Are you happy in anesthesiology?

[Morzh]

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Are you happy working as an anesthesiologist (0-10)?
What was your reason for going into anesthesiology in the first place?
Do you like your hours? Do you feel like you have enough time with your family/other interests?
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why?
Do you feel fairly compensated?
Would you choose anesthesiology again?
If you HAD to choose a different specialty, what would it be?
Anything else you'd like to share?

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[GA8314]

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Are you happy working as an anesthesiologist (0-10)? 8
What was your reason for going into anesthesiology in the first place? lots of reasons. every anesthesiologist of the 11 that I directly surveyed said they like their jobs AND would do it again if they could do it over again. That was very very compelling. Good pay. Reasonable residency duration. Never minded the service nature of the job or not being the hot shot in the OR.
Do you like your hours? Do you feel like you have enough time with your family/other interests? It's 2:00 a.m. right now. Just got woken up for an epidural. Comes with the territory. I take extra OB for extra $$ as I am early in my career. Absolutely, I feel that I have a good work/life balance. I also happen to like the job and that makes any additional hours that much more palatable.
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why? PP. I've known for 10 plus years that I wanted to be in PP anesthesia, preferably in a private group, as partner. I'm 5 mo away from that now.
Do you feel fairly compensated? Yes, but my savings rate and debt elimination rate reflects my view that anything can happen in the future, including some downward pressure on wages in our field, but there are also some opportunities.
Would you choose anesthesiology again? Yes. I really would. There are many worse ways to earn a living. Live below your means and you can live a very nice comfortable life. BUT, even if you were a 7 figure ortho spine guy, you MUST have a high savings rate. So, your lifestyle needs to reflect that. But, you can become financially independent if you do the right thing (lots of overtime and aggressively save and pay back any loans you may have). The last part is key.
If you HAD to choose a different specialty, what would it be? maybe Cardiology, but that's 2 more years minimum longer and 1-2 years beyond that for fellowship...
Anything else you'd like to share? This field has DEMAND on it's side. So does most of medicine. As for "lifestyle", if you do the right things, there is no reason a 30 something young doc can't live well, but below their "means" (whatever that means) and have a high savings rate at the same time. Go out and get White Coat Investor. Good book. See blog under same name. Good reading.

 

[Stank811]

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Are you happy working as an anesthesiologist (0-10)? 9
What was your reason for going into anesthesiology in the first place? Enjoyed the medicine of the speciality and the flexibility of being able to do a bunch of regional in a ortho room one day and being able to do a critically ill cardiac patient the next.
Do you like your hours? Do you feel like you have enough time with your family/other interests? Yes, my group is on the busier side from what I hear but at the same time my hours are 40-60hrs a week depending on call and time of year.
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why? PP, because it allowed me to do the majority of my own cases and dive into the business side of anesthesiology immediately after graduating. I also felt I was treated more fairly in regards to compensation immediately after graduation going into PP.
Do you feel fairly compensated? Yes
Would you choose anesthesiology again? No question, yes
If you HAD to choose a different specialty, what would it be? After anesthesiology, not sure...probably a surgical field that allowed for flexibility in what I did on a day to day basis...I wouldn't like having to do a small set of surgical procedures the same way everyday for the rest of my career.
Anything else you'd like to share?

Don't go into the field because you think you can make bank working 30-40hrs a week. The individuals that make big salaries often work their tail off for that number in anesthesiology. Or they take advantage of others which can be found in any specialty.

 

[soorg]

For me, any unhappiness tends to be more so with the general state of medicine rather than anesthesia. Things like redundant paperwork, defensive medicine, consent mania, the constant threat of salary reductions all drive me nuts.

The worst part about anesthesia is being the surgeon's bitch. Doing cases at any hour of the day, whenever it's convenient for them really makes me unhappy. I'm sick of doing D&Cs at 3 am just bc the OB/GYN is in-house for 24 hour call and has nothing better to do.

 

[Nivens]

I

 

[Nivens]

(But that is a medicine issue- not specific to anesthesia)

 

[Turtlez]

I just finished a medical management elective (essentially sat in on administrator meetings for 2 weeks). Pretty much convinced me to do pain and go into private practice. Made me so angry to come face-to-face with suits collecting double-doctor-pay "working" from 9:30 to 4pm. I'll take a harder road and less money if it means I'm working for me.

