A Model of Hierarchical Professionals: Cooperation and Conflict between Anesthesiologists and CRNAs

This paper examines a labor market with two professional groups both cooperating and directly competing with each other: certified registered nurse anesthetists (CRNAs) and anesthesiologists (MDAs). We develop a model where the supply of MDAs endogenously determines (1) the earnings of CRNAs and MDAs, and (2) the extent of supervision of CRNAs by MDAs. We also analyze how MDAs may lobby to limit the scope of practice of CRNAs, and the resulting market equilibrium. Our theoretical model can be applied to the analysis of relationships between other hierarchical professionals with overlapping responsibilities, such as nurse practitioners and primary care physicians.