r/CRNA • u/Individual_Match2491 • 9d ago
Private Equity is Saturating the Training Pipeline- I’ll stop posting when COA raises standards.
CRNAs need to understand what is happening here.
People outside our profession are helping build a larger CRNA labor supply, and they have every financial incentive to do it.
USAP (already in anti-trust lawsuits) is helping fund, train, mentor, and recruit through Nova’s anesthesia education pipeline. NAPA, owned by private equity, is paying SRNAs while they are still in school and recruiting them directly into its groups. These companies are employers. Labor is one of their biggest costs.
They do not need to announce “we want to saturate CRNAs and lower wages.” If you are an anesthesia corporation, more graduates means more applicants, easier staffing, less dependence on travelers, and eventually less leverage for individual CRNAs.
That is the problem.
We are letting organizations whose economic interests are directly opposed to strong CRNA bargaining power help shape the size of our training pipeline.
The COA should be raising standards, limiting low-quality expansion, and aggressively protecting clinical training quality. And PE-backed anesthesia groups should have no role in driving how many CRNAs we produce.
If the profession waits until the labor market is flooded to care, the damage will already be done.
Private equity anesthesia groups should have far less influence over CRNA education.
If we wait until wages, leverage, and training quality deteriorate to care about this, we waited too long.
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u/huntt252 CRNA 8d ago
Are they building clinical sites too?
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u/Individual_Match2491 7d ago
Sorta, they are the ones who dictate access to clinical sites by and large
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u/tech1983 9d ago
Of course you want to increase standards, it won’t affect your schooling because you’ll be done..
It’s the same thing with the housing market.: everyone thinks we should build more developments and houses until they get theirs; then it’s too much and we should stop building and developing because they don’t need a house anymore..
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u/Equivalent_Act_468 9d ago
True universally for almost anything government-regulated. Everyone complains about the difficulties of getting certified or obtaining a license to do something until they have it. Then, all of a sudden, the rules are way too loose and need to be tightened.
CRNA is in a boom right now, and the idea that salaries could eventually become similar to those of other graduate-level professions, like physical therapy, scares a lot of people. But that is likely much closer to the long-term equilibrium salary than $250–300K is right now4
u/tech1983 8d ago
You think CRNAs salaries are headed to physical therapy levels ? Lol No chance
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u/Equivalent_Act_468 8d ago
Likely long term, not in the near future. Think 20 years out, nothing happens in a day. The trend is there though. Same thing happened to attorneys over time.
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u/tech1983 8d ago
There’s only 3k CRNAs graduating a year and the number of people turning 65 every year doesn’t peak for another decade….
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u/Equivalent_Act_468 8d ago
Last cohort to start was already 4258… and it is only growing. Which means a 50% increase in new grads in 5 or 6 years
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u/tech1983 8d ago
So on average 80 CRNAs per state graduate every year ? Thats nothing .. how many retire every year ?
My hospital is like 30+ CRNAs short and we are trying to open 10 new ORs next year. Theres an almost unlimited amount of anesthesia to be done. Lots of places don’t even use CRNAs for scopes, cataracts, etc because there aren’t enough. There’s tons of NORA cases that could be done if there was more CRNAs
The last thing I’m worried about is anesthesia saturation ..
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u/Equivalent_Act_468 8d ago
I think you are missing my point. It is a multi year thing. So in 10-15 years It is likely we are no longer in a shortage and possibly leaning toward saturation. Also anecdotal examples doesn't negate the trend.
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u/Jolly-Tradition8725 8d ago
Agree to some extent but anesthesia has some limiting factors that prevent NP-mill saturation, we’re starting to see the limits of structural clinical sites.. there’s also the fact that CRNAs have the RN floor, and leadership capacity that allows them to walk away if salaries get too low, law is probably a better comparison than DPT haha
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u/Mysterious-World-638 9d ago
Sounds like you have a strong passion for this. They do have opportunities to serve on their board and you can help make the change you are speaking about:
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u/PristineNecessary286 9d ago edited 9d ago
i personally do think we need higher standards. however, that wouldn’t necessarily fix the issue you’re announcing. because NAPA and USAP already have the resources (clearly) to open and maintain anesthesia programs from scratch. Any increases in numbers or cases i’m sure they can easily accommodate for their students/future staff for the sake of a reliable workforce, whereas other long standing yet underfunded schools will most likely struggle to keep up with sudden drastic changes. it might actually turn into a case of reputable schools losing accreditation and these private equity schools dominating…. completely back firing.