Please expand on this further. Thanks

 

[ambiturner]

Doing cases at any hour of the day, whenever it's convenient for them really makes me unhappy. I'm sick of doing D&Cs at 3 am just bc the OB/GYN is in-house for 24 hour call and has nothing better to do.

Do you take home call? Just to play devil's advocate, if you are also in house then isn't it in you and your group's best interest to be doing as many cases as you can? I know it's a real boon to our waitlist/overtime situation when the night team knocks some cases out.

 

[BLADEMDA]

Do you take home call? Just to play devil's advocate, if you are also in house then isn't it in you and your group's best interest to be doing as many cases as you can? I know it's a real boon to our waitlist/overtime situation when the night team knocks some cases out.

My "best interest" after 0000 is to get as much sleep as possible. If anything needs to get done late at night is should just be OB or trauma as the rest can usually wait until the next day.

 

[deleted171991]

My "best interest" after 0000 is to get as much sleep as possible. If anything needs to get done late at night is should just be OB or trauma as the rest can usually wait until the next day.

I can't wait for the day when the public will force working hours restrictions on physicians, the same way the do with pilots or commercial drivers. Having to work more than 12 hours in any 24 hour-period is just bad medicine.

 

[ambiturner]

To actually answer your question,

Are you happy working as an anesthesiologist (0-10)? 7
What was your reason for going into anesthesiology in the first place? Good mentors, research interests, enjoyed the basic science of it. It also fits my personality pretty well.
Do you like your hours? Do you feel like you have enough time with your family/other interests? Our field's hours are pretty good. I work more than I thought I would, but don't have to deal with a lot of the nonsense that many other fields have to do after hours
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why? Academics. I could be happy in PP too though.
Do you feel fairly compensated? Yes, as far as academic jobs for new grads I got a pretty good deal. You will always hear about someone who got a job with more money, more vacation, more non-clinical days, etc though.
Would you choose anesthesiology again? Yes. Future developments may make me reconsider this position, though.
If you HAD to choose a different specialty, what would it be? Orthopedics or ENT, although I don't think I'd be as good of a fit for them as anesthesia
Anything else you'd like to share? Be honest with yourself and try to understand your personality and what makes you tick when you pick a field. Another thing I think a lot of people pick specialties for perceived prestige, or money, coolness etc but don't really understand the day to day of the work. You may shadow a neurosurgeon and be fascinated with brain surgery but guess what... > 90% of PP neurosurgery is spine surgery, brain tumors aren't that common. That's just one example but medicine is full of examples like that where the reality of the field is not what you might see as a student.

 

[Nivens]

Please expand on this further. Thanks

Not much more to say, except that it would make you physically ill to hear how physicians are discussed in those meetings. Nothing disrespectful, mind you, but these folks are 100% focused on squeezing as much money out of their employees as possible. Remarkable how little the patient or improving quality of care is brought up.

One thing I will mention to the OP, as is it something I have struggled with and continue to struggle with myself, is be very mindful of the difference between finding something interesting on an intellectual level, and enjoying to job. You are (most likely) not training to be a basic scientist, and while physicians must be well-versed in the scientific underpinnings of their work, we really are focused on application to improve the health and well-being of our patients. This is related to ambiturner's comment about neurosurgery above, but I want to flip it the other way and suggest there are actually specialties and subspecialties you might enjoy the day-to-day work of even if they don't blow your cortex at the basic science level.

For example- I came into residency enamored with ICU medicine and cardiopulmonary physiology. I just love reading and learning about it- it's all very mechanical and can be quite elegant, and I seem to have a knack for it. However, it's becoming clear as I work through the year that I don't enjoy working in the ICU as much as I thought I would. Now, this could be due to a lot of reasons (I'm an intern, it's a MICU or CCU, this is a crazy tertiary center, etc, etc), but still, I've been forced to consider the possibility that my "book" interests don't align with my "work" interests. On the other hand, I elected to do two weeks in a pain clinic, more to rule it out as a subspecialty than anything else, and loved it. I'd never had any particular interest in pain as a science or outpatient medicine, but I really enjoyed the interaction that stems from the patient coming to me/my attending's advice as "the doctor". Don't get me wrong: some of them were nightmarish, but this was mitigated by a well-oiled system in place to deal with problem patients, and the majority were grateful and thoughtful and the whole thing was kind of awesome. Not for everyone, I'm sure, but very possibly for me, and I think that had I reflected on my personality and the sort of work I actually enjoyed as a medical student, rather than just the things I enjoyed studying, I may have come up with some additional options for myself. There exists a positive feedback loop: the things you enjoy studying you are better at, which garners more praise and better grades, which makes you study more and grow more confidence, and so on. Try and break out of that and ask what will actually make you happy. Pay particular attention to how you feel at the END of rotations. Think you love surgery but are hugely relieved when your surgery rotation is over? That's a sign.

