How bad is the CRNA problem. Will MDs always have a job

[pgg]

Seeing as it was only a few years ago that I was a fourth year medical student deciding about anesthesiology, I guess I should give my two cents. I really like the field. Pediatric anesthesia in particular is challenging and interesting and for me pays an absurdly high amount for the satisfaction I derive from it. It's great to look forward to work!

Now do I see myself having to deal with a lower salary? Sure. But honestly I would do this job for 200k and work 50-60hrs a week. Probably even 175k. 200k in the south goes a long way...provided you invest and save/live below your means. For a single guy you can live like a king...for a family of 3-4 it's not that much worse. Plus it's easier if you send your kids to public school and don't need a mcmansion/benz. Even easier if you raise your kids right and they get scholarships to state schools lol. Working for those hours and that wage I don't see MDs going anywhere soon....particularly if you are fellowship trained and board certified....you are a bargain for the hospital in terms of the quality patient care you give compared to a CRNA.

I guess you just have to have realistic expectations...200k is decent and in all likelihood that's a low estimate for where salaries will end up. Working in a poor state and in an academic center in a children's hospital that is 80-90% medicaid I still am paid significantly higher than that. Benefits are good too. Also it's sobering to see the peds subspecialists (PICU/peds cardiology/NICU attgs etc) that work just as hard (actually harder) and make LESS. Can you imagine a interventional peds cardiologist making 175k to start? After doing SEVEN years of training! But yet the peds subspecialists I work with are fine...even happy! And no, none of them came from money or were rich outside of medicine.

I remember as a fourth year worrying about my choice so much, but in the end it worked out great. My greatest worry was having a job and making a decent wage. I definitely surpassed my expectations. I guess the only advice I would have for those pursuing the field today is just become as clinically proficient as you can in residency, consider a fellowship and of course pass your boards (preferably on the first attempt). You won't be as rich as a neurosurgeon, but you probably won't have as many ex-wives (or husbands.)

Well put, good perspective.

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[BLADEMDA]

Seeing as it was only a few years ago that I was a fourth year medical student deciding about anesthesiology, I guess I should give my two cents. I really like the field. Pediatric anesthesia in particular is challenging and interesting and for me pays an absurdly high amount for the satisfaction I derive from it. It's great to look forward to work!

Now do I see myself having to deal with a lower salary? Sure. But honestly I would do this job for 200k and work 50-60hrs a week. Probably even 175k. 200k in the south goes a long way...provided you invest and save/live below your means. For a single guy you can live like a king...for a family of 3-4 it's not that much worse. Plus it's easier if you send your kids to public school and don't need a mcmansion/benz. Even easier if you raise your kids right and they get scholarships to state schools lol. Working for those hours and that wage I don't see MDs going anywhere soon....particularly if you are fellowship trained and board certified....you are a bargain for the hospital in terms of the quality patient care you give compared to a CRNA.

I guess you just have to have realistic expectations...200k is decent and in all likelihood that's a low estimate for where salaries will end up. Working in a poor state and in an academic center in a children's hospital that is 80-90% medicaid I still am paid significantly higher than that. Benefits are good too. Also it's sobering to see the peds subspecialists (PICU/peds cardiology/NICU attgs etc) that work just as hard (actually harder) and make LESS. Can you imagine a interventional peds cardiologist making 175k to start? After doing SEVEN years of training! But yet the peds subspecialists I work with are fine...even happy! And no, none of them came from money or were rich outside of medicine.

I remember as a fourth year worrying about my choice so much, but in the end it worked out great. My greatest worry was having a job and making a decent wage. I definitely surpassed my expectations. I guess the only advice I would have for those pursuing the field today is just become as clinically proficient as you can in residency, consider a fellowship and of course pass your boards (preferably on the first attempt). You won't be as rich as a neurosurgeon, but you probably won't have as many ex-wives (or husbands.)

Great post and a perfect example of "realistic expectations" for a 4th year med student going into Anesthesiology. I still think the job prospects are better for those doing a fellowship; no guarantee but the odds tilt heavily in your favor with a tight job market.

 

[LeverArm]

Seeing as it was only a few years ago that I was a fourth year medical student deciding about anesthesiology, I guess I should give my two cents. I really like the field. Pediatric anesthesia in particular is challenging and interesting and for me pays an absurdly high amount for the satisfaction I derive from it. It's great to look forward to work!

