CNN Money: Anesthesiologist #36 on list of "Best Jobs in America"

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They're saying a 10-year job growth of 24%. I'm not sure what that means. Does that simply mean that there will be 24% more jobs in 10 years? And how do they derive that number? Does this account for expanded midlevel/CRNA practice rights?

And I'm not too disappointed that we rank behind EM and ortho. Collectively we were the only three doctors on that entire list. So they recognize the value. The lowest rank in any of the categories for all of the jobs was a "C". And we get that for job stress. Depending on where you practice and what type of practice arrangement you have I'm sure it should be an "F" for a lot of us.
 
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BuzzPhreed said:
They're saying a 10-year job growth of 24%. I'm not sure what that means. Does that simply mean that there will be 24% more jobs in 10 years? And how do they derive that number? Does this account for expanded midlevel/CRNA practice rights?

And I'm not too disappointed that we rank behind EM and ortho. Collectively we were the only three doctors on that entire list. So they recognize the value. The lowest rank in any of the categories for all of the jobs was a "C". And we get that for job stress. Depending on where you practice and what type of practice arrangement you have I'm sure it should be an "F" for a lot of us.
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As I posted in another thread, according to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. The specialty seems to be top-heavy with the fat cat gray-hairs. Maybe this has something to do with it?

 
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Carbocation1 said:
As I posted in another thread, according to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. The specialty seems to be top-heavy with the fat cat gray-hairs. Maybe this has something to do with it?
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With decreased reimbursements, who knows when they'll retire... and if they do retire, will cRNAs take their spots?

Hospital administrator came in as #5...
 
they probably also didn't consider most physician fields... like those forbes salary rankings that puts anesthesiologist as #1. they probably only picked a few fields
 
That's a joke. EM has a 'C' for stress level.....yea, telling a family that their kid died from an asthma attack or is a quad from a bad MVC - totally low stress. Then seeing someone who thinks their 3 years of back pain should get an rx for narcotics.....that totally leads to job satisfaction.

Anesthesia as a C? Managing a hypotensive patient with a ton of co-morbidities getting a big vascular surgery. That sounds so chill. AmIRight???
 
Wolverines83 said:
when a yoga/pilates instructor has an A rating for benefit to society I can't say I exactly hold the integrity of the list in high regard
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This type of cynicism and negativity is pathognomonic for severely misaligned chakras brah. Namaste'.
 
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TimesNewRoman said:
That's a joke. EM has a 'C' for stress level.....yea, telling a family that their kid died from an asthma attack or is a quad from a bad MVC - totally low stress. Then seeing someone who thinks their 3 years of back pain should get an rx for narcotics.....that totally leads to job satisfaction.

Anesthesia as a C? Managing a hypotensive patient with a ton of co-morbidities getting a big vascular surgery. That sounds so chill. AmIRight???
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I think you have it backwards. C as in low score (bad job) because of high stress.

gratefulgas said:
This type of cynicism and negativity is pathognomonic for severely misaligned chakras brah. Namaste'.
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Guess I need some reiki
 
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Just goes to show you what a useless rag CNN Money is.
 
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Carbocation1 said:
As I posted in another thread, according to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. The specialty seems to be top-heavy with the fat cat gray-hairs. Maybe this has something to do with it?
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And as the gray hairs go, they'll no doubt sell out their practices to AMCs and go laughing all the way to the bank. Not that I blame them, I'd do the same damn thing.
 
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Wolverines83 said:
I think you have it backwards. C as in low score (bad job) because of high stress.



Guess I need some reiki
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No, I meant that C is way undervaluing the stress of emergency medicine and anesthesia.

If practicing emergency medicine is a C, what on God's green earth could be an F for stress?

I'm not in anesthesia, but I can't imaging having a sick one on the table and a d-bag surgeon puts you at a C either.
 
TimesNewRoman said:
No, I meant that C is way undervaluing the stress of emergency medicine and anesthesia.

If practicing emergency medicine is a C, what on God's green earth could be an F for stress?

