Both anesthetists (CRNAs) and anesthesiologists are key to keeping patients safe and comfortable during surgeries and other procedures. They often work closely together, but their training and responsibilities aren’t the same. Beyond training and pay, the lifestyle and work-life balance can also vary between the two roles, including work hours, call schedules, and flexibility.
Many patients don’t realize there are two different types of anesthesia providers, and the terms anesthetist and anesthesiologist often get used as if they mean the same thing. That can make it unclear who’s actually providing care and what kind of training they have. Today, we’ll break down the key differences between anesthetists and anesthesiologists.
Anesthetist vs. Anesthesiologist
Education and Training
The biggest difference between anesthetists and anesthesiologists is the amount of education and training it takes. Anesthesiologists are fully licensed physicians who complete a bachelor’s degree followed by four years of medical school, earning either an MD or DO degree. This is consistent with the amount of time that it takes to become a doctor. After medical school, anesthesiologists then complete a residency program in anesthesiology. This typically lasts four years and includes clinical training along with the possibility of additional years and training in subspecialties.
Anesthetists, most commonly Certified Registered Nurse Anesthetists (CRNAs), typically begin their careers as registered nurses (RNs). They then earn a Bachelor of Science in Nursing (BSN) or another related degree. Then, before applying to CRNA school, prospective candidates generally must have at least 1-2 years of experience in the field before applying to get a doctoral degree at a CRNA school.
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Roles and Responsibilities
Both anesthesiologists and nurse anesthetists are trained to manage pain, monitor vital signs (like a patient's heart rate and oxygen levels), and respond quickly to any complications that arise during medical procedures.
Anesthesiologists typically have overall responsibility for developing and overseeing anesthesia care plans. They do this by taking into account a patient’s medical history, the type of procedure, and potential risks. A day in the life of an anesthesiologist may include handling complex or high-risk cases and medical emergencies.
On the other hand, CRNAs generally play a more hands-on role in administering anesthesia. They closely monitor patients throughout surgery and adjust medications as needed to ensure safety and comfort.
Work Settings
Both anesthesiologists and CRNAs can work in a variety of healthcare environments and in different forms of employment. Anesthesiologists, like all physicians, can work with 1099 or W-2 employment, and the same is true of CRNAs. Anesthesiologists are more often found in large hospitals or trauma centers. While not a hard-and-fast rule, nurse anesthetists are more prevalent in rural or smaller hospitals and medical centers.
Salary and Cost Differences
When you look at physician salaries by specialty and experience, the average anesthesiologist's salary is generally higher than the salaries for anesthetists. This is primarily because they are physicians with extensive medical training and responsibility for complex decision-making and oversight. According to Medscape, the average salary for an anesthesiologist is $543,000.
However, it's important to understand that CRNAs also earn high salaries compared to many other nursing and healthcare roles. In fact, anesthetists are one of the highest-paying advanced practice nursing specialties, and they can earn $200,000+ per year. But because they are (relatively) lower paid, some healthcare systems use CRNAs rather than anesthesiologists as a way to help reduce overall costs.
Of course, salary levels for both roles can vary significantly based on a number of different factors, including the geographic location, experience levels, the type of employer, the independent contractor or employee status, and whether the provider works in a high-demand specialty area.
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Autonomy and Supervision
Anesthesiologists have full autonomy as physicians, and they are licensed to practice medicine independently. This allows them to diagnose conditions, create treatment plans, and lead anesthesia care teams. The amount of autonomy an anesthetist has varies depending on state regulations. Some states allow CRNAs full authority to administer anesthesia without physician oversight, while others require anesthetists to work under the direction of a licensed anesthesiologist.
The Bottom Line
Both anesthesiologists and anesthetists (CRNAs) are essential to modern healthcare, and both play a key role in patient safety during surgeries and procedures. The key difference is that anesthesiologists are licensed physicians with extensive medical training, while CRNAs are highly trained advanced practice nurses. Neither role is “better,” but they offer different career paths depending on a person’s goals, time commitment, and interest in medicine.
Factors like salary, autonomy, and work setting can vary widely depending on location, employer, and state laws. Because of this, it's crucially important to look at the full picture rather than just one aspect of the job.
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