Beyond The Mask: Innovation & Opportunities For CRNAs

Ep 49: Thanksgiving Day Special: Showing Gratitude for the AANA

Happy Thanksgiving! To celebrate this wonderful day of gratitude, we welcome on AANA CEO Randy Moore and AANA Senior Director of Federal Government Affairs Ralph Kohl to help us give thanks for an organization that does so much for the CRNA profession every year.
 
Full show notes: https://beyondthemaskpodcast.com/?p=2172 
 
On this episode: 
1:37 – Thanksgiving morning!
2:00 – We’re thankful for our guests today, Randy Moore, CEO of the AANA, and Ralph Kohl, the Senior Director of Federal Government Affairs for the AANA.
2:35 – This podcast will focus on giving thanks for the AANA.
3:12 – Ralph explains what he’s thankful for.
4:15 – What this organization means to Randy.
6:31 – What mentors – past or current – are you thankful for knowing? Randy first.
8:13 – Ralph on his mentors.
10:23 – What does success look like for the AANA from Randy’s perspective?
11:49 – Ralph’s idea of success.
12:39 – What should every CRNA be thankful for?
14:49 – How would you explain your enthusiasm for the AANA?
18:43 – How do you want to be remembered if you move on, Ralph?
20:55 – What about Sharon, what are you thankful for from the AANA?
22:00 – Jeremy shares what he’s thankful for.

Ep 48: How OSAEMR is Changing Data Collection for CRNAs

Dan Simonson and Jack Hitchens are long-time CRNAs that identified a need in the profession to be able to easily track and manage data. That’s why they created the Open-Source Anesthesia Electronic Medical Record, which they believe provides great value – at no charge – to CRNAs around the world. Find out everything you need to know about OSAEMR and its future.
 
Full show notes: https://beyondthemaskpodcast.com/?p=2163 
 
Today's rundown: 
1:55 – Welcome in our two guests, Dan Simonson and Jack Hitchens.
3:55 – Today’s topic is OSAEMR or Open-Source Anesthesia Electronic Medical Record. Here’s some background on what it is.
4:46 – Why is this important for our profession?
5:32 – This even allows you to track your data as a student.
6:26 – This is a project Dan and Jack have worked on for five years. Here’s how it all started.
8:54 – A labor of love for Dan and Jack.
10:21 – It’s been a way for both guys to contribute to the profession and more than 400 CRNAs are using it now around the world.
11:44 – How does this interface with other systems already in place?
13:10 – Have these EMRs been helpful in the development in OSAEMR
15:02 – Is there a reason people wouldn’t want this data out there?
16:14 – What is OSAEMR’s motto relative to data?
17:28 – There’s no data being captured in plastics work but this can change.
20:04 – Pain management procedures are going to be a part of the data collection.
21:09 – Here’s what CRNAs can do to help OSAEMR continue to move forward and grow.
23:04 – There are three versions of the product currently.
25:56 – What are the near-term goals for the product?
26:51 – Final thoughts from Dan.

Ep 47: How Legal Cases Have Shaped the CRNA Industry

We were on location at the North Carolina Association of Nurse Anesthetists and wanted to get a historical perspective on CRNAs. With the help of past AANA presidents Sandy Ouellette and Nancy Maree, we take a look back at the important battles fought and won by nurse anesthetists through the years that help shape the way our industry operates today.
 
Full show notes: https://beyondthemaskpodcast.com/?p=2167 
 
On today's show: 
1:37 – We’re recording live from the North Carolina Association of Nurse Anesthetists meeting.
1:51 – Two popular guests, Nancy Marie and Sandy Ouellette, join the show.
2:37 – Sandy highlights some of the past challenges that will help CRNA’s unite and fight future issues.
3:12 – Background on Frank vs South and why that decision is still important today.
5:04 – The next important case involved Dagmar Nelson in the 1930s.
6:34 – The road to reimbursement was a 7-year process in the 1980s.  
7:50 – How the ANA helped turn around the industry when it began dying out in late 80s.
9:25 – The ongoing issue of federal supervision of nurse anesthetists in Medicare. Why we need to remove it and what role states are playing.  
13:31 – ANA threw their support behind antitrust cases.
18:06 – Antitrust fights still go on today.
19:24 – Nancy explains the antitrust and fraud case against Twin City Hospitals in 2004 and what came from it.
23:42 – What role has the ASA played in all of the challenges and crises the industry has faced?
26:30 – The recent Anesthesia Care Team statement and why many believe it’s restrictive.
29:13 – What can ANA members do today to help the association succeed and remain strong moving forward?
30:36 – Why membership is so important for ANA.
32:24 – New students and new graduates seem to be the biggest hole in membership.
36:20 – Can the ANA be listening to members better? Here are issues they have spoken out on.
40:24 – Jeremy’s perspective as an outside on the membership issue.
44:11 – Final thoughts from Sandy on why it’s such a great time to be a CRNA.  

