procedure being done.
- Regional Anesthesia – a form of anesthesia that is used for pain management of a larger area of the body. A patient is fully conscious during this type of anesthesia.
- Local Anesthesia – similar to regional anesthesia but for a much smaller area of the body.
Anesthesiologists often spend so much time overseeing that they have little hands-on tasks in the operating room, but this completely depends on the type of practice and the cases that are at hand.
While a CRNA could handle many operations to cut down on the expense of the procedure, there is a clear line in the responsibilities of an anesthesiologist that cannot be taken on by a CRNA as this is out of their scope of training.
There is a classification system that predicts the risk and complexity of the procedures based on a variety of factors that only an anesthesiologist can determine.
This system is called the ASA Physical Status Classification.
The ASA system takes into consideration the state of the patient as well as the complexity of the procedure. Thischartbreaks down the levels of ASA within the scope of adult anesthesia, pediatric anesthesia, and obstetric anesthesia.
While an anesthesiologist can complete every level on this chart, a CRNA cannot. To best utilize your anesthesiologist team, a healthcare practice would set up a system that allows each member to fill their roles.
Following this classification system, an anesthesiologist should be responsible for the more complex procedures that fall into the ASA levels 4, 5, and 6. There may be times when an anesthesiologist should complete a procedure if it falls into ASA levels 1, 2, and 3.
A CRNA must also be board certified and state licensed. But, the recertification of a CRNA is not every ten, but every four years. They must also pass the Continued Professional Certification exam every eight years.
A certified registered nurse anesthetist’s clinical responsibilities could include:
- assessment and evaluation
- administering of pre-anesthetic drugs
- developing an anesthesia care plan
- performing airway management
And much more.
While an anesthesiologist could also complete these responsibilities, it makes much more sense to allow the CRNAs to handle these to increase the profit margin of the practice.
Within the ASA Physical Status Classification, these duties fall within the ASA 1, 2, and sometimes 3.
The American Association of Nurse Anesthetistsgives a detailed description of what this position entails and what types of responsibilities a CRNA could include.
They also provide information on the possibilities of advanced pain management duties as well as non-clinical responsibilities of a CRNA.
In 14 states, CRNAs require no supervision of an anesthesiologist, although this is a widelydebated issue.
A practice that employs both anesthesiologists and CRNAs should take advantage of the cost-effectiveness of allowing the CRNAs to take some of the workload off the anesthesiologist and increase the productivity of the entire anesthesia care team.
CRNA vs. Anesthesiologist: Quality of Care
The biggest concern to a healthcare system is how these two medical professionals compare when it comes to the quality of patient care they offer.
There are many different areas of anesthetics that may need addressing:
- Cardiothoracic Anesthesiology
- Critical Care Anesthesiology
- Neurosurgical Anesthesiology
- Obstetric Anesthesiology
- Pain Medicine
- Pediatric Anesthesiology
Both CRNAs and anesthesiologists can qualify to work in these areas. However, CRNAs may need to undergo extra training in order to gain these clinical privileges. Anesthesiologists often specialize in one of these areas.
When utilized in the correct manner, well-trained CRNAs and anesthesiologists should be providing the best possible quality of care for all patients.
The quality of care comes into question when health professionals begin to take on responsibilities out of their abilities or are overwhelmed by too many responsibilities due to the lack of help from health care professionals that offer a supporting role.
The Big Debate Issue
Anesthesiologists claim to enter the workforce with five times the clinical experience than CRNAs.
However, The AANA claims that CRNAs log 9,369 hours between their nurse anesthesia educational program and their critical care program.
Since anesthesiologists claim to earn 12,000 hours of clinical training, these numbers don’t add up.
This contradictory data is a result of two opposing titles vying for their part in the anesthetic industry.
TheCochrane Collaboration, an evidence-based medical collaboration, completed a review of the years of varying studies already done on this topic.
Even this review, which aimed at putting a definitive answer on the subject, turned up some conflicting conclusions.
While theAmerican Society of Anesthesiologistsclaims that this review proves their value as an anesthesia provider,nursessay that it only backs up their claims.
However, both anesthetics and CRNAs have a valued place in meeting the anesthesia needs of this country and when they are used in the right capacity. Not only can they take care of patients, now they can also do it in the most cost-effective way.
CRNA vs. Anesthesiologist: Cost Effectiveness
Of course, all healthcare professionals looking to hire an anesthesiology care team hold an interest in comparing the cost-effectiveness of either CRNAs or anesthesiologists.