Clearly I think about this stuff a lot lol

 

[sloh]

Not much more to say, except that it would make you physically ill to hear how physicians are discussed in those meetings. Nothing disrespectful, mind you, but these folks are 100% focused on squeezing as much money out of their employees as possible. Remarkable how little the patient or improving quality of care is brought up.

One thing I will mention to the OP, as is it something I have struggled with and continue to struggle with myself, is be very mindful of the difference between finding something interesting on an intellectual level, and enjoying to job. You are (most likely) not training to be a basic scientist, and while physicians must be well-versed in the scientific underpinnings of their work, we really are focused on application to improve the health and well-being of our patients. This is related to ambiturner's comment about neurosurgery above, but I want to flip it the other way and suggest there are actually specialties and subspecialties you might enjoy the day-to-day work of even if they don't blow your cortex at the basic science level.

For example- I came into residency enamored with ICU medicine and cardiopulmonary physiology. I just love reading and learning about it- it's all very mechanical and can be quite elegant, and I seem to have a knack for it. However, it's becoming clear as I work through the year that I don't enjoy working in the ICU as much as I thought I would. Now, this could be due to a lot of reasons (I'm an intern, it's a MICU or CCU, this is a crazy tertiary center, etc, etc), but still, I've been forced to consider the possibility that my "book" interests don't align with my "work" interests. On the other hand, I elected to do two weeks in a pain clinic, more to rule it out as a subspecialty than anything else, and loved it. I'd never had any particular interest in pain as a science or outpatient medicine, but I really enjoyed the interaction that stems from the patient coming to me/my attending's advice as "the doctor". Don't get me wrong: some of them were nightmarish, but this was mitigated by a well-oiled system in place to deal with problem patients, and the majority were grateful and thoughtful and the whole thing was kind of awesome. Not for everyone, I'm sure, but very possibly for me, and I think that had I reflected on my personality and the sort of work I actually enjoyed as a medical student, rather than just the things I enjoyed studying, I may have come up with some additional options for myself. There exists a positive feedback loop: the things you enjoy studying you are better at, which garners more praise and better grades, which makes you study more and grow more confidence, and so on. Try and break out of that and ask what will actually make you happy. Pay particular attention to how you feel at the END of rotations. Think you love surgery but are hugely relieved when your surgery rotation is over? That's a sign.

Clearly I think about this stuff a lot lol

Great post! This is how I feel about critical care medicine as an intern as well. I find myself reading and listening to podcasts about critical care, trying to extract what's relevant to PM&R (my actual specialty). I'd never want a life practicing critical care though.

 

[johncunningham]

Are you happy working as an anesthesiologist (0-10)? During the day... 8.5-9ish. At night 4-5ish. Night work is different and harder. Sick patients having urgent cases and for me, lots and lots of OB.

What was your reason for going into anesthesiology in the first place? I really just felt like it fit. I love the OR environment and I'm friends with and go out for drinks with nurses, techs, my partners, random surgeons. It really can be fun.

Do you like your hours? Do you feel like you have enough time with your family/other interests? My kids are still school aged. They are my other interests. I work 50ish hours a week. Usually 1-2 weekend shifts and a weekday night/month.

Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why? I am lucky I am in a great PP group. I've said this before, If you find a good-great PP job, TAKE IT. The academic jobs will always be there.

Do you feel fairly compensated? I do.

Would you choose anesthesiology again? I would

If you HAD to choose a different specialty, what would it be? Hindsight... I really liked interventional cards and or radiology and GI. All very procedure oriented. All with OR like work environment. Except... I hate clinic. I think I made the right choice. For me the idea of having to see patients in an office 1,2,3 days a week would make me cry.