Ep 46: Employment Contracts – Prevalent Issues with Mark Silberman

Accepting a new job is such a rewarding feeling that motivates you to get to work and continue growing your career, but understanding your employment contract first is vital. Mark Silberman, legal counsel for the AANA, will break down the specifics of a contract, what you need to know, and how to protect yourself. Plus, he’ll help us understand the different types of employment statuses and which is better for CRNAs.
 
***CE CREDIT ALERT: Did you know you can get continuing education credit from the AANA for listening to this episode? Go to https://knowledgenetwork.aana.com/home to get the details and get your credit today! And see a list of other episodes that qualify for CE credit here: https://beyondthemaskpodcast.com/series-ce-credit
 
Show Notes: https://beyondthemaskpodcast.com/?p=2142
 
Today's rundown:
2:29 – Welcoming on our guest today, Mark Silberman, who is legal counsel for the AANA
3:05 – What we’re talking about on this show and why it’s important.
4:17 – Mark breaks down the parts of a contract and what you need to know about one.
5:45 – A real-life example from a CRNA of a contract that didn’t get put in writing.
6:47 – Let’s define the differences between an employee and an independent contractor.
9:08 – Mark explains independent contractors even further.
10:20 – Trying to understand why some independent contractors are classified that way when they appear to be an employee.
12:02 – It all comes down to what is the intention.
13:16 – You have to remember that employers will almost always have leverage because they hold the commodity: the job.  
13:57 – Define ‘employee at will’ and how many states have that status.
15:48 – What’s the difference between job description and employee contract?
16:59 – Job descriptions are not enforceable. The contract specifics are.
18:02 – Does every CRNA need a contract?
20:06 – The biggest mistake people make when they’re looking at a contract.
21:44 – What are the most important things CRNAs should pay attention to in a contract?
20:07 – Can you re-negotiate your contract?
24:31 – Let’s talk non-competes. Every state has its own interpretations of these.
27:46 – How do we find out if these non-competes are enforceable?
29:12 – What happens when a new employer takes over?
31:39 – Should Independent contractor CRNAs incorporate for protection?
33:11 – Final words of wisdom for CRNAs entering a contract.

Ep 45: Empowering Nurses in Electoral Politics

Nurses have all the right attributes to be successful in politics but there are so few in office around the country. We want to help change that by empowering nurses to feel confident and comfortable running for office. We’ll spend this episode discussing why it’s an important topic and we’ll learn more a new campaign school that Sharon Pearce and Kimberly Gordon are working to launch in 2020.
On this episode: 
1:52 – Introducing our topic and our guest Kimberly Gordon.
2:19 – Sharon talks about what her and Kimberly have done together in the past.
3:45 – Why is this topic so important?
4:57 – Only two nurses serve in office at the Federal level right now.
5:21 – Why aren’t there more nurses in office?
7:01 – North Carolina has three nurses in state legislature, including Gale Adcock.
8:10 – Who are the two nurses on the national level?
8:52 – Neither of those are advanced practice nurses, which we’ve never had at the Federal level.
10:01 – Let’s talk about the breaking down barriers project Sharon and Kimberly are working on at Yale.
12:37 – We’ve met nurses from all over the country and they feel like this is very important.
13:40 – We as nurses are really late to this game. Physicians have been training people for politics since the 70s.
14:34 – Is it intimidating for nurses to consider running for office?
15:35 – Occupation-specific schools have become popular for a reason.
16:29 – A huge barrier is we don’t like to ask for money or help and that’s an issue.                                                                                                                   
18:41 – We’re not asking people to run for governor. We want to build a pipeline that starts in county commissions, school board, places like that.
19:32 – Maybe one day we’ll have a nurse as president.
19:55 – What kind of timeline are we talking about for this project?
20:34 – Yale has provided so much acceptance and assistance through this process.
21:39 – “If you’re not at the table, you’re on the menu.”
22:51 – Applications open on January 1, 2020.
Get the full show notes and additional resources here: https://beyondthemaskpodcast.com/?p=2135