To do this, one would have to be aware of the average pay that either profession would expect to earn.
Anesthesiologist Annual Salary
According to the most recentMedscapecompensation analysis for an anesthesiologist, the average annual salary is $398,000.
The Bureau of Labor Statisticshas a much lower range for the salary of an anesthesiologist. According to their data, their average annual salary is only $262,000.
Of course, the actual market value of an anesthesiologist depends on many factors.
TheMedscapereport also revealed that 31% of anesthesiologists use nurse practitioners as part of their own practice.
Interestingly enough, only 8% of anesthesiologists who use NPs or PAsreporteddecreased profitability due to their hiring.
Example from Study
However, one study published byEconomics, Education, and Health Systems Researchused a wide variety of formulas to measure the cost-effectiveness of hiring an anesthesiologist.
This study compiled data that showed the added cost of hiring an anesthesiologist was worth the investment. The concluding paragraph of the publication sums the findings up succinctly.
“This study demonstrates that provider costs for physician-directed anesthesia are similar to provider costs for nonmedically directed nurse anesthesia and, when cost savings with reduced mortality are considered, physician anesthesia seems to decrease net health care costs. Even if all model assumptions are least favorable to physicians, these cost-effectiveness analyses suggest that incremental gains in life expectancy with a physician-directed versus nonmedically directed nurse model of care can be obtained at a cost deemed reasonable by society.”
It’s not just about how much money you can save, but the liability that would come with cutting these costs.
Learn more in these articles:
What Is a Fair Anesthesiologist Salary? | How Much Do Pain Management Specialists Make?
CRNA Annual Salary
The Bureau of Labor Statisticslists the annual salary of a CRNA as $181,000. If a CRNA specializes in outpatient care, they could earn as much as $224,000 in the United States.
While these numbers are lower than an anesthesiologist’s salary, it is above the average pay of a primary care doctor.
CRNAs can earn up to $227,000 in the five top-paying states:
Just as the median wage would differ depending on several factors for an anesthesiologist, the same is true of a CRNA.
- The number of years of nursing experience a CRNA has earned
- The location of the position
- The type of healthcare system
All these factors would affect the market value of a CRNA.
TheLewin Group conducted a study of the cost-effectiveness of hiring a CRNA. This study showed 25% more potential revenue versus the cost to employ a CRNA without supervision. (Of course, they prepared this study for the American Association of Nurse Anesthetists, so we can imagine that it would be somewhat biased.)
There’s no denying that CRNAs are cheaper to hire than anesthesiologists and should be employed in the best capacity to do a high volume of repetitive cases to increase productivity and revenue at a lower cost.
Pros of Hiring an Anesthesiologist
An anesthesiologist is a trained doctor with extensive knowledge of medicine above and beyond just anesthesiology. This makes them better suited to make executive decisions when an emergency arises.
Anesthesiologists will always carrymalpractice insurance. This covers much of the potential risks of a patient or family member suing forwrongful death or injury.
The residency that an anesthesiologist must complete (and the following optional fellowship) provides for much more hands-on practice of anesthesiology than that of a nurse anesthetist.
This prepares them well to take on the responsibility of all anesthesia practices. Further, it provides the opportunity for some to sub-specialize in various areas of anesthesiology.
For example, if an obstetrician wants to hire an anesthesiology professional, they could employ a doctor that completed a fellowship in obstetric anesthesiology.
Pros of Hiring a CRNA
A CRNA is a viable money-saving alternative to hiring additional anesthesiologists if one cannot cover all your practice’s anesthesiology responsibilities.
As this article helps to prove, CRNAs come very well trained.
Due to the improvements in the technology of anesthesia practices, they can complete most of what an anesthesiologist can by merely following the near-perfect formula.
No matter how great a CRNA, their training cannot replace the expertise of an anesthesiologist and that is why anesthesiologists get paid more.
CRNAs are often younger than anesthesiologists when entering the field due to the fewer years of education needed. This gives them ample opportunity to gain valuable nursing experience early on.
Under physician supervision, CRNAs are undeniably a solid part of the anesthesia team. Their help allows for the completion of more surgeries each year, leading to an increase in profit margins for healthcare facilities.
Understandably, there is a big worry about the safety of using a stand-alone CRNA as the only means of administering anesthetics. In no way would this article claim to deny the qualifications of an anesthesiologist.
