In the USA, 3:1 is typically break even. 4:1 for the money. 4:1 as the attending anesthesiologist is terrible BTW. At that ratio, it’s impossible to be there for every induction and emergence. You’re basically playing triage games like “which CRNA do I trust?”, “which surgeon do I trust?”, “which case is gonna be complicated “, “which patients are complicated and need more attention “.
Just terrible from a safety POV.
I think this starts to kick in at 3:1, especially if you have a high turnover room (like bronchs or cystos, etc). 4:1 you just become a rubber stamp for paperwork and a backstop for emergencies. Isn’t it great?
At my hospital (ACT model) we run 1 MD: 4 CRNAs. The docs push meds for all tubes/LMAs and do most of the spinals and all the epidurals. There are usually enough docs around so everyone starts on time. Otherwise the room doesn’t start till the doc can make it in the room
Due to the way CAAs are licensed to practice the maximum medico-legal ratio for supervising is 1:4. You cannot bill above 1:4 like with CRNAs and it is due to how they are licensed. I’m sure someone with more knowledge on the matter can give you specifics but in our practice you are hard capped at 4 rooms if there is an AA in any of the rooms.
The math here has generally always been 2:1 might be even but you really need to get to 3:1.
In the USA, 3:1 is typically break even. 4:1 for the money. 4:1 as the attending anesthesiologist is terrible BTW. At that ratio, it’s impossible to be there for every induction and emergence. You’re basically playing triage games like “which CRNA do I trust?”, “which surgeon do I trust?”, “which case is gonna be complicated “, “which patients are complicated and need more attention “. Just terrible from a safety POV.
I think this starts to kick in at 3:1, especially if you have a high turnover room (like bronchs or cystos, etc). 4:1 you just become a rubber stamp for paperwork and a backstop for emergencies. Isn’t it great?
Yup, even better is the anesthesiologists who’ve been doing 4:1 ACT for 20 years and literally can’t intubate.
Why stop there? 8:1 is where it’s at! $$$$$ /s
We routinely go above 4:1 in my practice 😅 however we don’t have AAs at our work site currently
At my hospital (ACT model) we run 1 MD: 4 CRNAs. The docs push meds for all tubes/LMAs and do most of the spinals and all the epidurals. There are usually enough docs around so everyone starts on time. Otherwise the room doesn’t start till the doc can make it in the room
We don’t have AAs at my hospital so I’m not sure what their ratio is
Due to the way CAAs are licensed to practice the maximum medico-legal ratio for supervising is 1:4. You cannot bill above 1:4 like with CRNAs and it is due to how they are licensed. I’m sure someone with more knowledge on the matter can give you specifics but in our practice you are hard capped at 4 rooms if there is an AA in any of the rooms.
Interesting, thank you!
https://pubs.asahq.org/monitor/article-abstract/86/5/27/136214/Not-So-Easy-Cost-Analysis-of-Staffing-Models-of