According to the American Association of Nurse Anesthetists (AANA), Certified Registered Nurse Anesthetists (CRNAs) safely deliver over 58 million anesthetics to patients across the United States every year. This makes up more than half of the U.S. anesthesia workforce.
For recruiters, understanding the differences between CRNAs and anesthesiologists is essential. Both roles are critical to anesthesia teams, yet they differ in education, scope of practice, and responsibilities.
Recognizing these distinctions ensures the right provider is selected - aligning with organizational needs while maintaining safe, cost-effective anesthesia care.
This article outlines seven key role differences between CRNAs and anesthesiologists to support smarter, more strategic recruitment decisions.
Let’s begin.
What is a CRNA?
CRNAs are advanced practice nurses specializing in anesthesia.
Their training includes a nursing degree, clinical experience, and a doctoral-level nurse anesthesia program.
Here is a quick look at what a CRNA does:
CRNAs make up over 80% of anesthesia providers in rural counties across the United States. In fact, CRNAs serve as the only anesthesia providers in about one-third of all hospitals in the U.S. and in over two-thirds of hospitals located in rural areas.
In the military, CRNAs have full practice authority. They serve as the primary anesthesia providers for U.S. service members. This includes roles on the front lines, aboard Navy ships, and within air evacuation teams worldwide.
Projections indicate a 38% growth in CRNA employment by 2032.
What is an Anesthesiologist?
Anesthesiologists are licensed physicians who specialize in anesthesia administration, perioperative care, and pain management.
Their responsibilities extend beyond administering anesthesia; they develop individualized anesthesia plans, monitor patient responses throughout the perioperative period, and oversee post-anesthesia care.
Here is a brief overview of the role of an anesthesiologist:
In 2023, the United States had approximately 33,500 anesthesiologists, with California employing the highest number at over 5,000.
The 7 Key Role Differences - CRNA vs. Anesthesiologist
Now that you understand both roles, let's explore the seven key differences that set them apart:
1. Education and Training Requirements
Certified Registered Nurse Anesthetist (CRNA)
To become a CRNA, candidates must first obtain a Bachelor of Science in Nursing (BSN) or a related field, followed by securing an unencumbered registered nurse (RN) license.
A minimum of one year of full-time experience in a critical care setting is required before applying to a nurse anesthesia program.
Subsequently, candidates must complete a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which typically ranges from 36 to 51 months in duration.
As of 2025, all CRNA programs mandate a doctoral degree for entry into practice, aligning with the profession's commitment to advanced clinical training.
Upon graduation, candidates must pass the National Certification Examination (NCE) to practice as CRNAs.
Anesthesiologist
Aspiring anesthesiologists embark on a more extended educational journey, beginning with a four-year undergraduate degree, often emphasizing pre-medical studies. This is followed by four years of medical school to earn a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
After graduation, a one-year internship is required, followed by a three-year anesthesiology residency, totaling 11 to 12 years of education and training. Following residency, anesthesiologists can also pursue one- to two-year fellowships in areas like pain management, critical care, or pediatric anesthesiology - although this is not obligatory. Before they can practice independently, they must obtain a state medical license, which typically requires passing the U.S. Medical Licensing Examination (USMLE).
After licensure, many anesthesiologists take the extra step of earning board certification through the American Board of Anesthesiology (ABA). While not required, it is strongly recommended as a mark of advanced expertise and professional commitment.
Recruitment insight: Training duration impacts candidate pool availability and salary expectations. Longer training periods in anesthesiology tend to narrow the candidate pool and elevate salary demands, while shorter pathways for CRNAs result in a broader supply of professionals with more moderate salary benchmarks.
2. Scope of Practice and Autonomy
CRNAs and anesthesiologists hold distinct roles when it comes to clinical authority. CRNAs are trained to administer anesthesia, monitor patients, and manage anesthesia care using standardized protocols. In many states, they are allowed to practice independently without physician oversight. In others, state laws require some level of physician supervision.
As of now, CRNAs can provide anesthesia care without physician supervision in 22 states and Guam.
“Riddle emphasized that CRNAs are authorized to administer anesthesia at all levels in every state, and 24 states have opted out of Medicare supervision requirements. In addition, many state laws do not require a physician anesthesiologist to fulfill supervisory roles. He noted it was time for the VA to embrace a similar anesthesia care model.” - Dru Riddle, president of the American Association of Nurse Anesthesiology (AANA)
In contrast, anesthesiologists, as licensed physicians, typically have broader clinical authority. They develop individualized anesthesia plans and manage complex cases.