I'm not in anesthesia, but I can't imaging having a sick one on the table and a d-bag surgeon puts you at a C either.
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no argument there. i didn't see anything below a C. Maybe that's as low as it goes? Then again I didn't look at all of them. if there is, in fact, a D or F rating, then I don't know what to say.
 
TimesNewRoman said:
No, I meant that C is way undervaluing the stress of emergency medicine and anesthesia.

If practicing emergency medicine is a C, what on God's green earth could be an F for stress?

I'm not in anesthesia, but I can't imaging having a sick one on the table and a d-bag surgeon puts you at a C either.
Click to expand...

maybe being a soldier in a war?
 
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anbuitachi said:
With decreased reimbursements, who knows when they'll retire... and if they do retire, will cRNAs take their spots?

Hospital administrator came in as #5...
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Anesthesiology in the USA is changing from Group practices to AMCs, ACOs, Hospital employed positions. More and more groups are being swallowed up or eradicated every week due to financial pressures created by CMS and more Medicaid with the ACA. The result is more midlevel provides doing more of the work with less need for Anesthesiologists.

Even with the upcoming retirement of senior Anesthesiologists there will be glut of labor on the market which will drive salaries down. Again, this is due to the change from SOLO MD care to a 1:4 ACT model. In fact, poorer hospitals may even go 1:6 utilizing CRNA labor over Anesthesiologists.

Thus, you should not count on retirement as a reason for entering this field as salaries will likely decrease for this specialty over the next several years. The AANA's official position on anesthesia is that "Anesthesiologists are not needed at all when there is a CRNA doing the anesthetic."
 
AANA Urges Medicare to Consider Hospital Anesthesiology Efficiency Measures
The AANA has recommended that Medicare consider the costs of various anesthesia delivery models and of hospital anesthesia subsidies per anesthetizing location as part of quality measures intended to capture the efficiency of hospital anesthesia services.

The June 21 letter, signed by President Janice Izlar, CRNA, DNAP, stated, "The Agency may want to consider the costs of meeting the seven medical direction steps as part of the anesthesiology spending and cost-efficiency measure. Under the medical direction practice model, the medical directing anesthesiologist must complete seven steps in order to bill for this modality. The Agency has clearly stated that medical direction is a condition for payment for anesthesiologist services and not a quality standard."

The AANA discussed the ways that the requirements associated with anesthesiologist medical direction claims contribute to healthcare cost growth, noting specifically the requirement that the anesthesiologist be "present at induction." "For every minute spent waiting for an anesthesiologist to arrive and be present at induction, some of the costliest resources in the hospital are wasted. The clock is running on the surgeon, circulating nurse, scrub tech, and nurse anesthetist waiting in the operating room. Waiting costs cascade throughout the day, postponing the surgery schedule to require overtime and on-call staff, delaying the surgeon's rounds to affect patient care and discharge of the patient from the healthcare facility. Waiting costs also add opportunity costs, diverting needed resources from other patient care," continued the letter.

The letter also recommends including the cost per anesthetizing location as part of the proposed anesthesiology measure since hospitals pay an average of $160,096 per anesthetizing location to anesthesiology groups, and increasing the weight placed on clinical process of care measures, such as the Surgical Care Improvement Project (SCIP) measures, under the hospital value based purchasing program.
 
Sirach38 said:
The AANA is smoking crack. Let them all become independent.
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Don't be so happy. Let me translate it to you.
Now (on average): 3 CRNAs per anesthesiologist.
Future (let's say for only 50% of the locations): 3 CRNAs, no anesthesiologist.

Question? Where will all those anesthesiologists (up to 25% of the entire workforce) go? Most of them will either have to retire or find something else to do. The remaining ones, the lucky ones with a job, will do firefighter crappy work and sick cases, for decreasing salaries. "Oh, you don't like it? We have 3 people ready to sign tomorrow."

And we haven't even considered all those solo anesthesiologists who will get replaced with independent CRNAs, or will compete with them every single day, at current CRNA salaries or lower.

