PP CRNA salary more than Academic Anesthesiologists

[otis86]

I've been interviewing at some academic institutions. The salary is so shamefully low its embarrassing. I know private practice CRNA's that make more than the salary that is offered at these places. In my opinion, no amount of Ivy Leage prestige can suffice for a lesser educated, less trained mid-level provider earning more than us. Why do we need all these years of education then? Is the crisis that is hitting Emergency Medicine bound for Anesthesia next? Over 500 unfilled spots in this years Emergency Medicine Match cycle. Thoughts?

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[pgg]

My thought is that if your sense of self worth depends on what other people are earning, you're in for a rough life of disappointment and heartburn.

Market forces are what they are. Don't doubt the value of your education because some actor, athlete, YouTuber, or CRNA earns more than you.

Academic jobs pay less than private practice jobs because they do less clinical work and because they offer benefits or a lifestyle that people accept in return for less money. News at 11.

Every single one of us could choose to chase high dollar jobs, right now ... if we also choose to work in certain places, under certain circumstances, or for a certain number of hours. Decide what you want, take it, pay the price, enjoy the spoils. Maybe ... pick a number that is enough and seek it out, and when you find a place you can earn it under circumstances you can tolerate or even enjoy, take the job and allow yourself to be happy with it. Even if some travel CRNA who flew in on Spirit Airlines and is staying at the Extended Stay Hilton over by the gas station is making more than you per hour.

 

[Iso4ane]

I cracked 500k as an academic anesthesiologist, would I have made more as a private given how much I worked, maybe. But, I’m doing alright and can’t complain all too much. Comparing myself to others would just be a cause of depression.

 

[T-burglar]

Academics exploits its workers

 

[dabears505]

Private groups are going bankrupt paying said crnas and working like dogs. So maybe that cush academics life ain't so bad.

 

[IlDestriero]

I cracked 500k as an academic anesthesiologist, would I have made more as a private given how much I worked, maybe. But, I’m doing alright and can’t complain all too much. Comparing myself to others would just be a cause of depression.

I’m close as well for 40ish hours a week after a promotion. 6-7 weeks vaca and another 6-7 of non clinical academic time. Sit cases often and never cover more than 2:1. ~1 call/mo. Works for me. Not all academic jobs suck.

 

[narcusprince]

My thought is that if your sense of self worth depends on what other people are earning, you're in for a rough life of disappointment and heartburn.

Market forces are what they are. Don't doubt the value of your education because some actor, athlete, YouTuber, or CRNA earns more than you.

Academic jobs pay less than private practice jobs because they do less clinical work and because they offer benefits or a lifestyle that people accept in return for less money. News at 11.

Every single one of us could choose to chase high dollar jobs, right now ... if we also choose to work in certain places, under certain circumstances, or for a certain number of hours. Decide what you want, take it, pay the price, enjoy the spoils. Maybe ... pick a number that is enough and seek it out, and when you find a place you can earn it under circumstances you can tolerate or even enjoy, take the job and allow yourself to be happy with it. Even if some travel CRNA who flew in on Spirit Airlines and is staying at the Extended Stay Hilton over by the gas station is making more than you per hour.

Im definitely happier in PP. Plus this year I will make close to 4-5 Navy Anesthesiologist FTEs with 10 weeks vacation. And definitely work harder but alot more smarter. The navy training was good from an organizational process improvement standpoint. Everyone has a number. Pick it and run with it.

 

[CubsDynasty]

One side of it is that academics pays as little as possible, until market forces cause them to get closer to market rate. Usually years after an exodus. The other side is I know many CRNAs who make 500+, some even 700+ as locums hustling. Plenty of locum gigs offering them 200+/hr, and a few 250. That’s why I sometimes laugh at some of the new grad offers. They’re happily accepting less than CRNAs. So not at all surprising PP CRNAs make more than academic MDs

 

[abolt18]

I've been interviewing at some academic institutions. The salary is so shamefully low its embarrassing. I know private practice CRNA's that make more than the salary that is offered at these places. In my opinion, no amount of Ivy Leage prestige can suffice for a lesser educated, less trained mid-level provider earning more than us. Why do we need all these years of education then? Is the crisis that is hitting Emergency Medicine bound for Anesthesia next? Over 500 unfilled spots in this years Emergency Medicine Match cycle. Thoughts?