Anything else you'd like to share? Whatever you choose to do, try to be very good at it. I know that sounds trite, but people will notice if you are good at what you do and whether you like doing it. They also notice poor performers. It makes life much much easier if people respect you for the way you interact with others and know that you do a good job and practice good medicine. Everyone will have a bad day, a bad case, or a bad outcome. When it happens and folks can recognize that you are a good person and a good doctor it makes those events much more tolerable on many levels.

Good Luck

John

 

[Jimmy Chitwood]

The worst part about anesthesia is being the surgeon's bitch. Doing cases at any hour of the day, whenever it's convenient for them really makes me unhappy. I'm sick of doing D&Cs at 3 am just bc the OB/GYN is in-house for 24 hour call and has nothing better to do.

I'll be anyone's bitch if it means I don't have to go to clinic. Give me bull**** cases at 3am any day instead of 2-3 days a week of clinic during normal business hours.

 

[nowayout617]

I'm a CA-1. Truly I cannot tell whether I hate my program, or my life in general. The two have started to blend together.

 

[Ignatius J]

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Are you happy working as an anesthesiologist (0-10)?
What was your reason for going into anesthesiology in the first place?
Do you like your hours? Do you feel like you have enough time with your family/other interests?
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why?
Do you feel fairly compensated?
Would you choose anesthesiology again?
If you HAD to choose a different specialty, what would it be?
Anything else you'd like to share?

10
Flexibility; immediate results; no clinic/rounding
Yes and yes
Private practice and no
Yes
Yes
Eh, a surgical subspecialty that has minimal hospital visits during the night like ophthalmology or orthopedic surgery
Not really

 

[aimedicine]

Bump.

 

[deleted171991]

Bump.

Seriously?

 

[criticalelement]

Ill answer..

I would be a lot happier if I knew for certain I would have the same job in five years.. BUt when you are waiting for the other shoe to drop and facing moving to a city 100 miles away to work while the wife stays with the kids. NOT FUN!!!!

 

[aimedicine]

Seriously?

yes.

 

[aimedicine]

Ill answer..

I would be a lot happier if I knew for certain I would have the same job in five years.. BUt when you are waiting for the other shoe to drop and facing moving to a city 100 miles away to work while the wife stays with the kids. NOT FUN!!!!

its gotten that bad uh?....100 miles tho?....this is more reason im really keen on a pain fellowship

 

[Ignatius J]

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Edit: Ha! I don't even remember answering this a few months ago. That's scary.

 

[Urzuz]

Alright, I'll bite. The caveat is that I am evaluating my job and life right now.

There's a similar thread running in the EM forums with some good responses. I know there's a lot of talk here about the general future of this specialty, but I think people would enjoy hearing from current attendings how things actually are for you in 2016.

Are you happy working as an anesthesiologist (0-10)? 8
What was your reason for going into anesthesiology in the first place? Procedures, physiology, lack of clinic, short encounters with patients, leave work at the hospital and (usually) turn pager off
Do you like your hours? Do you feel like you have enough time with your family/other interests? I feel like I have enough time with family and for other interests but the hours are sporadic. As others have said above, night call sucks.
Do you work in an academic center or private practice? Have you ever switched from one to the other, if so why? Private.
Do you feel fairly compensated? Yes
Would you choose anesthesiology again? I think so, but maybe I would look into some other specialties a little more before choosing (radiology, orthopedics, cardiology)
If you HAD to choose a different specialty, what would it be? Tough because I didn't thoroughly evaluate a ton of other specialties, but from the outside looking in, I think I would have fun doing orthopedics.
Anything else you'd like to share? I love my job as it stands right now. I live in one of the best parts of the country, I'm compensated fairly, I don't have to deal with CRNAs, and life is good. Every specialty has its issues. Our issues are clearly a little more demeaning since we are fighting a turf war with murses, but overall it is a great gig. Also, for me, if you ignore the turf wars, the day to day BS, and all the bureaucratic nonsense, the actual science of anesthesiology is fascinating. While studying during residency and for boards some sick/nerdy part of me would actually enjoy reading about the intricate physiology and pharmacology, and how the drugs we give have such a profound effect on patients...but even more fascinating is how we are able to reliably predict and control those effects with our skills. Any day of the week I would choose to study anesthesiology over the physiology of bones and what happens when you hammer nails through them!