However, when it comes to filling the ongoing need for cost-effective healthcare:
The extensive required training of a certified registered nurse anesthetist gives them plenty of expertise to be the sole provider of this care (although not to the extent of an anesthesiologist).
The advancement of research and development in anesthetic procedures has made anesthesiology much safer than in times past. Nurses and doctors use the exact same methods to administer anesthetics.
Of course, big inner-city hospitals may require an extensive team of anesthesiologists, anesthetic assistants, as well as CRNAs.
Smaller practices and rural areas that cannot afford these big teams (or lack anesthesiologists to oversee nurses) can still offer safe and effective anesthetic care with the employment of CRNAs (or multiple CRNAs overseen by just one anesthesiologist for complex cases).
In the end, it’s up to each healthcare practice to weigh the pros and cons of hiring a CRNA vs. anesthesiologist and make the best decision for their needs.
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Example interview answers
"I want to be a nurse anesthetist because I want to pursue my passion of caring for other people during sensitive times. I believe my compassion and patience can help me provide the best care for every patient under my supervision.
Burnout. CRNA burnout is real, and it's perhaps the biggest challenge that CRNAs face is the mental and physical fatigue from the job.How do you stand out in CRNA applications? ›
Job Shadow CRNAs for 40 hours
Shadowing a CRNA is an important part of becoming a CRNA. To fully gain an understanding of what the work of a CRNA is, you must shadow one first. Most applicants only shadow for 8 hours. In order to stand out from other applicants, I suggest you shadow a CRNA for 40 hours.
The number one thing that you will be asked in CRNA interviews is about drugs. You're going to have to know various drugs down to the cellular level of how they react to receptor sites. By far, the most common thing asked in CRNA's interviews is to know your ICU drugs, vasoactive drips, sedative drugs, and ACLS drugs.What qualities make a good CRNA? ›
Professionalism, quick critical thinking, and problem solving skills are key traits for successful CRNAs. Certified registered nurse anesthetists are also required to complete ongoing education throughout their careers.What do I need to know for my CRNA school interview? ›
- Why do you want to become a CRNA? (This question WILL be asked. ...
- What would make you a successful CRNA?
- Tell us about yourself and your experience.
- Tell us about your strengths and weaknesses?
- How do you describe success?
- How do you handle conflict? ...
- What leadership experience do you have?
CRNAs are known for their specialized skills in airway management, intubation, and advanced patient assessment, including excellent patient safety records, and because of temporary changes in the law, they were able to “step up and safely fill essential healthcare needs in a time of national crisis,” reports the AANA.What is the objective of a nurse anesthetist? ›
A nurse anesthetist provides pain medication (anesthesia) care for patients before, during, and after surgery. They administer medications to keep patients asleep or pain-free during surgery and constantly monitor every biological function of the patient's body.Who is the highest paid CRNA? ›
Top 10 highest-paying states for nurse anesthetists.
|Average CRNA Salary||$276,540|
|Local Estimates||Get local estimate|
The average CRNA salary is so high because the position requires very advanced knowledge and skills. While many nursing positions only require that you have a Bachelor's degree, or even an Associate's degree, Certified Registered Nurse Anesthetists need at least their Master's of Science in Nursing (MSN) degree.
Highest-Paying Workplaces for Nurse Anesthetists.
|Workplace Setting||Average Salary|
|Outpatient Care Centers||$254,180|
The average GPA of accepted students is 3.7. You are right where you need to be with this domain. Evidence of academic ability is extremely important. Graduate education in general and anesthesia education in particular are very demanding, academically.What is the hardest CRNA school to get into? ›
- University of Arizona CRNA Acceptance Rate is 10%
- University of Minnesota CRNA Acceptance Rate is 10%
- Clarkson CRNA Acceptance Rate is 9%
- Marquette CRNA Acceptance Rate is 7%
- Oregon University CRNA Acceptance Rate is 7%
- Gonzaga CRNA Acceptance Rate is 6%
Ample opportunity means CRNAs can choose a schedule that fits their needs. There are options to work full-time, part-time, as needed, on call, or even overnight. This flexibility is great for finding the optimal work-life balance.
- Why do you want to work with the NHS? ...
- How might you deal with emotionally taxing situations in this role? ...
- What is your priority when looking after patients? ...
- Detail a time when you've had to work under pressure. ...
- What is your proudest achievement in your nursing career to date?