Love,
Cassandra
 
FFP said:
Don't be so happy. Let me translate it to you.
Now (on average): 3 CRNAs per anesthesiologist.
Future (let's say for only 50% of the locations): 3 CRNAs, no anesthesiologist.

Question? Where will all those anesthesiologists (up to 25% of the entire workforce) go? Most of them will either have to retire or find something else to do. The remaining ones, the lucky ones with a job, will do firefighter crappy work and sick cases, for decreasing salaries. "Oh, you don't like it? We have 3 people ready to sign tomorrow."

And we haven't even considered all those solo anesthesiologists who will get replaced with independent CRNAs, or will compete with them every single day, at current CRNA salaries or lower.

Love,
Cassandra
Click to expand...

Yes I realize this. All anesthesiologists of the future will need 1-2 fellowships to compete in this type of market.
 
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Is there any push-back from surgeons about this? It seems like a surgeon would take on more liability (whether rightly so or not) with independent CRNAs....lawyers will always go after those with bigger pocketbooks. Versus right now, the anesthesiologists would be the primary to get sued (assuming it was primarily an anesthesia-related bad outcome).
 
Work hard, save, keep your skills up, and lobby. It's all you can do. And don't underestimate the power of a powerful lobbying effort.
 
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afob100 said:
Is there any push-back from surgeons about this? It seems like a surgeon would take on more liability (whether rightly so or not) with independent CRNAs....lawyers will always go after those with bigger pocketbooks. Versus right now, the anesthesiologists would be the primary to get sued (assuming it was primarily an anesthesia-related bad outcome).
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I asked this to one of my surgeon mentors who clearly stated that she would NOT operate in a crna-only setting due to liability and patient safety issues.
 
FFP said:
Don't be so happy. Let me translate it to you.
Now (on average): 3 CRNAs per anesthesiologist.
Future (let's say for only 50% of the locations): 3 CRNAs, no anesthesiologist.

Question? Where will all those anesthesiologists (up to 25% of the entire workforce) go? Most of them will either have to retire or find something else to do. The remaining ones, the lucky ones with a job, will do firefighter crappy work and sick cases, for decreasing salaries. "Oh, you don't like it? We have 3 people ready to sign tomorrow."

And we haven't even considered all those solo anesthesiologists who will get replaced with independent CRNAs, or will compete with them every single day, at current CRNA salaries or lower.

Love,
Cassandra
Click to expand...
To me it seems like the very worst would be for anesthesiologists to work at CRNA rates ~$150-200k. It would be bizarre to use a CRNA over an anesthesiologist at the same rate. Not seeing how any MD/DO goes unemployed before the CRNA.
 
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afob100 said:
Is there any push-back from surgeons about this? It seems like a surgeon would take on more liability (whether rightly so or not) with independent CRNAs....lawyers will always go after those with bigger pocketbooks. Versus right now, the anesthesiologists would be the primary to get sued (assuming it was primarily an anesthesia-related bad outcome).
Click to expand...

I think we will really start to appreciate lawyers when all CRNAs start practicing completely independently. It's going to be quite a pot of gold for them. The AANA is pushing for the destruction of CRNAs. Yes anesthesiologist salaries will go down but CRNAs will be on the street begging for jobs. Militant CRNAs are much too stupid to see this.
 
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Spikebd said:
To me it seems like the very worst would be for anesthesiologists to work at CRNA rates ~$150-200k. It would be bizarre to use a CRNA over an anesthesiologist at the same rate. Not seeing how any MD/DO goes unemployed before the CRNA.
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if MDs are working for 150-200 (65hrs/week), crnas will get 80-100 (40hrs/week) and claim to be equal but cheaper

PS: they won't correct for hours worked, call covered, or efficiency so they'll claim to cost half as much.
 
nolagas said:
if MDs are working for 150-200 (65hrs/week), crnas will get 80-100 (40hrs/week) and claim to be equal but cheaper

PS: they won't correct for hours worked, call covered, or efficiency so they'll claim to cost half as much.
Click to expand...