Now do I see myself having to deal with a lower salary? Sure. But honestly I would do this job for 200k and work 50-60hrs a week. Probably even 175k. 200k in the south goes a long way...provided you invest and save/live below your means. For a single guy you can live like a king...for a family of 3-4 it's not that much worse. Plus it's easier if you send your kids to public school and don't need a mcmansion/benz. Even easier if you raise your kids right and they get scholarships to state schools lol. Working for those hours and that wage I don't see MDs going anywhere soon....particularly if you are fellowship trained and board certified....you are a bargain for the hospital in terms of the quality patient care you give compared to a CRNA.

I guess you just have to have realistic expectations...200k is decent and in all likelihood that's a low estimate for where salaries will end up. Working in a poor state and in an academic center in a children's hospital that is 80-90% medicaid I still am paid significantly higher than that. Benefits are good too. Also it's sobering to see the peds subspecialists (PICU/peds cardiology/NICU attgs etc) that work just as hard (actually harder) and make LESS. Can you imagine a interventional peds cardiologist making 175k to start? After doing SEVEN years of training! But yet the peds subspecialists I work with are fine...even happy! And no, none of them came from money or were rich outside of medicine.

I remember as a fourth year worrying about my choice so much, but in the end it worked out great. My greatest worry was having a job and making a decent wage. I definitely surpassed my expectations. I guess the only advice I would have for those pursuing the field today is just become as clinically proficient as you can in residency, consider a fellowship and of course pass your boards (preferably on the first attempt). You won't be as rich as a neurosurgeon, but you probably won't have as many ex-wives (or husbands.)

I nominate this for best SDN post on this topic! Reading this while preparing for my anesthesiology residency interview put a smile on my face. Well done!

 

[twostep376]

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[BLADEMDA]

My apologies again to Dejavu. This thread was never intended to insult Dejavu or anyone else. To all those who just matched into Anesthesiology I truly wish you the best in your career going forward and I hope you realize how important politics are in this field.

 

[BLADEMDA]

Seeing as it was only a few years ago that I was a fourth year medical student deciding about anesthesiology, I guess I should give my two cents. I really like the field. Pediatric anesthesia in particular is challenging and interesting and for me pays an absurdly high amount for the satisfaction I derive from it. It's great to look forward to work!

Now do I see myself having to deal with a lower salary? Sure. But honestly I would do this job for 200k and work 50-60hrs a week. Probably even 175k. 200k in the south goes a long way...provided you invest and save/live below your means. For a single guy you can live like a king...for a family of 3-4 it's not that much worse. Plus it's easier if you send your kids to public school and don't need a mcmansion/benz. Even easier if you raise your kids right and they get scholarships to state schools lol. Working for those hours and that wage I don't see MDs going anywhere soon....particularly if you are fellowship trained and board certified....you are a bargain for the hospital in terms of the quality patient care you give compared to a CRNA.

I guess you just have to have realistic expectations...200k is decent and in all likelihood that's a low estimate for where salaries will end up. Working in a poor state and in an academic center in a children's hospital that is 80-90% medicaid I still am paid significantly higher than that. Benefits are good too. Also it's sobering to see the peds subspecialists (PICU/peds cardiology/NICU attgs etc) that work just as hard (actually harder) and make LESS. Can you imagine a interventional peds cardiologist making 175k to start? After doing SEVEN years of training! But yet the peds subspecialists I work with are fine...even happy! And no, none of them came from money or were rich outside of medicine.

I remember as a fourth year worrying about my choice so much, but in the end it worked out great. My greatest worry was having a job and making a decent wage. I definitely surpassed my expectations. I guess the only advice I would have for those pursuing the field today is just become as clinically proficient as you can in residency, consider a fellowship and of course pass your boards (preferably on the first attempt). You won't be as rich as a neurosurgeon, but you probably won't have as many ex-wives (or husbands.)

If you agree with above poster there is NOTHING to worry about. However, if you desire to be at the top of the heap instead of the bottom in terms of the CMS food chain then look elsewhere in the house of medicine. There will be jobs for all the graduating Residents in the coming years but the pay won't be as good as it was several years ago.

The biggest fallout from the CRNA/AANA is the drop in wages due to the increased competition for jobs. A plethora of cheap midlevel labor means more Anesthesiologists won't be doing their own cases but will instead supervise midlevels. That said, perhaps more Anesthesiologists will retire or semi-retire opening up more job positions for younger people.

