Why Shouldn't Specialist Nurses Be Paid More Than Family Doctors?

Recently I encountered the following headline on the web: “Specialist nurses paid higher salaries than family doctors.” Knowing that my students graduate to become the highest paid members of the nursing profession, I suspected that the “specialist nurses” were CRNAs (Certified Registered Nurse Anesthetists). Yes, I was right – the article is referring to CRNAs. But this article is misleading and reflects a bias that is crying out for comment. Here is the article followed by my thoughts.

Specialist nurses paid higher salaries than family doctors
Parija Kavilanz, senior writer, On Thursday March 11, 2010, 2:32 pm EST

Despite the growing shortage of family doctors in the United States, medical centers last year offered higher salaries and incentives to specialist nurses than to primary care doctors, according to an annual survey of physicians' salaries.

Primary care doctors were offered an average base salary of $173,000 in 2009 compared to an average base salary of $189,000 offered to certified nurse anesthetists, or CRNAs, according to the latest numbers from Merritt Hawkins & Associates, a physician recruiting and consulting firm.

And the firm's projections for 2010 indicate that the average base salary for family physicians will be about $178,000 compared to $186,000 for CRNAs.

CRNAs are advanced practice nurses who administer anesthesia to patients. An important distinction between CRNAs and anesthesiologist is that when anesthesia is administered by a nurse anesthetist, it is still recognized as the practice of nursing rather than a practice of medicine

"It's the fourth year in a row that CRNAs were recruited at a higher pay than a family doctor," said Kurt Mosley, staffing expert with Merritt Hawkins & Associates.

CRNA salaries have trended higher as the number of surgical procedures picked up pace over the past few years, fueling demand for anesthesiologists and anesthetists.

Mosley said medical doctors and specialists, including anesthesiologists, typically have four to five years more of medical training than CRNAs. After spending a lot of time speaking with physicians around the country, he said many family doctors are starting to feel like "second-class citizens."

This type of income disparity "won't make them feel better," he said. Most primary care doctors say they're already struggling to make ends meet as their costs rise faster than what Medicare and private insurers are paying them .

Looking at these compensation trends, the biggest concern for the nation's health care system is how to encourage more medical students to pick primary care as their specialty at a time when the nation is already facing a shortage of about 60,000 primary care doctors.

"The demand for primary care doctors will increase twofold when health reform happens and millions of more Americans have access to health care," said Mosley. "Who is going to triage these patients? It's not the neurologist or pulmonologist. It has to be the primary care doctor."

The American Association of Nurse Anesthetists (AANA) maintains that CRNAs are being fairly compensated.

"From our perspective, we are fairly compensated for the level of responsibility that we shoulder," said Lisa Thiemann, senior director of professional services with the AANA.

"We are at the head of the patient's bed. We deliver anesthesia and we keep the patient safe," said Thiemann, who has been a CRNA for 14 years.

"Once nurses and physicians arrive at anesthesia training, we use the same textbooks and same cases. The training is not too different between the two groups," she said. "We all deliver anesthesia the same way."

Copyright © 2010 Cable News Network and Time Inc. and their affiliated companies. All Rights Reserved.

How dare any nurses make more money than any doctors! Take note that apples are being compared with oranges, because the services provided by primary care physicians versus anesthetists are vastly different. Logically the salary of nurse anesthetists should be compared with that of anesthesiologists because both groups provide basically the same services. Likewise, the salary of primary care physicians (also called family doctors) should be compared with that of nurse practitioners who provide basically the same services. I “Googled” the missing 2009 average base salaries to make the comparisons shown below.

2009 Average Base Salaries

Anesthesiologist  $317,000
versus
Nurse Anesthetist  $186,000

Primary Care Physician $173,000
versus
Nurse Practitioner  $83,000

Note that nurse anesthetists are more cost effective than anesthesiologists, and nurse practitioners cost less than primary care physicians.
Nurses are upgrading their knowledge and skills and filling an increasing need. In many rural areas, nurse anesthetists are the sole providers of anesthesia. And as an instructor who continues to teach physiology and related sciences to future nurse anesthetists for the thirty-seventh year, I can tell you that the textbooks are the same as those in medical school. The same mountaintop is reached despite the somewhat different paths taken.
Maybe doctors think they should always make more money than any and all nurses and that nurses should always be subservient to them. But doctors and nurses are healthcare professionals in their own right, and it’s in the best interest of the patients that they compete in the market place like everyone else. Maybe the public should be asking whether the big discrepancy in remuneration to specialist MDs versus specialist RNs for the same work is warranted?

Certified Registered Nurse Anesthetist (CRNA)
For many, the nurse practitioner is The Doctor

Recently I have rekindled the artistic spark of my girlhood.  Here is "Illinois Winter Magic."

