The purpose of this research was to examine the collaborative perceptions that Certified Registered Nurse Anesthetists (CRNAs) and anesthesiologists have of each other in nurse anesthesia educational programs. Methods included a cross sectional survey of all nurse anesthesia programs in the United States. Data was collected from the program director and one anesthesiologist of each program. Results highlight important areas of potential conflict between the two groups. Data reflected unequal and hierarchal relationships existing between CRNAs and anesthesiologists regarding shared responsibility, access, power, and recognition in healthcare decision making. Conclusions from this study show there are definite philosophical and political issues that have an impact on nurse anesthesia education and can be destructive not only to programs of nurse anesthesia but also to the entire field of anesthesiology. A major area of concern raised in the present study was that inadequate collaborative practices persist which could be indicative of critical deficiencies in the educational system and clinical practice settings of both providers. Efforts by all involved must be made at the national, state, and local levels to establish better relationships between CRNAs and anesthesiologists. Mending counterproductive differences is imperative for cost-effective and high quality anesthesia services.