Anesthesia vs IM

[AdmiralChz]

Rough group in this thread. You’re either with the mob mentality or not. At the end of the day, I’m very happy and would do it all again in a heartbeat.

I even know new fellowship grads happy and even thrilled with *gasp* AMC Jobs! Oh the horror!

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[narcotics999]

I actually don't make that much additional money from ACT work. An increasingly large percentage of the income I (we) generate is from pain medicine, consulting, HR/billing, real estate, etc. If you took all our hospitals and flipped them to physician only care tomorrow, it'd probably drop my gross income maybe 10-15% for the year.

I argue in favor of ACT care because it is a great model. I appreciate that there also are jobs out there for those too lazy to handle it or that just prefer to not have the hassle. Different strokes for different folks and what not.

"I appreciate that there also are jobs out there for those too lazy to handle it"

Maybe I understand wrongly:

Are you indicating that solo MDs are too lazy to handle this SUPERIOR ACT model?

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[It's lupus!]

This is the most positivity I have personally witnessed in regards to ACT on SDN

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[deleted171991]

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair

Also, it's all relative. One man's hell is another man's heaven. It's a matter of personality, CV, opportunities, and life experience.

I am sticking to my opinion that the best job in anesthesia is solo 7-3, no nights/weekends/calls, AKA "mommy track". Very doable in IM/FP, not so much in anesthesia.

 

[deleted162650]

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair

Also, it's all relative. One man's hell is another man's heaven. It's a matter of personality, CV, opportunities, and life experience.

I am sticking to my opinion that the best job in anesthesia is solo 7-3, no nights/weekends/calls, AKA "mommy track". Very doable in IM/FP, not so much in anesthesia.

I got a mommy track job for ya if ya want it buddy.

 

[AdmiralChz]

”It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair

I guess, but the average anesthesiologist makes nearly double what the average PCP does. With not all that much more work. That has to be considered.

 

[vector2]

I guess, but the average anesthesiologist makes nearly double what the average PCP does. With not all that much more work. That has to be considered.

We're compensated for the intensity and the risk, not necessarily the hours. No one in the IM clinic is routinely inducing an iatrogenic coma that causes loss of ventilation and hemodynamic compromise or placing invasive tubes and lines. Advances in technology have lulled a lot of other physicians into thinking routine automatically means safe, but I'd argue that we are paid for the 0.1% of the time things aren't going according to plan A.

 

[bizdr]

Also most Anesthesiologists do have to wake up at like 6am, and probably have to spend nights in the hospital still as an attending.

 

[dannyboy1]

The biggest issue I have with medical direction, aside from the politics and money associated with it, is that I find it unethical knowing that I could do a better job by myself, yet I am allowing others to practice on innocent patients that don't know any better.

You are not “allowing” anything. The practice and hospital are allowing the CRNA practice. You are the patients fireman not their doctor. If the patient makes it to PACU alive, neurologically intact and hemodynamically stable then it goes in the win column.

 

[2Fast2Des]

Is it really practicing anesthesia if your job is to basically do pre ops, post ops, make sure the nurses get their breaks, be the fall guy and sign away your license, and not really be involved in the anesthetic? Sign me up! During residency when we had the chance to "supervise," I honestly never felt more useless, hated the feeling of not being able to be involved. Sure it was great being able to be out of the OR for periods of time, but having the personal satisfaction of conducting an anesthetic to my liking is rewarding. Maybe I'm just doe-eyed and my tune will change once I get older and jaded

 

[dannyboy1]

Is it really practicing anesthesia if your job is to basically do pre ops, post ops, make sure the nurses get their breaks, be the fall guy and sign away your license, and not really be involved in the anesthetic? Sign me up! During residency when we had the chance to "supervise," I honestly never felt more useless, hated the feeling of not being able to be involved. Sure it was great being able to be out of the OR for periods of time, but having the personal satisfaction of conducting an anesthetic to my liking is rewarding. Maybe I'm just doe-eyed and my tune will change once I get older and jaded

You can love it or you can hate it. Your employer dosent care, so long as you do it...

 

[Urzuz]

You are not “allowing” anything. The practice and hospital are allowing the CRNA practice. You are the patients fireman not their doctor. If the patient makes it to PACU alive, neurologically intact and hemodynamically stable then it goes in the win column.

Sad but true. The reason why I used the word allow is because many supervising anesthesiologists (on this board especially) will say that the anesthetic is their own and the buck stops with them, but ultimately most if not all of them "allow the nurse to take the first look" in a difficult intubation, "try the arterial line a couple times" before taking over, "not change their anesthetic plan" as long as it won't put the patient in the morgue...all in the name of not hurting the nurses' feelings. Then they come onto this board and talk a big game about how they are the captains of the ship, when in reality everyone (the CRNAs, the surgeons, the administrators, etc) knows who truly has their boots on the ground in delivering the patients' anesthesia.

