User talk:Uptowner

Anesthesia provision in the US
Please do not delete large amounts of content from Wikipedia articles, as you did at Anesthesia provision in the US. If you have a problem with the U.S. Law and Anesthesia Provision section or any other par

t of the article, please discuss it on the talkpage. I would note that your deletion also removed a number of other parts of the article including: Please be more careful with edits in future to check what you are deleting, and leave an edit summary explaining your changes. Controversial changes should be discussed on the talkpage- a lot of very productive discussion at Talk:Anesthesia lead to considerable progress in resolving content disputes there. Thank you, WjBscribe 23:22, 13 February 2007 (UTC)
 * See also section
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I didn't delete anything from the article. I returned the article to its previous, unvandalized state. Uptowner 22:35, 14 February 2007 (UTC)


 * Describing other's edits as vandalism is an unproductive way of refering to content disputes. I particularly find your description of my addition of the sections in the list above as vandalism offensive. I have looked through the section you object to and have changed it to more neutral language. If you still find it problematic discuss it. But those legal decisions are clearly relevant to the article. If there are contrary ones please cite them. If you don't feel the desciption of the outcome of the cases is accurate, please suggest alternatives. But it was never vandalism. WjBscribe 23:35, 13 February 2007 (UTC)

The changes to my paragraph were never discussed. Iwonder if the other users are warned about deleting parts of the article when they delete my paragraph.Uptowner 23:39, 13 February 2007 (UTC)

The other users are intentionally misleading the reader. Anesthesiologists and nurse anesthetists do not work 'in parallel'. The anesthesiologist supervises the nurse in 90% of their cases. To call this working in parallel is intentionally misleading and implying equivalence that is not the reality. Uptowner 22:35, 14 February 2007 (UTC)
 * It is the case that nurses are supervised in 90% of cases this should definitely be mentioned in the article. Can you cite a reilable source to confirm this? WjBscribe 23:46, 13 February 2007 (UTC)

This site's slide show shows the breakdown explainig both the crna claim of 2/3 of cases and my claim of 90% for physicians. http://www.aaasc.org/membership/documents/KMiller_Anesthesia_Presentation_05.ppt I was slightly off in my statement as it turns out. Physicians administer or supervise 90% of anesthestics while nurses are supervised in 85% of their anesthetic administration.Uptowner 00:42, 14 February 2007 (UTC)
 * Could we possibly get this info in a better format than a powerpoint slideshow? It not really what WP:RS requires... WjBscribe 00:47, 14 February 2007 (UTC)

As Georgia AA and I have discussed previously in other forums, his view of anesthesia in America is severely constricted. When he says CRNAs and MDAs (anesthesiologists) do not work in parallel he is like one of Aesop's blind men describing an elephant -- by only feeling one part of the animal. What applies in Atlanta is not the B

Ok.ig Picture. I have often worked alongside MDAs, independently, with not a hint or a trace of supervision. He imputes that I'd say I'm equal to an MDA. Not so. They are perioperative specialists. But, in the OR, I am a functional equivalent, supplying the same service at half the price, and CRNAs cost about one-tenth as much to train.

deepzCRNA 03:24, 14 February 2007 (UTC)

Ok. Here it is in another format. http://www.upenn.edu/ldi/issuebrief6_2.pdf This study of 217440 cases had 89.4% supervised by physicians. It also interestingly had a higher mortality rate in cases where nurses were not supervised by anesthesiologists. Please correct the article WJBscribe. Deep, I wouldn't claim that you are supervised at every moment. You don't need an anesthesiologist constantly present while performing nursing duties in the OR. You do need to have an anesthesiologist available when diagnosis is required and in any unusual circumstances. You are not a functional equivalent because your training isn't as broad or deep, doesn't focus on diagnosis, and doesn't focus on medical decision making. Your training focuses on following protocols which are frequently adequate, but not always.

Uptowner 22:15, 14 February 2007 (UTC)

I just dont understand you
Here is the thing uptowner. You continually add 'opinion' without evidence to these article and wonder why it gets changed back? We are providing evidence for our claims, you are not. Why? b/c the evidence dosent exist. A line in a ppt slide out of nowhere does not constitute evidence. A very one sided ppt fraught with spelling errors (its SIBLER). Either pony up or stop editing content.Mmackinnon 04:22, 14 February 2007 (UTC)

_______________________________

Here's one source of the pseudo-science claim that American anesthesia is 90% stupervised by MDAs:

http://www.asahq.org/Newsletters/1998/05_98/National_0598.html

Please note that the sidebar clearly states:

"The views expressed herein are those of the authors and do not necessarily represent or reflect the views, policies or actions of the American Society of Anesthesiologists."

Not verifiable, not reproducible -- not science. In other words, Dr Grogono expresses his opinion that 90% are supervised, then it becomes accepted among the ASA militant as gospel. Typical.

deepzCRNA 22:50, 14 February 2007 (UTC)

My citation is a legitimate study. I don't know what you are talking about. You won't find the % of supervised cases on your precious AANA site because they are in the business of propaganda. Quoting a 90% or another large medical direction rate doesn't suit their aims to make nurses into pseudo-physicians with b.s. nursing 'doctoral' degrees so they are silent on the subject of medical direction rates in the real world. By the way, I'm not saying that CRNAs are necessarily pseudo-physicians, only that that is the goal of one misguided organization, the aana. Uptowner 23:07, 14 February 2007 (UTC)

____________________________

Silber's politically motivated 'research' has been widely debunked. Here are two citations:

http://www.aana.com/resources.aspx?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=673

and

http://www.aana.com/resources.aspx?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=675

Remember his original abstract, entitled, "Do Nurse Anesthetists Need Supervision?" His conclusions were implicit in his starting title. Typical ASA behavior.

deepzCRNA 00:22, 15 February 2007 (UTC)

Wow, the aana doesn't agree. Shocking. I think you will be convinced of any study showing equivalent outcomes but by none that shows a difference. Anyway I was only using the study to show the percentage of cases that were supervised. Your articles don't argue against that. Uptowner 03:56, 15 February 2007 (UTC)

Do I understand you, Mr Georgia AA? -- you claim that the study you cite speaks to the Nationwide %age of supervised anesthetics, and not just the %age in Silber's 'research.' Can you quote a passage?

deepzCRNA 13:34, 15 February 2007 (UTC)

Are you calling me Mr Georgia AA? That's pretty silly. I assume you argued with Mr Georgia AA on your forums or something. It's not me. Perhaps you could invite him to join this discussion if you come across him again though. It's true that the ratio in that particular study is from the sample population and not of the nation as a whole. It is a very large study and it's 90% ratio is fairly consistent with my earlier citation of 85%. If you can offer up a better reference as to the rate of medical direction of nurse anesthetists we should replace that one. It's the best reference on the table though. Uptowner 19:25, 15 February 2007 (UTC)

So you admit it's not the nation as a whole but you still choose to extrapolate the %ages in at sample to represent some 40 million US anesthetics. Not very scientific. But very typical of ASA pseudo-science.

BTW, pat Georgia AA on the head, will ya.

deepzCRNA 03:03, 16 February 2007 (UTC)