Academic hospital. crnas making $280K for 40hrs/wk. Great benefits. 10% retirement match with mandatory 5% employee contribution. If they work as many hours as the docs, they make as much as them.

 

[Mehd School]

I'm making >$400k as an academic anesthesiologist with a crazy amount of admin time that is up to me on how I spend it. I don't know any CRNAs making what I make that aren't killing themselves or working in a place that they literally couldn't find anyone else to fill.

 

[Anesthesia_Guy]

I'm making >$400k as an academic anesthesiologist with a crazy amount of admin time that is up to me on how I spend it. I don't know any CRNAs making what I make that aren't killing themselves or working in a place that they literally couldn't find anyone else to fill.

Yeah but you also think Arkansas is nirvana so I'll be taking what you say with an enormous grain of salt.

 

[otis86]

My thought is that if your sense of self worth depends on what other people are earning, you're in for a rough life of disappointment and heartburn.

Market forces are what they are. Don't doubt the value of your education because some actor, athlete, YouTuber, or CRNA earns more than you.

Academic jobs pay less than private practice jobs because they do less clinical work and because they offer benefits or a lifestyle that people accept in return for less money. News at 11.

Every single one of us could choose to chase high dollar jobs, right now ... if we also choose to work in certain places, under certain circumstances, or for a certain number of hours. Decide what you want, take it, pay the price, enjoy the spoils. Maybe ... pick a number that is enough and seek it out, and when you find a place you can earn it under circumstances you can tolerate or even enjoy, take the job and allow yourself to be happy with it. Even if some travel CRNA who flew in on Spirit Airlines and is staying at the Extended Stay Hilton over by the gas station is making more than you per hour.

Less clinical work? I’m not sure what the setup is like where you are but here I am in the OR everyday, no non-clinical or admin days, 2-3:1 coverage depending on residents or CRNAs. Patients are very sick and complicated. The “chosen,” ppl are the ones who get the easy cases, are part of some BS committee that gets them out of the OR. But that’s a very small proportion of a department anywhere. Most academic centers backbones are busy workers like myself.

I don’t doubt my education but there is clearly a trend growing in medicine that is favoring mid-level providers over us.

 

[pgg]

Less clinical work? I’m not sure what the setup is like where you are but here I am in the OR everyday, no non-clinical or admin days, 2-3:1 coverage depending on residents or CRNAs. Patients are very sick and complicated. The “chosen,” ppl are the ones who get the easy cases, are part of some BS committee that gets them out of the OR. But that’s a very small proportion of a department anywhere. Most academic centers backbones are busy workers like myself.

I don’t doubt my education but there is clearly a trend growing in medicine that is favoring mid-level providers over us.

Obviously there's a bell curve and a continuum when it comes to volume of labor and compensation at different practices, but if you don't think academic practices are - on the whole - slower paced, lower volume, more generously staffed, and somewhat deluded in thinking their acuity level is soooo much higher than than the unwashed masses of private practices ... well, broaden your horizons a little.

And if you're really working your ass off for poor pay at one of those places, you're definitely on the wrong tail of the bell curve, and you should leave, rather than get angsty and jealous about CRNAs and whatever deal they got.

 

[aneftp]

Academics exploits its workers

It exploits the worker bees (usually new grads willing to stay at their home programs) or bridge gap docs looking for short term solution

The real faculty with 2 or more guaranteed non clinical days are exploiting the university.

 

[otis86]

Bro, I have worked in both sectors private practice and academic. PP has no standards and the quality of care is either great or terrible. There is no comparison, sick patients come to reputable centers to get taken care of not Sister Mary Joseph Hospital in Glendale. Academic centers are always short-staffed coast to coast from MGH to Stanford to Univ of Miami. Have you worked in Academics recently as a worker bee?

 

[ambiturner]

Bro, I have worked in both sectors private practice and academic. PP has no standards and the quality of care is either great or terrible. There is no comparison, sick patients come to reputable centers to get taken care of not Sister Mary Joseph Hospital in Glendale. Academic centers are always short-staffed coast to coast from MGH to Stanford to Univ of Miami. Have you worked in Academics recently as a worker bee?

The good PP groups in my area get ridiculously high acuity cases because they have excellent anesthesiologists, typically MD only or mostly MD, and excellent ICUs that the surgeons trust and they have impressive results. The bad places typically handle lower acuity and mostly do a lot of GI and ortho. I agree there’s little quality control though other than that the good groups were historically able to be very selective with hiring and that has kind of gone out the window.