Darlington Wisconsin October '09 Weekend - Photo Tour

The railroad was once very important to the town of Darlington Wisconsin as was the Pecatonica River that meanders alongside it.  The railroad transported goods and people, and the river sported recreational boats and powered the mill for the wheat that was then the main crop.  The railroad and mill are now gone. The upper millstone is now on display in the town's park by the River.  Except for some moss-covered ties alongside the Trail and the old Darlington Depot (now museum), there are no signs of the railroad that once connected Darlington to the world.  The Cheese Country Trail is now where the train tracks once were, and the Trail now sustains the town by accommodating ATM vehicles and snowmobiles.  The bucolic topography that was spared the last glacier remains.
Better views of Photo Tour!

Surprise for Excellence in Teaching

The students I taught during 2007, the first year of their three-year master degree program in nurse anesthesia, had their graduation ceremony on August 28th. What a wonderful surprise awaited me at my students’ graduation ceremony! I have been the science faculty in the anesthesia program for thirty-five years. The courses I teach during the first year provide the foundation in science that the students will build on throughout the rest of the program and their professional lives.
Now I have a plaque and a huge stack of cards sent by my former students, some of them from the very first class, to commemorate these years. The program director’s complimentary speech about the students’ evaluations of my teaching over the many years was a joy to hear announced to a large audience mostly comprised of the graduates’ families and friends. The generous check and the beautiful flowers were welcome too. But the teary-eyed smiles of my former students and the heartfelt messages in the many cards were the best parts of the surprise. These cards and the associated memories will be treasured always.

Tokens of Gratitude From My Students

Being the science faculty for the students in the School of Nurse Anesthesia is challenging and rewarding. The students are extremely smart, exceptionally stable, and among the nicest people you will ever meet. They are training to become the high-level medical professionals who keep you alive during surgery.
Here I am shamelessly bragging about the presents that the Class of 2011 gave me recently at the end of the first year of their rigorous three-year program. The T-shirt, while probably the most inexpensive of the presents, is the most priceless because it sports many of my sayings or what the students now call “Ronnie-isms” on the back. I am moved that they have memorized these remarks some of which refer to concepts they previously never knew.

Plus, the students really have sized me up. They know I am a T-shirt person. They have also observed that I have a big weakness for jewelry and prefer that it is coordinated. Look at the two beautiful sets of jewelry my students gave me.


The students presented these gifts to me during a wonderful special luncheon they put together in the hospital cafeteria just after they took the last of my exams. Teaching science to medical professionals like my students, who want to learn as much as they can so that they can be the very best nurse anesthetists, is an awesome responsibility I accept with pleasure!

PJ - 1st floor resident & garden terrorist

PJ is a garden terrorist - It remains to be seen if the fungus that attacked my apple tree has been defeated!

CAREER OVERVIEW - updated Nov. 9, 2014

PROFILE

·       Science professor specializing in animal physiology

·       Nearly fifty years of teaching experience at college and graduate school levels

·       Public speaker to professional groups and the general public on science and technology

·       Creator of curricula and numerous courses in biology and other sciences for academic programs in science, technology, and medicine

·       Exceptional track record of educating professionals in science, technology, and medicine who are successfully employed in their respective fields

FACULTY POSITIONS AND SUBJECTS TAUGHT

• Affiliate Clinical Assistant Professor - School of Nurse Anesthesia

NorthShore University HealthSystem 

in cooperation with DePaul University - Department of Nursing (2000 to present)

Ravenswood Hospital (1975-2000)

Science instruction for Anesthesia Program: Physics, Biochemistry and Molecular/Cell Biology, Nervous System, Endocrine System, Cardiovascular System, Respiratory System, Excretory System, Digestive System and Intermediary Metabolism

• Teacher

Chicago Public Schools (September 2006 – June 2008)

Substitute, Kindergarten to Grade 12 – All Areas

• MCAT Instructor

Princeton Review (October 2006 – August 2007)

Biology instruction for the Medical College Admission Test

• Adjunct Professor - Nurse Practitioners Master’s Degree Program

DePaul University - Department of Nursing (1999 to 2005)

Molecular Biology, Advanced Physiology and Pathophysiology

• Tenured Full Professor, Director - Biological and Physical Sciences Program, and Founder and Director - Electroneurodiagnostic Technology (ENDT) Program

East-West University (1984 to 2005)

General Biology, Cell Biology, Microbiology, Ecology, Anatomy and Physiology, Neuroscience, Diseases of Nervous System, Genetics and Evolution, Nutrition, Reproduction & Sexuality, Introduction to Nature, Chemistry, Physics, Math, Electroneurodiagnostic Technology

TEACHING EXPERIENCE as GRADUATE STUDENT

DePaul University

Human Anatomy, Human Physiology, Experimental Biology, Regulatory Biology, Immunology

