This comes from a comment Stan made here in another thread about a "5 hour colon resection" (not an exact quote, apologies to Stan) My experience in rural, solo (not CRNA only, solo) practice, surgical skill as a whole doesn't come close to my "urban" (such as it is) supervised practice. What do you guys (who do both) see? Is this unfair? I gotta tell ya, the odds of something simple going long are a lot better where there's no help than where there is. I've covered with a bunch of guys and to our credit, the anesthesia expertise is head and shoulders over the surgical (good thing for the patients). Sent a couple of pts. off to the "big city" (an all CRNA group with a real ICU) to the great consternation of the admin and surgeons. Be honest. I know, I know... best surgeons ever out in the sticks... Really, what do you guys think?