Professionalism and the CRNA

1. Professionalism and the CRNA Jan Mannino, CRNA, JD

2. 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

3. 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

4. Who Defines the CRNA Profession? • The profession • The Professional Organization (AANA) • Licensing Boards

5. Who Does NOT Define CRNAs • Nursing • Medical anesthesia • Medical licensure • CMS • Insurance companies • Accreditating Agencies • Hospitals and ASC Facilities

6. 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

7. Reimbursement • Getting paid for the value of your education and functions • Do not undervalue administration of anesthesia

8. Hospital Privileges • How should we be classified? • Allied health? • Mid-level practitoners? • Physician extenders? Anesthesia PROFESSIONALS (better word than provider)

9. Anti-trust Actions • Bhan case • Oltz case • Minnesota case

10. Future Considerations

11. Whistleblower Lawsuits • Medicare Fraud and Abuse

12. OIG ADVISORY • Fee splitting • Company model • Advantges for CRNA

13. Contract Negotiations • Critical to be considered a businessperson • Collect facts • Know your worth • Understand your opponent • Set your limits

14. 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

15. Professional Actions • Decorum • Dress • Ask Smart Questions • Understanding politics of the operating room • Patient Advocacy

16. 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

17. Final Thoughts • We would not be here today, except for: • Strong clinical skills • Basic education and Continuing education • AANA • Committed professionals

18. 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.