I have been out of residency for less than 5 years, and I know of the previous crisis in the 90's, but this time it seems to be much worse, and not only for anesthesiologists, but for physicians in general.
For me, the classical example of sh*tty medical job is family practice. Look where those guys are, after years of being micromanaged by CMS and insurance companies, even after having switched to a "care team" model, where they had NPs working for them. (Now many of those NPs are going independent, and they are also competing for the small population of patients who have good insurance that pays decently.) The PCPs are working their butts off seeing 40+ patients/day in a model which is anything but medicine. And the risk of mistakes does not go up proportionally, but exponentially with the number of patients, because of fatigue.
Anesthesia is exactly in the same spot nowadays. We used to work solo, now we are being pushed to supervise CRNAs who try to steal as much knowledge as possible from us, before they go independent (it's just a matter of time). They are already cherry-picking the easy (read relatively healthy, relatively young, privately-insured) cases. As a consequence, we get the difficult cases who don't pay so well, and the bean counters get the feeling that CRNAs are making way more money/case for them. So the next push is for us to do/supervise as many cases as possible; the only reason we still have a 1 anesthesiologist:3 CRNAs limit is probably Medicare. (By the way I personally would never accept to be a patient in a 1:3 setting, that's how little the anesthesiologist matters there.) That's again a recipe for disaster, especially since we are directing CRNAs that don't always follow our directions (because they don't lose their license for disobeying a supervising physician). Not to speak about the stress; it's nothing like what you dream of in medical school.
My advice is to choose a specialty where you can stand out and be your own boss (and where medical technology +/- trained monkeys cannot replace you easily in the future = almost none). Or just get a masters in something society still values. Anything else and you will be just a glorified worker in an assembly lane environment, in 10-20 years (if not already). The problem is that as demand/reimbursement for physician-level services decreases, and the supply of physicians stays the same or even increases (the more suckers the more money for lenders, medical schools etc.), you will end up making slightly more than the midlevels except with incomparable sacrifices. (Society has just decided not to give a crap about your sacrifices; just look at all the unemployed lawyers.)
In the end, when the supply/demand ratio is f*cked up, it doesn't really matter how good you are; that's why the Great Depression was so "great".