According to the American Association of Nurse Anesthetists (AANA), 89% of CRNAs feel “very satisfied” or “somewhat satisfied” with their job.What do you love about being a CRNA? ›
The independence that comes with being a CRNA amazes me each and every day. In my institution, I work with anesthesiologists and CRNAs who I enjoy working with. I love being independent in the sense that you develop good relationships with people you work with and you get to try new anesthetic techniques.What is the motto of the CRNA? ›
CRNAs' emphasis on safe, effective anesthesia care highlights one of the many hallmarks of nurse anesthesia; in fact, it is the motto of the American Association of Nurse Anesthetists (AANA).What type of person is a CRNA? ›
A CRNA (Certified Registered Nurse Anesthetist) administers and provides anesthesia - related care to patients before, during, and after surgery. CRNAs work with various medical practitioners, such as surgeons, dentists, and podiatrists, and act as a liaison between the patient and their leading care provider.What are the cons of being a nurse anesthetist? ›
The pros of being a nurse anesthetist are competitive benefits and stability, while the cons include extensive education requirements and the potential for liability.
- Consider a cheaper CRNA school.
- Open up a separate savings account for CRNA school.
- Apply for financial aid early.
- Get a second job or take extra shifts.
- Ask your employer to pay for your education.
- Apply for grants and scholarships.
If you do not pass within that first year, you will only have up to four more times within one more year to take and pass the NCE. There are no required waiting periods between individual exam attempts in a given year. You cannot schedule your retake exam with your previous eligibility notification.Is it harder to be a CRNA or anesthesiologist? ›
Education time line: CRNAs take between 7- 8.5 years to complete their education, including practicum experiences, but anesthesiologists take at least 12 years to complete their education and residency requirements.What special skills or talents are necessary for nurse anesthetist? ›
Intellectual-Conceptual, Integrative, and Quantitative Abilities: These abilities include measurement, calculation, reasoning, analysis, and synthesis. Problem solving, the critical skill demanded of nurse anesthetists, requires all of these intellectual abilities.What skills are needed to be a nurse anesthetist? ›
- Advanced Cardiac Life Support (ACLS)
- Patient care.
- Pain management.
- Airway management.
- Cardiopulmonary Resuscitation (CPR)
- Postoperative care.
- Teaching ability.
The major difference between these two professions is that anesthesiologist are medical doctors that administer anesthesia, while nurse anesthetists are registered nurses who may assist or collaborate with doctors in administering anesthesia, or may work entirely independently as they administer anesthesia.Is there a CRNA shortage? ›
The nationwide shortage of anesthesiologists and certified registered nurse anesthetists (CRNAs) is a significant problem for hospitals and health systems in the United States because surgical services account for the bulk of hospital revenue.What state has the lowest paid CRNA? ›
- Alabama CRNA Salary is US$157,430.
- Tennessee CRNA Salary is US$157,0700.
- Idaho CRNA Salary is US$150,670.
- Utah CRNA Salary is US$146,470.
- Arizona CRNA Salary is US$144,530.
Intense clinical requirements:
Most CRNA programs require 2,000 hours or more of direct anesthesia-related patient care. This time does not include the time you will spend preparing for clinicals and prepping for difficult cases. Completing intense clinical requirements on top of your coursework makes CRNA school hard.
The average age of an employed certified registered nurse anesthetist is 44 years old. The most common ethnicity of certified registered nurse anesthetists is White (81.0%), followed by Asian (6.6%), Hispanic or Latino (5.0%) and Unknown (3.8%).
While the CRNA degree is challenging, most health care professionals would agree that medical school for doctors is far more rigorous.Do CRNAs have worse outcomes? ›
17 While there are a limited number of studies on anesthesia quality and safety outcomes when provided by a CRNA versus an anesthesiologist, most research has found anesthesia-related complications and mortality rates between providers to be nearly identical.Where is the best place to work as a CRNA? ›
|1||Specialty hospitals - Privately owned|
|2||General Medical and Surgical Hospitals - State government owned|
|3||General Medical and Surgical Hospitals - Privately owned|
|4||General Medical and Surgical Hospitals - Local government owned|
What type of RN is most in demand? All RNs are in demand more than other occupations. The BLS projects 6% job growth for all RNs between 2021 and2031, compared to 5% job growth for all occupations. Some specialties that are in especially high demand are neonatal nursing, surgical nursing, and critical care nursing.Are CRNAs in high demand? ›
Yes, CRNAs are in very high demand.
