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