I am an academic worker bee too. Academic centers are always short bc it takes them 6-8 months to hire people, so you always have a period after someone leaves but before the new hires start and get rolling. And if they are ever able to staff up, someone will always come up with some reason why they need another day out of the OR and then you’re magically short again.

Every employed academic job I have ever looked at has a pretty standard $/hr model that is tied to market surveys and excellent benefits that, if used, make the package very competitive with PP (tuition reimbursement, CME, licensing/dues paid etc). Since the $/hr is fairly fixed the ways to work the system are therefore to 1) pick up incentive shifts and work more clinically, typically at a higher $/hr premium, 2) come up with reasons to be out of the OR so your clinical hours are lower (committees, admin appointments, etc).

If you’re coming out and considering an academic career, make sure you come up with a niche or pet project to work #2 because it’s rare someone is willing to grind #1 for more than a few years.

 

[Iso4ane]

1) pick up incentive shifts and work more clinically, typically at a higher $/hr premium, 2) come up with reasons to be out of the OR so your clinical hours are lower (committees, admin appointments, etc).

If you’re coming out and considering an academic career, make sure you come up with a niche or pet project to work #2 because it’s rare someone is willing to grind #1 for more than a few years.

This part at my institution (and I'm sure others) is very important. I've carved out a few niches for myself, that allowed my to make as much as I do, and yet still get a decent amount of time off. If I was a academic generalist doing only ortho, GI, and surg onc, endo, I likely would not have picked this job.

 

[TexBlazer2106]

I’m close as well for 40ish hours a week after a promotion. 6-7 weeks vaca and another 6-7 of non clinical academic time. Sit cases often and never cover more than 2:1. ~1 call/mo. Works for me. Not all academic jobs suck.

You have roughly one week off per month (grouping vacation and nonclinical time) making almost 500k a year with a 40 hour work week? Something seems off here.

 

[CardiacIntensivist]

Academics exploits its workers

disagree. Depends on the place. I've earned over well over most private practice anesthesiologists and worked about 60 hours/wk on average.

 

[chocomorsel]

Private groups are going bankrupt paying said crnas and working like dogs. So maybe that cush academics life ain't so bad.

Some of these groups that have CAAs need to hire some. And let the crazy CRNAs walkout.

 

[chocomorsel]

Less clinical work? I’m not sure what the setup is like where you are but here I am in the OR everyday, no non-clinical or admin days, 2-3:1 coverage depending on residents or CRNAs. Patients are very sick and complicated. The “chosen,” ppl are the ones who get the easy cases, are part of some BS committee that gets them out of the OR. But that’s a very small proportion of a department anywhere. Most academic centers backbones are busy workers like myself.

I don’t doubt my education but there is clearly a trend growing in medicine that is favoring mid-level providers over us.

That trend comes from lobbying power and the public's love for nurses and hate for doctors. If doctors behaved the way some of these nurses behave on social media they would be vilified. But yet nurses can **** talk doctors all day long, pad their resumes with fluff and then insist on being called Drs in the hospital, brag about how much smarter and experienced they are and much more money they are making than docs, and the public eats it up and they are loved even more.

The **** is weird but as doctors we also don't know how to come together and bully the system properly.

Nurses use their unions and organizations to bully and buy their way to the top by getting legislature get passed in their favor. We spend time individually bullying people that we think are beneath us instead of using all that damn bulllying power to unite together not be undermined!! We have this ideal image that we are supposed to uphold for the public and therefore our organizations put their tails in between their legs and cower and hide because they can't piss off the nurses.

All the while the nurses continue to piss on us.

It is ridiculousness.

 

[Arch Guillotti]

disagree. Depends on the place. I've earned over well over most private practice anesthesiologists and worked about 60 hours/wk on average.

How are you so sure of this?

 

[Anesthesia_Guy]

That trend comes from lobbying power and the public's love for nurses and hate for doctors. If doctors behaved the way some of these nurses behave on social media they would be vilified. But yet nurses can **** talk doctors all day long, pad their resumes with fluff and then insist on being called Drs in the hospital, brag about how much smarter and experienced they are and much more money they are making than docs, and the public eats it up and they are loved even more.

