Transcript Professionalism and the CRNA

Professionalism and the
CRNA
Jan Mannino, CRNA, JD
Professional Responsibilities
 Commitment to professional competence
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Commitment to honesty with patients

Commitment to patient confidentiality

Commitment to maintaining appropriate relations with patients

Commitment to improving quality of care

Commitment to improving access to care
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Commitment to a just distribution of finite resources
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Commitment to scientific knowledge
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Commitment to maintaining trust by managing conflicts of interest

Commitment to professional responsibilities
Professional Responsibilities
• Commitment to professional competence
• Commitment to honesty with patients
• Commitment to patient confidentiality
• Commitment to maintaining appropriate relations with patients
• Commitment to improving quality of care
• Commitment to improving access to care
• Commitment to a just distribution of finite resources
• Commitment to scientific knowledge
• Commitment to maintaining trust by managing conflicts of interest
• Commitment to professional responsibilities
Who Defines the CRNA
Profession?
 The profession
 The Professional Organization (AANA)
 Licensing Boards
Who Does NOT Define
CRNAs
 Nursing
 Medical anesthesia
 Medical licensure
 CMS
 Insurance companies
 Accreditating Agencies
 Hospitals and ASC Facilities
Legal Component
 Practicing according to the standard of care of of the
profession
 Held to an anesthesia standard
 One of the few professions that is held to a medical
standard
Reimbursement
 Getting paid for the value of your education and
functions
 Do not undervalue administration of anesthesia
Hospital Privileges
 How should we be classified?
 Allied health?
 Mid-level practitoners?
 Physician extenders?
Anesthesia PROFESSIONALS (better word than provider)
Anti-trust Actions
 Bhan case
 Oltz case
 Minnesota case
Future Considerations
Whistleblower Lawsuits
 Medicare Fraud and Abuse
OIG ADVISORY
 Fee splitting
 Company model
 Advantges for CRNA
Contract Negotiations
 Critical to be considered a businessperson
 Collect facts
 Know your worth
 Understand your opponent
 Set your limits
Perceptions
 Nurses are not businesspeople
 It is unprofessional to talk about money
 The physician takes all of the responsibility
 Difference between an hourly employee and a
professional
 Nurses eat their young
Professional Actions
 Decorum
 Dress
 Ask Smart Questions
 Understanding politics of the operating room
 Patient Advocacy
Final Thoughts
 No one is happy for your success except your mother
 The AANA is the Power of the Profession
 Get involved
 Always do great patient care
Final Thoughts
 We would not be here today, except for:
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Strong clinical skills
Basic education and Continuing education
AANA
Committed professionals
References
 American Board of Internal Medicine Foundation.
American College of Physicians–American Society of
Internal Medicine Foundation. European Federation of
Internal Medicine Medical professionalism in the new
millennium: a physician charter. Ann Intern Med.
2002;136(3):243–246.