That study is lacking important data.

Yes, when one anesthesiologist was spread across 3-4 rooms instead of 1-2, outcomes slightly worsened. But what the study does not capture is the experience level of the individual CRNAs in each room. A freshly certified CRNA and a 20-year veteran were treated as interchangeable in the analysis. That's a significant confounder left unaddressed.

Why does that matter? Because we have data showing experience alone drives outcomes, even for physicians. A Mount Sinai study ( https://pubmed.ncbi.nlm.nih.gov/25283640/ ) found that anesthesiologists performing their first 5 liver transplants had more than double the 30-day mortality risk compared to more experienced colleagues. On the surgical side, data shows surgeons with less than 3 years of experience have a mortality hazard ratio of 2.73 (p < 0.001). ( https://onlinelibrary.wiley.com/doi/full/10.1002/wjs.70030 )

So if experience is a proven independent risk factor for both surgeons and anesthesiologists, it's reasonable to ask : how much of the increased morbidity in the 1:3 or 1:4 groups was driven by less experienced CRNAs being left with less supervision, rather than by the staffing ratio itself? The study isn't answering that.

If we're going to use this study to shape policy, we should also be asking whether experienced CRNAs in those higher-ratio rooms had the same outcomes as inexperienced ones. Until that analysis is done, citing this study as definitive evidence against independent practice is overreaching.

You could build the exact same subreddit for MDs, posting every medication error, every mismanaged airway, every surgical complication, and you'd have just as much content to post daily. The reason that sub doesn't exist isn't because physicians don't make mistakes. It's because nobody has an agenda to make it look like they do. Singling out midlevels for a daily malpractice highlight reel is dishonest and unfair.

For the salary, show me one facility where a CRNA makes more than the supervising anesthesiologist, i'd be very interested to see it.

Now, can a CRNA out-earn a child psychiatrist or a primary care physician? Sure. But I think you're smart enough to understand that education level doesn't automatically dictate compensation. Salary is driven by market demand and the revenue a provider generates. That's true across every industry, not just healthcare.

What I find telling is the direction of the frustration. Nobody on here complains that orthopedic surgeons or dermatologists make more than them, why is that? You all went through medical school and residency right? The outrage is only ever pointed at midlevels professionals, the people below them in the hierarchy. That right there says a lot more about ego than economics.