The **** is weird but as doctors we also don't know how to come together and bully the system properly.

Nurses use their unions and organizations to bully and buy their way to the top by getting legislature get passed in their favor. We spend time individually bullying people that we think are beneath us instead of using all that damn bulllying power to unite together not be undermined!! We have this ideal image that we are supposed to uphold for the public and therefore our organizations put their tails in between their legs and cower and hide because they can't piss off the nurses.

All the while the nurses continue to piss on us.

It is ridiculousness.

What happened to the fly on the toilet seat? He got pissed off.

 

[Mehd School]

Yeah but you also think Arkansas is nirvana so I'll be taking what you say with an enormous grain of salt.

I just said that Northwest Arkansas is probably a higher ranked place to live then where you are and I haven't gotten any information since to change my mind

 

[aneftp]

True academic (University of XX) in same location as college campus. Yes. They are get lower. Mid 350s these days plus call incentives to push to low to even mid 400s. But for hours worked and slower pace and less calls in house. It’s not too bad of a deal for most.

There are quasi fake academic places with residency programs that are academic only in name. Now those places the docs can and will make a lot more with call incentives.

 

[Anesthesia_Guy]

I just said that Northwest Arkansas is probably a higher ranked place to live then where you are and I haven't gotten any information since to change my mind

I don't need or want to provide any information to counter your asinine assertion😃

 

[Anesthesia_Guy]

True academic (University of XX) in same location as college campus. Yes. They are get lower. Mid 350s these days plus call incentives to push to low to even mid 400s. But for hours worked and slower pace and less calls in house. It’s not too bad of a deal for most.

Deplorable....despicable....outlandish and whatever other words Jackie Chiles would use to describe this pittance of a salary which a good percentage of CRNAs exceed.

 

[ambiturner]

You have roughly one week off per month (grouping vacation and nonclinical time) making almost 500k a year with a 40 hour work week? Something seems off here.

Ivory tower academic hospitals charge amounts that would make pre NSA AMCs blush

 

[IlDestriero]

Ivory tower academic hospitals charge amounts that would make pre NSA AMCs blush

That’s true. I had an abdomen and pelvis MRI with contrast and the bill submitted was >$16,000.

 

[IlDestriero]

You have roughly one week off per month (grouping vacation and nonclinical time) making almost 500k a year with a 40 hour work week? Something seems off here.

It’s true. I’ve posted my income and progression before. Since then we had a market adjustment, an extra bonus this year because we’ve done so well, and a promotion increase. My children’s hospital system is more of a hybrid academic practice and our finances are independent of the university and hospital system unlike most traditional academic programs, though we are faculty. It’s the best of both worlds.
A couple of other things-
1. I’ve been doing this for 20 years.
2. Our hospital is an 800 lb gorilla that asks and gets high reimbursements.
3. There are a lot of insured patients local and from elsewhere, as well as overseas cash payers, who come for super specialized care by sub specialists.
4. It’s hard to work much over 40 hours a week when between post call days, academic time, a vaca day, etc. I rarely work 5 days a week.
5. I get ~150% of my bonus potential, because I bring it.

 

[BlueRug]

maybe it’s time for a new job/pay thread in the private forum

 

[chocomorsel]

It’s true. I’ve posted my income and progression before. Since then we had a market adjustment, an extra bonus this year because we’ve done so well, and a promotion increase. My children’s hospital system is more of a hybrid academic practice and our finances are independent of the university and hospital system unlike most traditional academic programs, though we are faculty. It’s the best of both worlds.
A couple of other things-
1. I’ve been doing this for 20 years.
2. Our hospital is an 800 lb gorilla that asks and gets high reimbursements.
3. There are a lot of insured patients local and from elsewhere, as well as overseas cash payers, who come for super specialized care by sub specialists.
4. It’s hard to work much over 40 hours a week when between post call days, academic time, a vaca day, etc. I rarely work 5 days a week.
5. I get ~150% of my bonus potential, because I bring it.

BRING IT!!!
LOVE THIS FOR YOU!!! YOU DESERVE IT.

 

[nimbus]

That’s true. I had an abdomen and pelvis MRI with contrast and the bill submitted was >$16,000.

This is what my ivory tower anesthesiologist was paid for a procedure I had a while back (possibly at your institution). This is much more than we get in PP from the same insurance company (UHC) for the same procedure. Bottom line is that these national/international referral centers have tremendous bargaining power.