 

[BLADEMDA]

How bad is the CRNA problem? Will MD anesthesiologists always have a job?

1. CRNA problem is a real issue and getting worse with an AANA unconcerned about patient safety.
2. Anesthesiologists will always have a job.
3. CRNAs are safe providers as a whole but require supervision for complicated cases and should not be permitted Independent practice.

 

[aneftp]

1. CRNA problem is a real issue and getting worse with an AANA unconcerned about patient safety.
2. Anesthesiologists will always have a job.
3. CRNAs are safe providers as a whole but require supervision for complicated cases and should not be permitted Independent practice.

I really don't get the aana propaganda.

We all know the percentage of crnas who cannot practice independently far outweighed the percentage of anesthesiologist who cannot practice solo. (Yes there are a few MDs who can't practice solo). Just trying to be "fair and balanced here".

Yet the AANA wants to say ALL crnas can practice solo. At least that's what they claim. While some can do solo cases even complex cases. Most don't go at it alone.

You really think rural CRNA only places do complex cases day in and day out? No. They punt those cases out.

There are many doing solo at Asa 1-2 surgery centers. So they essentially "move the field goal posts closer" when when they claim safety.

So why doesn't the ASA just demand if crnas want independence why don't they just immediately open the flood gates.

The Asa is falling for every trap the aana sets. Of course military crnas have practice solo. It's also impossible to sue military health care providers. Great on the job experience. Which is how most "independent minded crnas" come about.

Now let the 25 year CRNA fresh out of Crna school do Asa 3-4 cases solo out of school with no backup. Let the public experiment begin. It just takes on case to get the public's attention.

Yet it's a slow bleed by the aana. Cause they know the truth. That most graduating srnas are not capable of indepdendent practice.

 

[Ignatius J]

I really don't get the aana propaganda.

We all know the percentage of crnas who cannot practice independently far outweighed the percentage of anesthesiologist who cannot practice solo. (Yes there are a few MDs who can't practice solo). Just trying to be "fair and balanced here".

Yet the AANA wants to say ALL crnas can practice solo. At least that's what they claim. While some can do solo cases even complex cases. Most don't go at it alone.

You really think rural CRNA only places do complex cases day in and day out? No. They punt those cases out.

There are many doing solo at Asa 1-2 surgery centers. So they essentially "move the field goal posts closer" when when they claim safety.

So why doesn't the ASA just demand if crnas want independence why don't they just immediately open the flood gates.

The Asa is falling for every trap the aana sets. Of course military crnas have practice solo. It's also impossible to sue military health care providers. Great on the job experience. Which is how most "independent minded crnas" come about.

Now let the 25 year CRNA fresh out of Crna school do Asa 3-4 cases solo out of school with no backup. Let the public experiment begin. It just takes on case to get the public's attention.

Yet it's a slow bleed by the aana. Cause they know the truth. That most graduating srnas are not capable of indepdendent practice.

I think you hit the nail on the head here. Great post. As a guy who has seen sRNAs months away from practice, I can tell you that God help us all if we start sending those types out to handle complex patients.

 

[wjs010]

the public values human life indefinitely ( as they should), but does not value any of the hard work the anesthesiologist had to go through to save the life or the fact that they save these lives, and therefore would not mind at all if certain doctors ( many different specialties) worked absolutely for free.. seems fair. NOT

 

[IanMcGalt]

NOT was replaced by 'said no one ever'
Are you bringing NOT back?

 

[wjs010]

NOT was replaced by 'said no one ever'
Are you bringing NOT back?

pretend i said "said no one ever" at the end of that . lol. But really, it's nothing anyone said or didn't say..it's just obvious from the current anesthesia environment and the general doom and gloom of these boards.

 

[BossMD]

Average salary of Anesthesiologist is around $330,000 currently.
Is it really possible for AANA and Obamacare to cause it to drop to $200k in a decade to come?
I doubt it.
What's your input?

 

[BLADEMDA]

Average salary of Anesthesiologist is around $330,000 currently.
Is it really possible for AANA and Obamacare to cause it to drop to $200k in a decade to come?
I doubt it.
What's your input?

$250K. That's the new norm for some competitive job markets where AMCs hold the contract. Want $300K? You may not get it without a fellowship 4 years down the road.