The math doesn't add up. It won't fly for long.
 
Sirach38 said:
I think we will really start to appreciate lawyers when all CRNAs start practicing completely independently. It's going to be quite a pot of gold for them. The AANA is pushing for the destruction of CRNAs. Yes anesthesiologist salaries will go down but CRNAs will be on the street begging for jobs. Militant CRNAs are much too stupid to see this.
Click to expand...

I agree. While the premium for MD/DO over CRNA may drop, there will likely always be that premium.

All the if this, then that hypothesizing is just that. Pure speculation.
 
Sirach38,

Anesthesiologists won't just need 1-2 fellowships to still have a job. They will need a different specialty, or job description. Be it CCM, pain, or PSH/surgical hospitalist.

It won't happen overnight. It will take 15-20 years, but I have no doubt it will happen.
 
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Spikebd said:
To me it seems like the very worst would be for anesthesiologists to work at CRNA rates ~$150-200k. It would be bizarre to use a CRNA over an anesthesiologist at the same rate. Not seeing how any MD/DO goes unemployed before the CRNA.
Click to expand...
You don't realize that, in a market that's oversaturated with quasi equivalent providers, all salaries will go down while duties will go up. Have been witnessing it in the last 5 years, more or less since graduation.
 
Carbocation1 said:
I asked this to one of my surgeon mentors who clearly stated that she would NOT operate in a crna-only setting due to liability and patient safety issues.
Click to expand...
Guess what? He'll have no choice, as patients don't nowadays either. So he'll learn to put up with it, sooner or later. Wanna bet?
 
GA8314 said:
Work hard, save, keep your skills up, and lobby. It's all you can do. And don't underestimate the power of a powerful lobbying effort.
Click to expand...
You can't lobby against technological progress and market forces. It's just a matter of time.

Also, the bean counters are not on our side. Doctors lost the battle a long time ago, when they allowed clinically incompetent non-physicians to run healthcare.
 
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Sirach38 said:
I think we will really start to appreciate lawyers when all CRNAs start practicing completely independently. It's going to be quite a pot of gold for them. The AANA is pushing for the destruction of CRNAs. Yes anesthesiologist salaries will go down but CRNAs will be on the street begging for jobs. Militant CRNAs are much too stupid to see this.
Click to expand...
They have been working independently in certain states. Still no flurry of lawsuits. They are smart enough to stay away from difficult surgeries, which also tend to attract the sickest of patients. Those are reserved for us, since those are also the worst paying ones. ;)

They might get paid less than us but, when adjusted to malpractice risk and daily stress, they will be/are? paid so much better.
 
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FFP said:
They have been working independently in certain states. Still no flurry of lawsuits. They are smart enough to stay away from difficult surgeries, which also tend to attract the sickest of patients. Those are reserved for us, since those are also the worst paying ones. ;)

They might get paid less than us but, when adjusted to malpractice risk and daily stress, they will be/are? paid so much better.
Click to expand...

Sure in the current system it works. That's why the AANA should be working to keep the current system instead of pushing for further independence if they were truly working in the interest of CRNAs. Total independence will destroy the job market for CRNAs and greatly reduce our salaries. It's a lose lose situation that they are pushing for.
 
Sirach38 said:
Sure in the current system it works. That's why the AANA should be working to keep the current system instead of pushing for further independence if they were truly working in the interest of CRNAs. Total independence will destroy the job market for CRNAs and greatly reduce our salaries. It's a lose lose situation that they are pushing for.
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The current system already sucks, compared to 10 years ago. If anesthesia gets worse by the same order of magnitude in another 10 years, I might just stop practicing it, the same way pain docs are leaving their (sub)specialty in droves now.

They are doing to anesthesia exactly what they did to FP. Just look at the lives of primary care docs. It's nothing new. If you know a bit of history, and apply common sense, you will reach the same conclusions.
 
FFP said:
The current system already sucks, compared to 10 years ago. If anesthesia gets worse by the same order of magnitude in another 10 years, I might just stop practicing it, the same way pain docs are leaving their (sub)specialty in droves now.
Click to expand...

