Anesthesia or Medicine? Pros and Cons

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uclalee

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Can't decide between Anesthesia or Medicine. Pros and Cons?

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Do a search ... look on gas forums at the top (Anesthesia FAQ). You really should come up with your own pro/con list since mine might be very different from yours.

Hopefully you have some idea now since you are going to be a fourth year next year. Didn't you do a medicine rotation? And a surgery rotation?

If you really are serious you should schedule an anesthesia elective as early as possible so you can decide if you really like it.

Quickly ...

Anesthesia
PROS - NO rounding, quick decisions with results often observed fast, only take care of one patient at a time, PROCEDURES, NO outpatient office (unless you are pain)
CONS - reimbursement is declining, lots of politics (having to work with difficult personalities in the OR), little respect from the rest of the medical field (you are known as the doctor who sits and does crossword puzzles - even though this is often untrue), little gratification (patients don't usually remember the anesthesiologist), early hours

Medicine
PROS - taking care of a variety of patients at once, have the option of MANY specialties following graduation, have a lot of down time
CONS - ROUNDING, ROUNDING, ROUNDING, slow pace sometimes, did I mention rounding, LONG hours
 
sorry loveumms, the reimbersement for anesthesia is NOT declining, it's steady if not on the rise again....
 
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Do a search ... look on gas forums at the top (Anesthesia FAQ). You really should come up with your own pro/con list since mine might be very different from yours.

Hopefully you have some idea now since you are going to be a fourth year next year. Didn't you do a medicine rotation? And a surgery rotation?

If you really are serious you should schedule an anesthesia elective as early as possible so you can decide if you really like it.

Quickly ...

Anesthesia
PROS - NO rounding, quick decisions with results often observed fast, only take care of one patient at a time, PROCEDURES, NO outpatient office (unless you are pain)
CONS - reimbursement is declining, lots of politics (having to work with difficult personalities in the OR), little respect from the rest of the medical field (you are known as the doctor who sits and does crossword puzzles - even though this is often untrue), little gratification (patients don't usually remember the anesthesiologist), early hours

Medicine
PROS - taking care of a variety of patients at once, have the option of MANY specialties following graduation, have a lot of down time
CONS - ROUNDING, ROUNDING, ROUNDING, slow pace sometimes, did I mention rounding, LONG hours

That is only going to be true for the IM resident or academic attending. I think Medicine get's bashed on too much for "rounding forever." During 2 months of inpatient medicine at academic facilities I never spent the stereotypical 45 minutes discussing potassium. The fact is that many of the pts on an IM service are too complicated to be "rounded on" in 5 minutes like surgeons tend to do. What people on SDN disdainfully call "rounding" is often actually "patient care."

Anesthesiology rules. Has anyone ever met a miserable one?
 
yea, if you look at physician surveys, anesthesiologists are always the 'happiest' with their lives.
 
yea, if you look at physician surveys, anesthesiologists are always the 'happiest' with their lives.

That's because:
"He'll be suspending you in a near-death state—slowing your heart, numbing your nerves, loosening your grip on consciousness—while simultaneously siphoning off drugs for himself and, at times, shooting up right in the middle of the operation. One mistake and you could end up dead, or in a never-ending coma." :eek:

http://health.msn.com/general/articlepage.aspx?cp-documentid=100148089
 
That's because:
"He'll be suspending you in a near-death state—slowing your heart, numbing your nerves, loosening your grip on consciousness—while simultaneously siphoning off drugs for himself and, at times, shooting up right in the middle of the operation. One mistake and you could end up dead, or in a never-ending coma." :eek:

http://health.msn.com/general/articlepage.aspx?cp-documentid=100148089

I don't exactly look to Mens' Health for an objective view on any topic beyond "How to get rock-hard abs in 6 weeks"


Anesthesia
PROS - NO rounding, quick decisions with results often observed fast, only take care of one patient at a time, PROCEDURES, NO outpatient office (unless you are pain)
CONS - reimbursement is declining, lots of politics (having to work with difficult personalities in the OR), little respect from the rest of the medical field (you are known as the doctor who sits and does crossword puzzles - even though this is often untrue), little gratification (patients don't usually remember the anesthesiologist), early hours

On the contrary, I think anesthesiologists can have a very gratifying role. If you speak to patients, the anesthesiologist is often their favorite person. Ask most women who delivered a baby who they appreciated more- the anesthesiologist or the OB. They may not remember your name or recognize you in the hall, but...hey, not recognizing me in the hall sounds pretty good! Anyways, it is a role that patients appreciate, but, yes, if you need the reward of a patient shaking your hand and saying "Doc, you saved my life", gas probably isn't the right place to be.
 
