Let's look at Icu nurses in most medical centers' these days...The only lines they start are peripheral IVs, they only give drugs when it is ordered in the dose provided to them, and most of thier protocals are set up in a fashion of If A then do B. Meanwhile, Resp therapy programs are evolving where they are responsible to evaluate patients and create care plans for that patient including medications and therapies. RRT's intubate, start arterial lines/sticks WHEREVER they need to, and have guidlines and training on mechanical ventilation in all modes. Now look at anesthesia, we intubate, give drugs as we see necessary, mechaniacally ventilate patients etc. So i ask you DD where do you get off thinking you are soo much more qualified to go into anesthesia then a qualified RRT? And obviously you didn't even read that study that you have been asking for so damn much because where did it mention anything about MDAs telling the AA's anything? Once again you are showing the world how you are pathetically uninformed and scared about losing your job to AA's. WHY do you think AA's are going to be a threat to crna's or your job? Do you think that even if the national govt. passes legistlation allowing AA's to work wherever that all of a sudden Crna's would just lose thier jobs? No, AA's will practice side by side with crna's like we do now, the only difference that will occur is that more providers will be available which means less overtime, and less leverage for whiny anesthetists to demand more and more money to do the job you signed up for. We will all still be getting raises and make damn good livings for mid-level providers but the rise in pay will level off or all of healthcare will suffer since there isn't the amount of money for healthcare is NOT endless. MN, you and i are not arguing about anything, i stated before, keep rural america, we don't care. That fight you can take up with the ASA and leave AA's out of it. However, that same hosp. in rural america can hire 1 MDA and 2 anesthestists and continue with the act approach thus increase that hospitals ability to handle the periodic nightmare case that shows up in the middle of the night. Face facts guys, most surgeons don't know and don't want to know, how to deal with medically related emergencies, and good luck getting an ER doc in the OR to help out.