In many settings, they also supervise CRNAs or anesthesiologist assistants as part of a coordinated care team.
Recruitment insight: Align hiring with state regulations. CRNAs can work independently in some states, while anesthesiologists offer full medical authority. Adjust staffing models accordingly for efficiency.
3. Clinical Responsibilities and Decision-Making
In clinical practice, CRNAs and anesthesiologists share overlapping duties but differ in their decision-making authority. Consider a high-risk surgical procedure: a CRNA administers anesthesia, monitors vital signs, and adjusts anesthesia levels based on established protocols.
An anesthesiologist, however, evaluates the patient’s full medical history, customizes the anesthesia plan, and intervenes in unpredictable scenarios requiring advanced critical care expertise.
CRNAs follow standardized guidelines, while anesthesiologists make independent, case-specific medical decisions.
Recruitment insight: Hiring decisions should reflect case complexity. Facilities with high-acuity cases benefit from anesthesiologists, while outpatient care centers efficiently operate with CRNAs.
4. Supervision and Leadership Roles
CRNAs, as advanced practice nurses, may work independently or under physician supervision, depending on state laws and facility policies.
In states with full practice authority, they can provide anesthesia care without oversight. In other states, supervision by an anesthesiologist or collaborating physician may be required. On the other hand, anesthesiologists, as physicians, often lead anesthesia departments, overseeing clinical operations and guiding anesthesia care teams.
They are responsible for supervising CRNAs and anesthesiologist assistants, ensuring adherence to medical protocols and patient safety standards.
"Anesthesiologists can practice independently and supervise CRNAs and anesthesia assistants anywhere they practice. CRNAs may only practice independently if their state allows full-practice authority and CRNA-only models." - NurseJournal
Recruitment insight: State regulations shape hiring strategy. In CRNA-autonomous states, recruitment moves faster and costs less. In supervised settings, anesthesiologists ensure oversight of complex cases. Matching roles to regulations optimizes staffing and resources.
5. Compensation and Salary Expectations
Compensation for CRNAs and anesthesiologists varies significantly across the United States, influenced by factors such as experience, location, and workplace setting:
Certified Registered Nurse Anesthetists (CRNAs)
National Average: Approximately $214,200 annually.
Top-Paying States: According to recent data, these are the top-paying states for CRNAs based on average annual salary:
Anesthesiologists:
National Average: Approximately $302,970 annually.
Top-Paying States: The following states offer the highest average annual salaries for anesthesiologists:
Recruitment insight: Use salary benchmarks to set offers that accurately reflect the distinct responsibilities and qualifications of each role. If one option demands a higher salary, adjust the budget in other areas or explore alternative compensation packages to secure the ideal candidate without overspending.
6. Work Environment and Practice Settings
CRNAs often serve in rural hospitals, outpatient surgery centers, and clinics, providing anesthesia care in settings where anesthesiologists may be less available. In contrast, anesthesiologists, as medical doctors, typically practice in urban hospitals, academic medical centers, and specialized surgical facilities.
Recruitment insight: Recruitment messaging should highlight role-specific advantages tied to each setting. For CRNAs, emphasize autonomy, diverse practice opportunities, and flexibility in rural hospitals or outpatient centers. For anesthesiologists, focus on leadership, high-acuity cases, and collaboration within specialized teams. Adjust job postings and outreach to align with candidates’ career goals, ensuring stronger engagement and faster placements.
7. Career Outlook and Professional Development
CRNAs and anesthesiologists follow distinct career trajectories with different growth opportunities.
CRNA employment is projected to increase due to demand in outpatient surgery centers, pain clinics, and rural hospitals.
Their path allows for quicker workforce entry and flexibility in practice settings. Anesthesiologists have longer training, so they pursue specialized roles in academic medicine, critical care, and research. Their career progression often includes leadership in anesthesia departments and medical education.
Recruitment insight: Recruiters must consider career motivations – CRNAs seeking autonomy and mobility, anesthesiologists prioritizing specialization and long-term institutional roles – to attract the right candidates and align opportunities with professional development goals.
But what do these differences mean for your hiring strategy? Well, that brings us to the next point:
Implications for Smarter Recruitment
Here's how these key distinctions translate into practical insights for smarter recruitment:
1. Targeted Messaging
Craft job descriptions that highlight role-specific strengths and expectations to attract the right candidates. Focus on what matters most to each profession. Use clear, direct messaging that aligns with career motivations.