 

[Twiggidy]

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair

Also, it's all relative. One man's hell is another man's heaven. It's a matter of personality, CV, opportunities, and life experience.

I am sticking to my opinion that the best job in anesthesia is solo 7-3, no nights/weekends/calls, AKA "mommy track". Very doable in IM/FP, not so much in anesthesia.

Correct

 

[Twiggidy]

I guess, but the average anesthesiologist makes nearly double what the average PCP does. With not all that much more work. That has to be considered.

Also correct

 

[Twiggidy]

Also most Anesthesiologists do have to wake up at like 6am, and probably have to spend nights in the hospital still as an attending.

This is critical to think about when considering anesthesiology OP......even Obstetricians get to be at home

 

[Twiggidy]

Basically, Anesthesiology is an excellent choice as long as you don't have to spend the night in the hospital. Home call is the next best thing. No call is likely the holy grail.

 

[chocomorsel]

Rough group in this thread. You’re either with the mob mentality or not. At the end of the day, I’m very happy and would do it all again in a heartbeat.

I even know new fellowship grads happy and even thrilled with *gasp* AMC Jobs! Oh the horror!

MMan has repeatedly told us on this board about how much he "loves" the ACT model and how "wonderful" it is. We can all see that he's mostly about the money, which he has in so many words admitted to in the past. While there's nothing wrong with that, just be real and admit it. Don't come here talking about providing "the best model of care" as proven by 40 year old research because you partake in said model that has you running around all day putting out fires. We see the $$$ behind the model and know why it was created. Otherwise those old now retired and dead docs who started this whole ACT
bulls hit would have kept doing their own thing and let the nurses do their own thing separately had there not been any money to be made off the nurses.

Keep it real and admit what its about. Many people on this board see the lies, lies, and more lies behind it and call a spade a spade. Seems to me like he's always trying to convince himself why he's doing what he's doing instead of just saying, "screw y'all, I am gonna make the most hay while the sun shines and don't give a f what y'all mofo's say." Some people on this board who do keep it real, @Consigliere, can teach him a thing or two.

Yes, there are people who are tied down to geography or really enjoy running room to room sticking patients, arguing with nurses, and putting out fires. However, take away the monetary incentives, and many of these said people would be sitting the chair, playing sudoku, watching Netflix, trading stocks and occasionally managing a case intensely and direclty Like the rest of us schmucks.

It's not hard to keep it real.

 

[Consigliere]

It's not hard to keep it real.

True dat. But for the novices...be careful:

<iframe src="" width="640" height="363" frameborder="0" webkitallowfullscreen mozallowfullscreen allowfullscreen></iframe>
<p><a href="">Dave Chappelle - Keeping It Real</a> from <a href="Patrick Kemppainen">Patrick Kemppainen</a> on <a href="Vimeo: Watch, upload, and share HD and 4K videos with no ads">Vimeo</a>.</p>

 

[VA Hopeful Dr]

We're compensated for the intensity and the risk, not necessarily the hours. No one in the IM clinic is routinely inducing an iatrogenic coma that causes loss of ventilation and hemodynamic compromise or placing invasive tubes and lines. Advances in technology have lulled a lot of other physicians into thinking routine automatically means safe, but I'd argue that we are paid for the 0.1% of the time things aren't going according to plan A.

This. I'm FM, but for outpatient work we do essentially the same job as IM.

I haven't coded a patient since residency. My most invasive procedure is sticking a needle into the joint of a stable patient. If a patient has a BP of 80/40 and a HR of 140, I call the ambulance and that's it. All of my patients are breathing on my own at all times.

That's why y'all get paid way more than I do on a per hour basis.

 

[Twiggidy]

True dat. But for the novices...be careful:

<iframe src="" width="640" height="363" frameborder="0" webkitallowfullscreen mozallowfullscreen allowfullscreen></iframe>
<p><a href="">Dave Chappelle - Keeping It Real</a> from <a href="Patrick Kemppainen">Patrick Kemppainen</a> on <a href="Vimeo: Watch, upload, and share HD and 4K videos with no ads">Vimeo</a>.</p>

Yes, especially in anesthesiology, keeping it real can go wrong

 

[Twiggidy]

This. I'm FM, but for outpatient work we do essentially the same job as IM.

I haven't coded a patient since residency. My most invasive procedure is sticking a needle into the joint of a stable patient. If a patient has a BP of 80/40 and a HR of 140, I call the ambulance and that's it. All of my patients are breathing on my own at all times.

That's why y'all get paid way more than I do on a per hour basis.

And given all the risk involved, many people still think we get paid to much

 

[chocomorsel]

@Consigliere, that show was the s hit!!! Man I sure miss it.