Expert: JM Starkman, MD - 11/21/2010

Question
I'm having trouble getting worker's comp to approve use of crna when anesthesiologist is doing injection. Find it is the usual procedure but cannot find evidence based medicine to back it up.

Answer
Here's a great article about the pros and cons and politics of EBM:

http://www.medscape.com/viewarticle/559977_2

If you want YOUR way, then pay cash.  If you want someone else to pay, then plan on them getting it THEIR way.   If you're a CRNA, doctor or manager trying to get someone else to help establish cash flow for services that wouldn't be there without outside payment: good luck;   I can't help thinking present day health care expenditures will be able to sustain this sort of payment system for give-'em-whatever-they-ask-for much longer.