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

2. 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

3. 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

4. Who Defines the CRNA Profession?
The profession
The Professional Organization (AANA)
Licensing Boards

5. Who Does NOT Define CRNAs
Nursing
Medical anesthesia
Medical licensure
CMS
Insurance companies
Accreditating Agencies
Hospitals and ASC Facilities

6. 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

7. Reimbursement
Getting paid for the value of your education and functions
Do not undervalue administration of anesthesia

8. Hospital Privileges How should we be classified? Allied health?
Mid-level practitoners?
Physician extenders?
Anesthesia PROFESSIONALS (better word than provider)

9. Anti-trust Actions
Bhan case
Oltz case
Minnesota case

10. Future Considerations

11. Whistleblower Lawsuits
Medicare Fraud and Abuse

12. OIG ADVISORY
Fee splitting
Company model
Advantges for CRNA

13. Contract Negotiations
Critical to be considered a businessperson
Collect facts
Know your worth
Understand your opponent
Set your limits

14. 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

15. Professional Actions Decorum Dress Ask Smart Questions
Understanding politics of the operating room
Patient Advocacy

16. 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

17. Final Thoughts We would not be here today, except for:
Strong clinical skills
Basic education and Continuing education
AANA
Committed professionals

18. 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 ;136(3):243–246.