I don't exactly look to Mens' Health for an objective view on any topic beyond "How to get rock-hard abs in 6 weeks"

I'd think from your sarcastic reply that you'd have an appreciation for the intent of my post--funny in a "reefer madness" sort of way.

In all seriousness though, drug addiction is an occupational hazard for physicians in general, and especially among anesthesiologists. I don't mean to minimize the problem, but the whole "You're anesthesiologist might be shooting up in the middle of the procedure!" thing was too good to pass up.
 
Do a search ... look on gas forums at the top (Anesthesia FAQ). You really should come up with your own pro/con list since mine might be very different from yours.

Hopefully you have some idea now since you are going to be a fourth year next year. Didn't you do a medicine rotation? And a surgery rotation?

If you really are serious you should schedule an anesthesia elective as early as possible so you can decide if you really like it.

Quickly ...

Anesthesia
PROS - NO rounding, quick decisions with results often observed fast, only take care of one patient at a time, PROCEDURES, NO outpatient office (unless you are pain)
CONS - reimbursement is declining, lots of politics (having to work with difficult personalities in the OR), little respect from the rest of the medical field (you are known as the doctor who sits and does crossword puzzles - even though this is often untrue), little gratification (patients don't usually remember the anesthesiologist), early hours

Medicine
PROS - taking care of a variety of patients at once, have the option of MANY specialties following graduation, have a lot of down time
CONS - ROUNDING, ROUNDING, ROUNDING, slow pace sometimes, did I mention rounding, LONG hours

Whatever......here's my take as a practicing anesthesiologist for 4 years:

ANESTHESIA - 45-50 hour weeks - I make about $350K/yr
MEDICINE - More than 45-50 hour weeks - good luck making more than $200k/yr
 
he he.... anyway, you do have options out of anesthesia as well, although admittedly not as many as IM. You can pursue pain managment if you want more clinic, critical care if you want more management of interesting pts outside of the OR, and you can also subspecialize in pedies, cards, ob (if you are crazy), neuro, others. All of these are 1 yr fellowships (maybe 2 in some cases) after your anesthesia training is completed. As far as satisfaction, it depends on what you gain your satisfaction from, a job well done on a difficult case (anesth, btw, you go home, unattached after you do your work), or having the occasional patient thank you amidst the myriad of ones that say nothing, or hate your guts for various psychosocial reasons (IM, wearing your beeper, hoping the patient does well overnight). Don't get me wrong, nothing against those who IM, there are tons of reasons for choosing it, lots of opportunities, continuity of care (if that is your cup o tea), etc. BTW, I'm just an MS3 who hasn't figured out what I'm doing yet, so you can temper my statements with this fact...
 
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i still dont know why anestehisolosgistsfsd are paid so much
 
It's interesting seeing what people think about various lifestyles etc.

The one thing that gets me is how some specialties have "anti-lifestyle" factors. Family medicine, in the right setting, seeing say a max of 15 pts a day would be a fun job (although maybe a little too easy after a while)-- you get to socialize with your patients, people you've known a long time, plus you're a generalist, seeing the "average" person (as opposed to the really sick). Unfortunately family med docs see 30-50 pts a day and barely have time to say hello. Psych is similar where lots of insurance companies don't pay for psychotherapy -- only drugs. Let's not talk about OBGYN.

It's too bad.
 
Family medicine, in the right setting, seeing say a max of 15 pts a day would be a fun job

Fifteen patients a day is a little on the low side, unless you're in a low-overhead practice or are doing retainer medicine. However, both are viable options, if that's really what you want.

Unfortunately family med docs see 30-50 pts a day and barely have time to say hello.

Most of the FPs in my group see fewer than 30 patients/day (I average around 25), and we all earn well above the national average.
 
25 patients a day isn't bad. I just know my personal physician was seeing way too many patients and wasn't happy. I think he does spa and cosmetic procedures so he gets to have a more reasonable workload :laugh:

It's not really about salary but more about doing medicine to enjoy it; eg spending enough time with your patient to get some kind of emotional joy in it.
 
i still dont know why anestehisolosgistsfsd are paid so much

For starters, they can spell.

I'm sure it has something to do with their ability to allow patients to teeter on the brink of death, unable to produce any muscular contractions or sense any stimulus, allowing surgeons to perform all manner of medieval procedures without any recollection of the event. I'd pay good money for that.
 
I'm sure it has something to do with their ability to allow patients to teeter on the brink of death, unable to produce any muscular contractions or sense any stimulus, allowing surgeons to perform all manner of medieval procedures without any recollection of the event. I'd pay good money for that.