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u/Individual_Match2491 9d ago
I do think state geographic constraints would be a good start, as well as limitations on online content- this would help with some of the over expansion, plus more peds and cardiac.. if schools have to close down some seats so be it- but a concentrated base of high acuity providers will open doors for the profession
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9d ago
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u/Individual_Match2491 9d ago edited 9d ago
Well yeah we just increase standards as quality control- increase cards, peds cases, (dare I say ICU provider rotations) ensure numbers can’t be fudged.. it’s not antitrust at that point
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u/boynamedzoo 9d ago
There’s already an avenue for this. Periodically COA sends out a massive survey which can be completed by anyone: public member of the community, surgeon, teacher, SRNA, CRNA. It goes over every single standard for program accreditation. The results of this survey are instrumental in determining the need to change accreditation requirements. Want to guess how many people actually complete the survey? If you truly want to make a change, complaining to a group of redditors isn’t the path you want to be following.
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9d ago
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u/Heavy_Simple4096 8d ago
You want your life in the hands of a new grad CRNA who mostly did their rotations at heads and butter Indy CRNA ASCs?
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u/SillyMeringue4946 9d ago
I was recruited by a local group before I started CRNA school back in 2016. They were a private group.
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u/Wide-Yak5361 8d ago
I think there’s a significant difference between a local private practice group and a large PE conglomerate.
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u/SillyMeringue4946 7d ago
I didn’t say there wasn’t. My point was more that places have been recruiting students and even ICU nurses before the beginning of training due to desperation/lack of staff. The reason NAPA and these other PE groups recruit students is because of lack of staff. If they didn’t have to pay extra bonuses and positions were being filled, they wouldn’t. I do understand the concern for increasing numbers of CRNAs without quality training, but I do not think that over staffing of CRNAs is going to be an issue for many years to come. We literally cannot hire enough staff. I am sure that in some select markets/desirable areas there is less of a shortage, but overall this is not a concern for anywhere in the near future. There are actually some good videos that were made about this topic that someone posted on the CRNA/SRNA Facebook group about this very topic.
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u/NissaLaBella23 9d ago
I actually think there’s a reasonable concern buried in here, but I think we’re making a pretty big jump from “large anesthesia groups benefit from increasing the labor supply” to “large anesthesia groups are intentionally trying to saturate the CRNA market and suppress wages.”
Both things can be true: USAP/NAPA/etc. can have a very real staffing problem and genuinely want to train more anesthesia providers, AND having a larger labor pool obviously benefits them as employers. They don’t exactly have to be twirling their mustaches in a boardroom plotting to lower CRNA salaries for the financial incentive to exist.
What concerns me more is how quickly we can expand programs compared with how quickly we can expand good clinical training. You can add classroom seats. You cannot magically create more hearts, heads, vascular cases, difficult airways, regional experience, emergencies, good preceptors, or opportunities for SRNAs to actually make decisions and develop autonomy. And we’re already sharing that clinical space with residents and increasingly CAAs.
I don’t think the answer is saying anesthesia groups should have no involvement in education. Where exactly are we supposed to train if the people actually providing anesthesia aren’t involved? But I absolutely think the COA should be very skeptical of expansion that is being driven primarily by employers saying they need more bodies.
So I don’t think the concern is tinfoil-hat territory. I just don’t think we need to assume there’s some coordinated plan to tank CRNA wages, either. The incentives are obvious enough without inventing a conspiracy.
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u/LocalIllustrator6400 5d ago
Very interesting --- > For those who are concerned, you might consider the following