I'm not sure how your incoherent rambling addresses any of the statements made in my post. CRNAs are trained to work outside the ACT and do so safely every day in every state. This fact is indisputable. AAs are trained to depend on an MDA exclusively and therefore lack the clinical skills and ability necessary to work outside the ACT. AAs are simply not competent to work without an MDA while CRNAs do so safely every day in every state in the country. This is a HUGE difference in provider capability. Are you claiming that you are trained in any fashion other than that requiring exclusive dependance on an MDA?