20: From Penn to Solo CRNA Practice: The Unexpected Growth of Independent Practice

Most anesthesia providers assume that professional growth comes from increasingly complex cases, bigger hospitals, and higher-acuity patients. But what if growth can also come from stepping outside of what's familiar? In this episode, I sit down with Dr. T.D. Carnahan, CRNA, owner of Sandman Slumber Services, incoming Vice President of the Pennsylvania Association of Nurse Anesthetists (PANA), and Chair of the AANA Membership Committee. After years practicing at the University of Pennsylvania, TD took a leap of faith and transitioned into a solo CRNA practice providing anesthesia for oral surgery procedures in an office-based setting. We discuss what it means to practice independently, the responsibility that comes with owning every clinical decision, patient selection, preoperative evaluation, office-based anesthesia, and the unique anesthetic techniques he uses every day. We also explore the All-on-4 dental implant procedure, how TD approaches nasal intubation, and why he believes he is a stronger CRNA today than he was when he left one of the nation's premier academic anesthesia environments. Most importantly, we discuss a message that extends far beyond dental anesthesia: professional growth doesn't always come from higher acuity. Sometimes it comes from greater ownership, greater responsibility, and the willingness to pursue opportunities that challenge you in unexpected ways. Whether you're an aspiring CRNA, SRNA, practicing CRNA, or simply interested in the many ways nurse anesthetists impact patient care, this episode offers a fascinating look at a practice model that many people never see. Join us in the CRNA Mentor Community: https://facebook.com/groups/crnamentorcommunity Check out my other CRNA Mentor resources: https://stan.store/CRNAmentor New episodes drop every Monday—start your week off right with CRNA Mentor Monday!