For CRNAs:
- Emphasize autonomy in anesthesia administration, especially in outpatient centers and rural hospitals.
- Highlight flexibility in practice settings and work-life balance.
- Mention opportunities for independent decision-making and interdisciplinary collaboration.
- Specify certification requirements, expected caseload, and anesthesia techniques used.
For Anesthesiologists:
- Focus on leadership in anesthesia departments and high-acuity cases.
- Outline opportunities for specialization in pain management, critical care, and academic medicine.
- Highlight team-based roles in major hospitals and research institutions.
- Detail expectations for supervision, patient care complexity, and professional development pathways.
2. Candidate Alignment
To align candidates effectively, evaluate their priorities against role expectations.
If you're recruiting for outpatient centers needing independent practice, target CRNAs valuing autonomy and direct patient care.
Conversely, when filling roles demanding departmental leadership or complex clinical management, focus on anesthesiologists pursuing specialization and team oversight. Clarify candidate motivations upfront to accelerate hiring decisions and improve long-term retention.
3. Leverage Role Differences
Use role differences to refine sourcing, screening, and engagement strategies. Target candidates with precision by aligning recruitment efforts with their professional goals.
For sourcing, focus on:
- CRNAs – Engage candidates through nurse anesthesia programs, advanced practice networks, and rural healthcare associations.
- Anesthesiologists – Leverage medical schools, residency programs, and specialty societies like the ASA.
For screening, assess:
- CRNA candidates – Prioritize clinical experience in intensive care units and interest in independent practice.
- Anesthesiologist candidates – Look for leadership traits, subspecialty training, and experience managing complex cases.
For candidate engagement, highlight:
- CRNA roles – Emphasize flexibility, autonomy, and diverse practice settings.
- Anesthesiologist roles – Showcase career growth, high-acuity case management, and research opportunities.
Recruit Anesthesia Talent with Confidence
Hiring the right anesthesia provider starts with understanding the clinical, regulatory, and professional differences between CRNAs and anesthesiologists.
Whether your organization needs cost-effective coverage in rural settings or highly specialized care in urban hospitals, aligning your recruitment strategy to each role’s strengths makes all the difference.
Use the insights above to refine your sourcing, messaging, and candidate evaluation. That’s how you attract and retain the right anesthesia talent for long-term impact.
If you're interested to know how AAG/H can help you recruit your next CRNA or anesthesiologist, feel free to contact us today.
Frequently Asked Questions (FAQ’s)
What is the highest-paid CRNA?
In some states, nurse anesthetists earn top figures exceeding $280,000. Their pay reflects advanced practice, clinical experience in intensive care units, and proven success in safe, cost-effective anesthesia care at premier medical facilities.
Are anaesthetists doctors?
Yes. Anesthesiologists are licensed physicians who hold a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. They complete medical school, residency, and, in some cases, fellowship training.
Can CRNAs do cardiac anesthesia?
Yes. CRNAs with appropriate training and experience can provide anesthesia for cardiac surgeries. They work in high-acuity settings and are involved in managing patients during complex procedures, including trauma or cardiac cases.
Can a CRNA intubate?
Yes, they can. CRNAs are skilled in preoperative assessment and airway management. They use techniques such as intravenous anesthesia and regional anesthesia to support patient care and ensure safe anesthesia services.
What role does post-anesthesia care play in patient outcomes?
Post-anesthesia care units provide structured postoperative care. CRNAs and anesthesiologists monitor patient response to anesthesia and adjust the plan of care. This process ensures comprehensive anesthesia care and optimal recovery in outpatient surgery centers.
How do educational paths in the field of anesthesia differ?
CRNAs complete nursing school followed by a degree in nurse anesthesia through accredited nursing programs. In contrast, anesthesiologists follow a longer trajectory through graduate school, medical schools, and residencies. Both paths emphasize advanced training and clinical experience for safe anesthesia care.
What distinguishes the anesthesia plan for surgical patients?
An anesthesia plan is customized based on the patient’s medical history, the type of surgery, and anticipated risk factors. CRNAs and anesthesiologists develop these plans to ensure safe anesthesia delivery before, during, and after the procedure. The plan typically includes preoperative assessment, choice of anesthesia type, intraoperative monitoring, and postoperative care tailored to the patient’s specific needs.
Why is a team approach important in anesthesia services?
A team approach brings together CRNAs, anesthesiologist assistants, and other healthcare providers to coordinate care. This collaboration enhances safety, reduces costs, and supports high-quality outcomes across hospitals, surgical centers, and rural facilities.