Surgeon:

Hospital (one night in ICU and discharged from hospital on morning of POD2).

 

[emergentmd]

I don't think you will be able to put the CRNAs genie in the bottle but I am curious why market forces have not just flooded the market with CRNAs thus lowering their rate?

Like most medical specialties esp EM, they just open more residencies flooding the market. Why hasn't CMGs/HCA/schools open up/flood the market to reduce operating costs? They all just seem to care about quantity over quality anyhow.

 

[teacher2md]

I don't think you will be able to put the CRNAs genie in the bottle but I am curious why market forces have not just flooded the market with CRNAs thus lowering their rate?

Like most medical specialties esp EM, they just open more residencies flooding the market. Why hasn't CMGs/HCA/schools open up/flood the market to reduce operating costs? They all just seem to care about quantity over quality anyhow.

I think the ACGME requirements for anesthesiology are the rate-limiting step for residency spots. You can’t just open a residency anywhere and still be able to meet the requirements for Peds<3mo, cardiac, thoracic, intracranial neuro, etc.

I think the same is true to a lesser extent for CRNAs. Even though their requirements are watered-down (and they’re allowed to count observed procedures towards their numbers), there’s really no way to easily skirt the OR case requirements. There is a minimum 2 year requirement (they might even all be 3 years now)

NPs, on the other hand, can do a few months of online courses and shadow a couple times and now they’re hired by a hospital to work in the ER.

 

[GassYous]

I don't think you will be able to put the CRNAs genie in the bottle but I am curious why market forces have not just flooded the market with CRNAs thus lowering their rate?

Like most medical specialties esp EM, they just open more residencies flooding the market. Why hasn't CMGs/HCA/schools open up/flood the market to reduce operating costs? They all just seem to care about quantity over quality anyhow.

They have opened a ton of CRNA schools and lowered the barrier to entry to basically nothing. But with covid, there were a ton of retirements and a lot of groups are short. I've even seen some top notch groups advertising on gaswork.

These things seem to be cyclical though. I'm sure in 7 years anesthesia will be a ghost town again with low salaries and bottom of the barrel applicants while emergency medicine will have taken back your specialty from the evil cmgs.

 

[jon stewart]

also seems like the ivory towers dont just hire anyone who applies even is this shortage?

 

[Mehd School]

One thing people should realize is that working in academics can be outright painful. I am a clinician and have no interest in research. Residents aren't the only ones learning in academic centers. Many or most of the surgeons are too (me too as a newer attending). These people are used to operating in a setting where a 4 hour lap chole isn't a big deal. Attitudes overall are more often toxic. Support staff often is hourly and doesn't give two ****s how fast they move. Some of the surgeons are world class. Some of the world class surgeons get world class pathology sent to them from across the globe only to let their senior residents play robot on them for 6 hours. I overall enjoy working with and training residents but some days I absolutely do not. There are some that do not want to work hard, do not want to read up, and want to bolt for the door as early as possible and they're simply not a joy to interact with. I do Locums work at a small community hospital one town over and I'm very interested in joining them. When I do a block the nurse preps and drapes the patient, draws up my drugs, grabs my gloves and places the ultrasound in an appropriate position. At my main job I have to run around to find my "block nurse" because hospital policy FORBIDS me from performing a block without an RN present. At my Locums job when I get called for an epidural the patient is prepped and draped and my kit is open when I arrive. When I show up at my normal job I am usually the one sitting the mother up, calling the nurse in the room repeatedly and then ultimately having the husband sit in a chair in front of the mom and holding her in position so I can begin and so the labor RN will show up just in time for reporting me for starting a procedure without doing a time out with her first.

Anyway, I make a lot of money and have a lot of time off and I earn every damn cent of it in that hell hole.

 

[Mehd School]

also seems like the ivory towers dont just hire anyone who applies even is this shortage?

Eh, I have a residency classmate that signed up to work in an ivory tower and literally makes half my pay for the same amount of work. Easy pass for me.

 

[Arantius]

It’s apples and oranges. If you want to be academic and do all the “bowtie” things then do that. If you want to be in the PP trenches but get paid for the austere situations you are forced into then do that. I don’t think they even really compare. Pick a path and try to stay on that for at least 10 years to get through the initial hazing whichever path you go. Or be a gypsy locums like me forever…