But don't anesthesiologists pay the surgeons for the privilege of coming to their cases?

Don't hit me, I'm kidding. :D
 
But don't anesthesiologists pay the surgeons for the privilege of coming to their cases?

Don't hit me, I'm kidding. :D

If payment equals hours of hideous music, occasional diatribes and tolerating Machiavellian attitudes, then yes, they pay handsomely. ;)

Sorry that recent events may have caused you to add the disclaimer. I'm not that sensitive.
 
That's because:
"He'll be suspending you in a near-death state—slowing your heart, numbing your nerves, loosening your grip on consciousness—while simultaneously siphoning off drugs for himself and, at times, shooting up right in the middle of the operation. One mistake and you could end up dead, or in a never-ending coma." :eek:

http://health.msn.com/general/articlepage.aspx?cp-documentid=100148089

lol, i'm just a premed...but holy crap...did you guys even read that article?

Dr. Gold decided to take a close look at O.R. procedures and was immediately struck by the anesthesiologists' posture. They weren't standing upright or moving around, like everyone else involved in the operation, but spent the entire time crouched right next to the patient's head. Dr. Gold watched a heart operation and noticed that during the 10-hour procedure, the anesthesiologist never budged from his post, not even for a bathroom break.

Wait, he thought. What if the drugs are escaping from the patients' breath? The system for delivering drugs may be airtight, but how about the ventilation? Dr. Gold enlisted the University of Florida's nanotechnology group to use its mass spectronomy equipment to test for the presence of drugs above a patient's mouth. They scanned an O.R., and . . . jackpot! Sure enough, narcotics were detected not only in the air, but also on metal trays and tables--exactly the way vaporized gas would settle. "Fentanyl is extremely potent and active in the air--that's why the Russians used it to put everyone in the theater to sleep during the Chechen hostage crisis," Dr. Gold explains. "It's also easily absorbed through the skin."
 
lol, i'm just a premed...but holy crap...did you guys even read that article?

Dr. Gold decided to take a close look at O.R. procedures and was immediately struck by the anesthesiologists' posture. They weren't standing upright or moving around, like everyone else involved in the operation, but spent the entire time crouched right next to the patient's head. Dr. Gold watched a heart operation and noticed that during the 10-hour procedure, the anesthesiologist never budged from his post, not even for a bathroom break.

Wait, he thought. What if the drugs are escaping from the patients' breath? The system for delivering drugs may be airtight, but how about the ventilation? Dr. Gold enlisted the University of Florida's nanotechnology group to use its mass spectronomy equipment to test for the presence of drugs above a patient's mouth. They scanned an O.R., and . . . jackpot! Sure enough, narcotics were detected not only in the air, but also on metal trays and tables--exactly the way vaporized gas would settle. "Fentanyl is extremely potent and active in the air--that's why the Russians used it to put everyone in the theater to sleep during the Chechen hostage crisis," Dr. Gold explains. "It's also easily absorbed through the skin."

Wait, but isnt fentanyl usually administered IV? I wasn't aware of it being a vaporized gas in the OR. . .:p
 
I know a guy whose an Anesthisiologist, and he says the current crop of medical students are going into it for the wrong reasons, i.e. they think it's easy. According to him, it's pretty stressful, and a lot of people burn out by the age of 55. I was also surprised to hear that even as an Attending, he takes in house call once per week.
 
That's because:
"He'll be suspending you in a near-death state—slowing your heart, numbing your nerves, loosening your grip on consciousness—while simultaneously siphoning off drugs for himself and, at times, shooting up right in the middle of the operation. One mistake and you could end up dead, or in a never-ending coma." :eek:

http://health.msn.com/general/articlepage.aspx?cp-documentid=100148089
Hilarious. ROFLMAO. Oh my God. "simultaneously siphoning off drugs for himself" too damned funny:laugh: :laugh:
 
Hilarious. ROFLMAO. Oh my God. "simultaneously siphoning off drugs for himself" too damned funny:laugh: :laugh:

Unfortunately, it's too common. One warning sign of an anesthesiologist hittin' the juice is that his/her patients routinely c/o post-op pain, more so than others'. "100 fentanyl for you, 50 for me..."
 
gas

Pros: no clinic, , no continuity of care, money money money, most gas people are really cool, instant gratification

cons: boring

meds

pros: interesting sometimes, fellowships that let you escape from medicine

cons: tuning up COPD, heart failure, DM, and HTN foreve,makes me cringe; no money; potentially clinic, bad eggs

Winner: Gas - my list makes it very clear, unless you want a medicine fellowship go anesthesia.
 
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