The U.S. Bureau of Labor Statistics (BLS), job opportunities for RNs (which include CRNAs) are projected to be excellent and grow much faster than the national average relative to other occupations.
Essentially, the units that are the safest are any adult ICU. There can be many different types of adult ICUs out there. There's the SICU, MICU, the CVICU, the CCU, and the burn trauma unit. You can combine those letters any way you want to make any ICU.What GPA is too low for CRNA school? ›
Most programs require a GPA of at least 3.0, with some requiring as high as a 3.5. It's especially important that you earn a GPA of at least 3.0 in your health- and science-related courses for admission to most programs.What is a competitive CRNA GPA? ›
To be considered competitive for CRNA school you should aim to have a 3.5 or higher. Keep in mind that a lower GPA will still be considered because they look at the candidate as a whole. However, there are necessary steps you need to take to be competitive with a lower GPA.How old are most CRNA students? ›
Tell me about the Average SRNA
The average SRNA is about 30 years old, has around three years of experience in a critical care unit, and roughly 30% have kids.
An anesthesiologist has a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree, whereas a CRNA is a registered nurse who has a doctoral-level degree and has passed the National Certification Examination for Nurse Anesthetists.
The average CRNA first time test taker pass rate is 88%.
If the CRNA school is below this average rate, you may need to look more closely at the class size.
A certified registered nurse anesthetist (CRNA) typically works two 24-hour long shifts per week. There are some settings which a certified registered nurse anesthetist (CRNA) may work 8 or 12-hour shifts, but 24-hour shifts are also common. Was this answer helpful?What is future outlook for CRNA? ›
Projected job growth for nurse anesthetists is 26% from 2018-2028. There are over 40,679 nurse anesthetists currently employed in the United States. There are 62,419 active nurse anesthetist job openings in the US based on job postings. The average salary for a nurse anesthetist is $170,563.How do you make yourself stand out in a nursing interview? ›
- Know where you're going. Healthcare facilities are often big and confusing. ...
- Dress professionally. Professional attire tells interviewers you take them and the job seriously.
- Rehearse your nursing interview questions. Don't just prep answers. ...
- Pamper yourself. ...
- Listen and take notes.
- Choose professional attire. ...
- Research the company and role. ...
- Practice common interview questions. ...
- Compose questions to ask. ...
- Print out multiple copies of your resume. ...
- Take care of yourself before an interview. ...
- Arrive on time. ...
- Bring a notepad and pen.
3.5. Good work! The average GPA of accepted students is 3.7.Is a 3.4 GPA good for CRNA school? ›
To be considered competitive for CRNA school you should aim to have a 3.5 or higher. Keep in mind that a lower GPA will still be considered because they look at the candidate as a whole. However, there are necessary steps you need to take to be competitive with a lower GPA.Is a 3.5 competitive for CRNA school? ›
All CRNA programs require a minimum GPA of 2.75. This GPA requirement includes cumulative GPA in addition to GPA of science related courses. In general, the average GPA of students attending CRNA School is approximately a 3.5 GPA.What is a weakness to say in nursing interview? ›
Examples of common nursing weaknesses our experts say they hear include: Paying too much attention to detail. Wanting to do everything at once. Spending too long on paperwork.What are the 6 C's of nursing interview questions? ›
Interviewee: Before your interview, you must ensure you understand the six Cs of nursing, which are: care, compassion, competence, communication, courage and commitment.
- Take some time to think about the situation you're facing. Try to describe your situation in a sentence or two. ...
- Notice and name the feelings you have about the situation. Accept your feelings — it's understandable to feel the way you feel, given your situation. ...
- Learn more.
“I should be hired for this role because of my relevant skills, experience, and passion for the industry. I've researched the company and can add value to its growth. My positive attitude, work ethics, and long-term goals align with the job requirements, making me a committed and valuable asset to the company.”What should be the best answer to introduce yourself? ›
- Structure your answer in a way that makes sense. Stick to the past-present-future format, and you're all good!
- Keep it relevant and brief (1-2 minutes max). No one wants to hear your whole life story.
- Mention any of your top achievements and relevant work experiences.
I am from (name of your hometown) and I currently live in (name of your current residence). I've completed my diploma/graduation/post-graduation in (name of your course) from (name of your University). I have worked on a few projects in the past that have helped me gain good time management and creative skills.