University of Illinois

Human Physiology, Comparative and Adaptive Physiology, Cellular and Molecular Physiology

EDUCATION

Ph.D.  DePaul University 1987

• Biological Sciences / Animal Physiology

• Research in Immunology

M.S. University of Illinois 1969

• Biological Sciences / Animal Physiology

• Research in Neuroendocrinology

B.S.  University of Illinois 1965

• Teaching of Biological Sciences and General Science

• Student Teaching and Coursework for Secondary School Teacher Certification

SELECTED PROFESSIONAL SPEAKING ENGAGEMENTS

On the Tenth Voice

• Trans Talk: Explore the Myth and Science of Sexuality (Radio interview – March 22, 2014)

Secular Events Meetup

• Intersex People:  Who Are They?  (March 23, 2013)

Argosy University – A2Z

• Intersex People:  Who Are They?  (April 13, 2013)

Sex, God, and Science Conference - Chicago

• Gender Binary and LGBTI People -Myth and Medical Malpractice (April 29, 2012)

Freethought Festival, UW-Madison

• Gender Binary and LGBTI People -Myth and Medical Malpractice (April 27, 2012)

Fourth Presbyterian Church of Chicago, Changing Conversations program

• Myth and Science of Sexuality: Disordered or Just Different? (February 18, 2011)

Ethical Humanist Society of Chicago

• Myth and Science of Sexuality: Disordered or Just Different? (October 10, 2010)

Center On Halsted

• Intersex Lives: Issues and Personal Stories (March 10, 2012)

• Intersex People: What You Should Know and Why You Should Care! (June 11, 2011)

• Disordered or Just Different? Myth, Science, and Sexuality (September 16, 2010)

• Science of Gender (March 13, 2010)

Center for Inquiry/Chicago

• Disordered or Just Different? Myth, Science, and  Sexuality. (First Annual Spring Conference, April 24, 2010)

• Science and Sexuality (November 9, 2008)

LGBT Center of SE Wisconsin

• Science and Sexuality (November 15th, 2009)

Gay Liberation Network CAN TV

• Ending Professional Bigotry Against Transsexual People (August 14, 2009)

Michigan Womyn’s Music Festival

• Myth, Science, and Sexuality (August 5, 2010)

• Science and Sexuality (August 6, 7, 2009)

National Women’s Music Festival

• Disordered or Just Different? Myth, Science, and Sexuality (July 3, 2010)

• Science and Sexuality (July 4, 2009)

Reeling 2007 LGBT Film Fest Panel

• Discussion on sexuality issues at Chicago's Center On Halsted following local premiere of “The Gendercator" (November 21, 2007)

American Society of Electroneurodiagnostic Technologists

• Cranial Nerves for Intraoperative Neuromonitoring (Conference Call Seminar – September 26, 2007)

• Anatomy and Physiology of the Peripheral Nervous System for Nerve Conduction Studies (July 30, 2004)

• The Peripheral Nervous System and Common Compression Neuropathies (August 11, 1999)

• Anatomy and Physiology of the Peripheral Nervous System for Nerve Conduction Velocity Testing (September 22, 1994)

Central Society of Electroneurodiagnostic Technologists

• Anatomy and Physiology of the Central and Peripheral Nervous Systems for Intraoperative Neuromonitoring (April 22, 2004)

Southern Society of Electroneurodiagnostic Technologists

• Neuroanatomy for Evoked Potentials (Knott Lecturer, featured speaker) (April 24, 1996)

Illinois Society of Electroneurodiagnostic Technologists

• Anatomy and Physiology of the Peripheral Nervous System for Nerve Conduction Velocity Testing (October 28, 2000)

• Anatomy and Physiology of Peripheral Nervous System (September 22, 1994)

• Cranial Nerves with Emphasis on Vestibular Function (November 12, 1993)

• Anatomy of Somatosensory Evoked Potentials (April 27, 1991)

• Brain Regions (April 15-16, 1988)

• Cranial Nerves (October 24-25, 1986)

Northeastern Illinois University, Chicago Teacher's Center, College of Education

Workshops for Teacher Training

• Reproduction (May 13, 1989)

• Growth, Development and Puberty (April 1, 1989)

Illinois Association of Nurse Anesthetists

• The Cardiovascular System: Structure, Function, Regulation (October 10-12, 1980)

• Anesthesia and Cell Physiology (November 17-19, 1978)

• Anatomy and Physiology of Neck and Extracranial Regions (October 19-21, 1978)

PUBLICATIONS

• Drantz, Veronica. “The Gender Binary and LGBTI People: Religious Myth and Medical Malpractice,” Chapter 12 in Christianity Is Not Great: How Faith Fails. Edited by John W. Loftus, Prometheus Books, 2014.

