I think the only place the statement fails, through no fault of its own, is the use of 'supervise' and 'directing' which have absolutely no uniform definition. He is absolutely entitled to assign one of the many common ones for clarity of concept however. He presents common variants of the ACT which can be from institution to institution or even MDA to MDA and CRNA to CRNA in the same institution. It seems often a personality driven approach to anesthesia care rather than a purely scientific or evidenced based one. He could have used 'team leader' MDA vs 'egomaniac jackass' MDA, or 'confident anesthesia service coordinator' vs 'low self confidence unfit for leadership MDA'. Or a thousand others with varying nuances. I do not discount the effect the specific CRNA staff can have on this also. If your only 2 CRNAs for the night are frightening scatterbrains (not limited to the cRNAs only by the way) then you might well become an overbearing less confident ego maniac.And to my belief this statement is factually incorrect.
"Both CRNAs and our physician colleagues receive essentially the same extensive didactic education and clinical training in anesthesia," Ms. Molina told Medscape.
and this statement
Ed Wilkinson, a Medscape reader who has spent 25 years as a CRNA, said there is a crucial distinction between an anesthesiologist who supervises an anesthesiology team and one who directs it. A "supervising" anesthesiologist adds another set of hands, along with a particular perspective to the anesthetic plan. This can be invaluable in the more difficult cases involving very sick patients, he said. If an issue comes up, the supervising anesthesiologist consults with the CRNA to find a mutually agreed upon approach.
A "directing" anesthesiologist, on the other hand, will dictate the anesthetic plan (as well as the other criteria for Medicare reimbursement eligibility), and often does not respect the capabilities of the CRNAs involved, Mr. Wilkinson said.
is simply a political opinion on top of being factually incorrect.
Correct me if I'm wrong. Sorry - couldn't let these go.