Well you're going to critical care so you're safe ;)
 
FFP said:
The current system already sucks, compared to 10 years ago. If anesthesia gets worse by the same order of magnitude in another 10 years, I might just stop practicing it, the same way pain docs are leaving their (sub)specialty in droves now.

They are doing to anesthesia exactly what they did to FP. Just look at the lives of primary care docs. It's nothing new. If you know a bit of history, and apply common sense, you will reach the same conclusions.
Click to expand...

What specifically has gotten worse for you in the last 10 years? More work for less pay? Worse supervision ratios? Worse schedule?
Do you enjoy your job (at all)?
Is the sky falling? This forum is so depressing to read.
 
You don't realize that, in a market that's oversaturated with quasi equivalent providers, all salaries will go down while duties will go up. Have been witnessing it in the last 5 years, more or less since graduation.
Click to expand...

I don't know why a CRNA would want to gain more independence if it meant they would make 75% of their current salary. It seems like a bad strategy to me.
 
murdoc9 said:
What specifically has gotten worse for you in the last 10 years? More work for less pay? Worse supervision ratios? Worse schedule?
Do you enjoy your job (at all)?
Is the sky falling? This forum is so depressing to read.
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More work, less pay. Fewer solo jobs. Fewer jobs in general. Increasing supervision ratios. More and more militant CRNAs. Partnerships disappearing. More and more abuse from the bean counters.

Reality is always depressing. One doesn't really see what's going on until one becomes an attending, especially an employee. Until then, all the crap one reads on the Internet goes in the "this won't happen to me, because I have always been told I was special" box. Nobody's special. Except for geniuses like Elon Musk.
 
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Sirach38 said:
When do you start fellowship? I'd be curious to hear about critical care from an anesthesiologist's perspective once you start.
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You will know I am doing CCM by how I will disappear. :)

There are very few intensivists posting on the forum. Especially busy fellows.
 
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Sirach38 said:
I think we will really start to appreciate lawyers when all CRNAs start practicing completely independently. It's going to be quite a pot of gold for them. The AANA is pushing for the destruction of CRNAs. Yes anesthesiologist salaries will go down but CRNAs will be on the street begging for jobs. Militant CRNAs are much too stupid to see this.
Click to expand...
I have a nagging suspicion that when independent midlevels (in any specialty) start getting successfully sued in meaningful numbers, about 20 minutes later Congress will pass nationwide tort reform to put the brakes on it.

Independent "low cost" midlevels are the government's solution to expensive and limited access to healthcare. The people pushing healthcare in this direction are cynical, they are opportunists, they are pragmatic; they are not stupid. They know complications will rise. They know more malpractice suits will be filed. I think they will take steps to thwart any market forces that get in the way of that vision.

Before malpractice suits put the brakes on midlevel independence, the rules will be changed.
 
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Bottom line: There is ALWAYS something to bitch about in life. You're either the time of person that is grateful for what you have in life and take time to enjoy it or you're the type of person who never has enough, always sees the grass greener on the other side, and spends their life bitching about their situation. Anesthesiologist have and will always have great jobs compared to many Americans not to mention people in other parts of the world. Is Anesthesiology perfect? Absolutely not. Just like nothing else in life is perfect. But it's a hell of a good gig. This site is used as an outlet for many to pour out their frustrations which they may not be able to express in person. The doom and gloom is always the loudest because SDN is a good place to express frustrations. Don't let the negativity get to you. Life is beautiful and gas is a great field.
 
FFP said:
Maybe, and only for a while. Being an employee is never safe or ideal.
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Trust me, it's a smart move. At the absolute very least, you'll be a better physician and anesthesiologist and stronger candidate for any job, whether it be in PP or academics. It also gives you an out. Just in the past month I've gotten calls from recruiters and med directors trying to hire me for 3 fulltime CC jobs in L.A./OC/inland empire, all paying 400K+, full benefits, vacay
 
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