 

[GravelRider]

I like the practice of anesthesiology and the challenges that keep my on my toes everyday. I absolutely loathe the business of it. I hate that I go in everyday to subsidize some old crusty dinosaur who lacks skills, knowledge, and is just a general embarrassment to medicine. I work, so they don't have to. These old wastes of space sold out the field to nurses and are busy burning out new grads who could bring life and energy back into the field. Instead they take advantage of the young guys so they can pay for their alimony and still be on the golf course every afternoon.

Maybe I'm in a bad practice, but from looking around this problem is more widespread than you think.

 

[criticalelement]

I like the practice of anesthesiology and the challenges that keep my on my toes everyday. I absolutely loathe the business of it. I hate that I go in everyday to subsidize some old crusty dinosaur who lacks skills, knowledge, and is just a general embarrassment to medicine. I work, so they don't have to. These old wastes of space sold out the field to nurses and are busy burning out new grads who could bring life and energy back into the field. Instead they take advantage of the young guys so they can pay for their alimony and still be on the golf course every afternoon.

Maybe I'm in a bad practice, but from looking around this problem is more widespread than you think.

While those practices are deplorable, you are still there so it cannot be that deplorable. I dont blame the fat cats, I blame YOU for being there still. If you are unhappy BOUNCE!

 

[Man o War]

I like the practice of anesthesiology and the challenges that keep my on my toes everyday. I absolutely loathe the business of it. I hate that I go in everyday to subsidize some old crusty dinosaur who lacks skills, knowledge, and is just a general embarrassment to medicine. I work, so they don't have to. These old wastes of space sold out the field to nurses and are busy burning out new grads who could bring life and energy back into the field. Instead they take advantage of the young guys so they can pay for their alimony and still be on the golf course every afternoon.

Maybe I'm in a bad practice, but from looking around this problem is more widespread than you think.

Both times I searched for jobs I didn't even interview at places like this. I knew I'd eventually grow very resentful, which doesn't work for me. There are so many good, equitable practices out there if you're willing to relocate. Don't settle for this BS.

 

[Notorious T.E.E.]

I dont blame the fat cats, I blame YOU for being there still.

Exactly.

 

[LivetoTell]

I like the practice of anesthesiology and the challenges that keep my on my toes everyday. I absolutely loathe the business of it. I hate that I go in everyday to subsidize some old crusty dinosaur who lacks skills, knowledge, and is just a general embarrassment to medicine. I work, so they don't have to. These old wastes of space sold out the field to nurses and are busy burning out new grads who could bring life and energy back into the field. Instead they take advantage of the young guys so they can pay for their alimony and still be on the golf course every afternoon.

Maybe I'm in a bad practice, but from looking around this problem is more widespread than you think.

Yep, especially selling out to the nurses.

 

[anes121508]

I like the practice of anesthesiology and the challenges that keep my on my toes everyday. I absolutely loathe the business of it. I hate that I go in everyday to subsidize some old crusty dinosaur who lacks skills, knowledge, and is just a general embarrassment to medicine. I work, so they don't have to. These old wastes of space sold out the field to nurses and are busy burning out new grads who could bring life and energy back into the field. Instead they take advantage of the young guys so they can pay for their alimony and still be on the golf course every afternoon.

Maybe I'm in a bad practice, but from looking around this problem is more widespread than you think.

Hey, I've noticed you have been really unhappy with your job for some time now....what is keeping you there?....I only ask because it could be a learning point for young people like me

 

[GravelRider]

Hey, I've noticed you have been really unhappy with your job for some time now....what is keeping you there?....I only ask because it could be a learning point for young people like me

Just the difficulty that comes with moving and having a spouse change jobs. I'm in an area saturated by bad AMC jobs, so changing jobs isn't as easy as just putting in your notice and finding a new spot the next day. It's sort of like jumping from the pan into the fire. I have a lot of student debt, so I can't afford a few months off for a job search.

 

[Notorious T.E.E.]

Just the difficulty that comes with moving and having a spouse change jobs. I'm in an area saturated by bad AMC jobs, so changing jobs isn't as easy as just putting in your notice and finding a new spot the next day. It's sort of like jumping from the pan into the fire. I have a lot of student debt, so I can't afford a few months off for a job search.

Are you in Florida?