Regarding the issue of AAs in VA hospitals. That is a real can of worms. About 10 years ago the VA anesthesiologists started making the argument that since the standard of anesthesia has to be the same 24/7, it fell on the anesthesiologists to be on call. If a CRNA was on call, an MDA had to take call anyway to keep the night time standard the same as day time standard. Why have two people on call when the MDA could do the case all by themself? So there was a VERY large effort within the VA system to replace CRNAs with MDAs. At some, they would wait for a CRNA to retire or quit, then replace them with a MDA. At others, they would make the job a living hell to force the CRNA to quit. And at some, they fired the CRNAs, which resulted in some nasty law suits regarding the dismissal of vested federal employees. It was a real mess but in many cases, VA hospitals are now all MDA staffed.
Now how can they bring in AAs? All the arguments they used to get rid of the CRNAs would prevent them from bringing in AAs. The same issue of two providers on call would still remain. They can not open the doors to AAs without once again opening the doors to CRNAs.
Bottom line, the VA system as a health care system has opened the doors to AAs but the fight is still to be fought in the individual hospitals. Your best bet would be find a VA hospital that is advertising for a CRNA and apply for the job. If you can convince the MDAs there that you can do the job, perhaps for less money just to get in the door, you might be able to break down some walls.