Ep 44: Medicare Decisions For The Retiring (or Retired) CRNA

 
Retirement means many different things but one of the most important is transitioning to a new healthcare plan. For many people, Medicare becomes the best option but it can be difficult to sort through and understand. Who is eligible? What are my options? How much are premiums? We brought on Medicare guru Joanne Giardini-Russell to clear up a lot of questions for us.
On this episode: 
1:51 - Today we're talking about Medicare decisions for the retiring or retired CRNAs.
2:48 - Our guest today is a Medicare expert, Joanne Giardini-Russell
3:29 - Joanne gives us her background in the industry.
5:47 – Let’s start with the basics: what is Medicare?
7:09 – Who is eligible for Medicare and is it mandatory?
8:22 – If I’m still working at 65, does that effect anything?
9:44 – You don’t have to take Medicare at 65. It’s important to know that everyone’s situation is different.
11:14 – Understanding how the Health Savings Account plays into your decision.
11:54 – A lot of people don’t understand that premiums are income-related.
13:09 – When you start talking about retirement, planning needs to begin as soon as possible to work through options like these.
13:43 – Your HSA contributions get taxed and many people don’t know that.  
14:40 – What does the acronym IRMA mean?
17:51 – Client story about a couple found out they were paying more than they needed to for premiums.
19:35 – Are there other costs for Medicare beyond the premium?       
21:11 – You have two choices to handle the 20% beyond Medicare’s coverage.
23:02 – What are the pros and cons of the Medicare Advantage plan?
25:27 – What else does a CRNA need to know after they enroll? Let’s talk basics.
27:22 – If you’re over 65 and you’ve enrolled in Medicare, can you make changes or are you stuck?
28:44 – Pre-existing conditions do come back into play with Medicare.
29:33 – It’s very important to know that people with pre-existing conditions have one shot to get into Medicare. Here’s what you need to know.
30:23 – How much flexibility do you have in picking an insurance carrier?
32:29 – What are my annual requirements with Medicare coverage?
35:19 – Final thoughts from Joanne
Show notes and additional resources: https://beyondthemaskpodcast.com/?p=2123

Ep #43: The Future of Healthcare with Steve Mund

What does the next 5, 10, 20 years look like for the healthcare industry? That’s a question everyone would love an answer for, but there are many opinions out there. We sat down with Steve Mund to pick his brain on everything from insurance to costs to payments and more.
On this episode: 
1:59 – Introducing our guest on this episode, Steve Mund.
2:29 – Sharon shares some background on Steve.
4:24 – It’s an interesting time in healthcare and there’s no way to predict how it will change in the years to come.
6:57 – How to be a problem-solver for your department.
7:58 – The three payment models healthcare needs to engage in for the future.
10:14 – What about the accountability on the patient side?
11:19 – The providers get penalized but what about the payer?
12:57 – Jeremy shares a recent discussion he had with an insurance executive about drug costs.
14:01 – Let’s talk about mergers. Are their benefits to these large mergers?
14:59 – One prediction projected operating margin to be -16%.
15:55 – The length of stay can be an area of improvement potentially.
16:47 – Hospitals only operate on a 2.5-4% margin.
17:41 – Where is all the money going?
20:04 – What factors are driving the utilization of healthcare?             
22:03 – What does Steve see as the future of healthcare payers?
23:36 – The best way to stay informed is Becker’s Review.
25:29 – How do you determine value in healthcare these days?
26:58 – So how can providers show their value to their organizations?
27:42 – How can we help cut down on waste in financial, clinical and personnel areas?
29:16 - The waste isn’t always about money, it’s also about time.
30:40 - Some final thoughts from Steve.
Show notes: https://beyondthemaskpodcast.com/ep-#43:-the-future-of-healthcare-with-steve-mund/2115/

Ep #42: The Role of Nurse Practitioners in Healthcare

Nurse practitioners play such an important role in healthcare so let’s learn more about the profession. The CEO and president of the American Association of Nurse Practitioners join us on this episode to share their accomplishments, challenges, and goals to improve the industry and empower their nurses. Did you know the CEO of the Nurse Practitioners used to work for the AANA? Come join us for a great conversation. 
Here's what we have on this episode: 
1:46 – Welcome in our guests Sophia Thomas and David Hebert
3:06 – What is a nurse practitioner?
4:44 – Tell us more about your organization, AANP
5:47 – Sophia explains how the AANP is structured.
6:44 – David talks about his role at AANP and a little about the role of nurse practitioners.
8:41 – Why lobbying is so important in this line of work.
9:27 – The AANP has really increased their PR and media efforts in recent years.
11:31 – What are the challenges facing nurse practitioners today?
12:29 – David explains why nurse practitioners should be able to work independently.
14:23 – 28 states still require some sort of collaborations and that makes it difficult on NPs.
17:15 – It’s important for everyone in the profession to understand the issues and then get involved politically.
20:02 – Sharon talks about her goals to get nurses involved in the formulation side of the profession.
22:57 – We want to empower nurses to do more than just work and go home.  
23:46 – Quality and cost of healthcare is important to consumers, but so is convenience. These are things that nurse practitioners can provide.   
27:01 – A unified voice in the profession is very important and that’s the goal of the AANP.
28:26 – How does your credentialing work?
30:40 – What is David most proud of in his role at the AANP?
31:51 – David shares his history with AANA and what he remembers about that role.
34:18 – Some final thoughts from Sophia on the history of the profession.  
To get the full show notes and additional resources from Beyond the Mask, click here: https://beyondthemaskpodcast.com/?p=2108