Salaries are being slashed by AMCs and hospitals but as long as there is a new graduate stupid enough to take it the trend is lower pay going forward.

 

[sevoflurane]

Very sad. Our hard work is being exploited.

I wish there was a way to coallece and get out of this type of abuse...

Who wants to build a hospial that is owned and run by MDs?

 

[deleted171991]

I think that would be illegal in the US.

 

[chocomorsel]

I think that would be illegal in the US.

Why so? We can build and own surgicenters. Why not hospitals? I believe there are quite a few of them out there. There is one know I of one in DFW. Was closed for years and the story is a bunch of docs got together and bought it renovated it and run it now.

 

[group_theory]

I think that would be illegal in the US.

Why so? We can build and own surgicenters. Why not hospitals? I believe there are quite a few of them out there. There is one know I of one in DFW. Was closed for years and the story is a bunch of docs got together and bought it renovated it and run it now.

Physicians can't start or operate new hospitals/surgicenters anymore ... illegal under Obamacare (Section 6001 of the bill). Existing physician-own hospitals and surgicenters were grandfathered in, and allowed to continue - but new hospitals/surgicenters are not.


As for logic - it's politics and hospitals gave politicians money to help eliminate competition

 

[Baller MD]

Physicians can't start or operate new hospitals/surgicenters anymore ... illegal under Obamacare (Section 6001 of the bill). Existing physician-own hospitals and surgicenters were grandfathered in, and allowed to continue - but new hospitals/surgicenters are not.


As for logic - it's politics and hospitals gave politicians money to help eliminate competition

The AMA is a POS for supporting Obumacare.

 

[DermViser]

Why so? We can build and own surgicenters. Why not hospitals? I believe there are quite a few of them out there. There is one know I of one in DFW. Was closed for years and the story is a bunch of docs got together and bought it renovated it and run it now.

Nope. This was banned under Obamacare or any new ones. Lobbied by the American Hospital Association.

 

[JKP949]

As a nursing student & someone who would love to go to CRNA school- I am a little discouraged after reading this thread. I hate the very idea of being seen as someone who's after the MD anesthesiologists job b/c I'm not after their job; I WANT to work with them. I know there's cases I'll be able to handle on my own & there will be cases where I'd like the MD in the room. I know I can't do it all & my education background reflects that.

I don't agree with anything the AANA, ANA & all the other nursing associations have to say at all. Their liberal agenda is not mine. I don't believe they care for me or any nurse- they just want their agenda. IMO, Obamacare has ruined healthcare for doctors, nurses, PA's, pharmacists & patients.

 

[BestDoctorEver]

As a nursing student & someone who would love to go to CRNA school- I am a little discouraged after reading this thread. I hate the very idea of being seen as someone who's after the MD anesthesiologists job b/c I'm not after their job; I WANT to work with them. I know there's cases I'll be able to handle on my own & there will be cases where I'd like the MD in the room. I know I can't do it all & my education background reflects that.

I don't agree with anything the AANA, ANA & all the other nursing associations have to say at all. Their liberal agenda is not mine. I don't believe they care for me or any nurse- they just want their agenda. IMO, Obamacare has ruined healthcare for doctors, nurses, PA's, pharmacists & patients.

Not so for NP/PA/RN... Physicians are the ones getting the other end of the stick because the public eronously believes they are the greedy bastard driving up the cost of healthcare..

 

[Mman]

As a nursing student & someone who would love to go to CRNA school- I am a little discouraged after reading this thread. I hate the very idea of being seen as someone who's after the MD anesthesiologists job b/c I'm not after their job; I WANT to work with them. I know there's cases I'll be able to handle on my own & there will be cases where I'd like the MD in the room. I know I can't do it all & my education background reflects that.

No offense, but you claim to be a nursing student. How on earth do you "know" what sort of cases (if any) you will be able to handle on your own? You've never even been a nurse on the floor, let alone in the unit, or even gone to CRNA school, or even been left alone in an OR during a case. You aren't exactly qualified to comment on the situation.

IMHO having CRNA after someone's name doesn't qualify them to handle any case independent of MD supervision. It just doesn't. There are a good number of CRNAs running around that shouldn't be trusted on their own with an ASA 1 patient having minor surgery. Fortunately those patients are very hard to maim, though.