• Drantz, Veronica. "Science and Sexuality: The Biology of Sexual Identity, Sexual Orientation, and Intersexuality."  http://drdrantz-sciencessexuality.blogspot.com/ (August 25, 2008 to present)

• Drantz, Veronica. “Behavioral Objectives Improve Teaching and Learning Effectiveness” in Handbook for END School Development. 2nd edition. Carroll, IA: American Society of Electroneurodiagnostic Technologists Inc., 2001.

• Drantz, Veronica. “Anatomy and Physiology of the Peripheral Nervous System” Chapter 1 in Nerve Conduction Studies for the Technologist. Carroll, IA: American Society of Electroneurodiagnostic Technologists Inc., 1996.

• Drantz, Veronica. “Neuroanatomy for Evoked Potentials” in Evoked Potential Course Booklet. Pensacola Beach, FL: Southern Society of Electroneurodiagnostic Technologists, 1996.

• DeLise, Laura and Veronica Drantz. “Taking a Patient History” in ASET Newsletter. Carroll, IA: American Society of Electroneurodiagnostic Technologists Inc. (February 1995) 19-20. (Also published in NSSA News. Neurophysiological Sciences Society of Australia, May 1995.)

• Drantz, Veronica. “The Enumeration of Macrophages of Various Sizes and Nonspecific Esterase Activities in Rat Spleen and Peritoneal Cavity during the In Vivo Primary Humoral Response to Sheep Erythrocytes.” Ph.D. Thesis. Chicago, IL: DePaul University, 1987.

• Anderson, Richard C., Veronica E Drantz, Gerald W. Faust, and John T. Guthrie. "Population Genetics" (A BSCS Self- Instructional Program) Morristown, New Jersey: Silver Burdett Co., 1969.

• Drantz, Veronica. "The Development of Double Antibody Radioimmunoassay of Ovine Somatotrophic Hormone." M.S. Thesis. Urbana-Champaign IL: University of Illinois, 1969.

ADDITIONAL WORK EXPERIENCE

• Science Consultant

Ravenswood Hospital

Northeastern University - Chicago Teacher's Center, College of Education

• Certified Instructor of Cardiopulmonary Resuscitation and Basic Life Support

American Heart Association

• Forensic Analytical Chemist

Chicago Police Department Criminalistics Lab

PROFESSIONAL MEMBERSHIPS

• American Association for the Advancement of Science

• American Physiological Society

• American Society of Electroneurodiagnostic Technologists

• Center for Inquiry

• Chicago Council on Science and Technology

• Chicago Science Field Trips Meetup Club (organizer)

• Illinois Society of Electroneurodiagnostic Technologists

• National Association of Biology Teachers

• National Center for Science Education

• National Science Teachers Association

ACADEMIC AND PROFESSIONAL HONORS

• International Professional of the Year (2009)

• Foremost Educators of the World (International Biographical Center – 2008)

• Who's Who of American Women (17th, 18th, 21st, 23rd, 24th, 25th and 2008-2009 editions)

• Who's Who in the World (11th, 15th, 16th and 2006 editions)

• Strathmore’s Who’s Who (2005-2006)

• Who’s Who Among America’s Teachers (2003-2004)

• Who’s Who in America (55th, 56th, 57th, 58th and 2009 editions)

• Who's Who in American Education (3rd, 6th and 7th editions)

• Who’s Who in the Midwest (26th edition)

• Who's Who in Science and Engineering (2nd, 5th and 8th editions)

• The World Who’s Who of Women (13th and 15th editions)

• Knott Lecturer – American Society of Electroneurodiagnostic Technologists’ John Knott Educational Lecture Program (1996)

• Cardiopulmonary Resuscitation Award (Chicago Heart Association - 1990)

At NorthShore University HealthSystem

• Lifetime Achievement Award for Excellence in Teaching (2009)

At Ravenswood Hospital School of Anesthesia

• Instructor of the Year (1997)

At East-West University

• MSEIP Grant: Minorities in Science and Engineering Improvement Project (2002-2005)

(Development of ENDT Program courses in Polysomnography, Intraoperative Neuromonitoring, & Nerve Conduction Studies and acquisition of one-quarter million dollars worth of state-of-the-art equipment)

• Instructor of the Year (1986-1987)

At DePaul University

• Schmidt Academic Fellowship

• Who's Who In American Colleges and Universities

• Graduate Teaching Assistantships

• Schmidt Graduate Scholar

At University of Illinois

• National Science Foundation Fellowship

• National Science Foundation Research Assistantship

• Graduate Teaching Assistantships

• Phi Sigma National Honorary Science Society

• Phi Beta Kappa

• Graduation with High Honors

• James Scholar

• Dean's List

• University Scholar

• Alpha Lambda Delta National Honorary Society

VOLUNTEER WORK

Professional Advisory Council member - Beyond XXY, Inc., http://xxyintersex.com/our_board_of_directors.html

References available upon request