So, bottom line... what is the future of anesthesiology for MDs?

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Agreed. Well said.
Did you just call Argentina 1st world? :eek: Please visit Argentina. Hit up Brazil when you're down there too. Why not. And then every other state in South America. :) Then we will talk First World.



Agreed 100%.



Indeed. This is a simple idea based upon you feeling a certain way about things happening in the future -- I would make the argument that the terrorist one is not much different.


Potato, potahto. Which killed the 60yo man? 40 years of CAD? the massive MI? The pastrami sandwich the morning of?
I would think that his relatives would say he died of an AMI. A cardiologist might say he should have paid attention to the warning signs.
The Coroner will say MI. His wife will say it was the "F-ing pastrami sandwich that killed Harold..." Does it matter? Bottom line is, his CAD could have gone on for 20 more years without that MI, agreed? BUT he had the MI (9/11). And then died. If we're living in a post-MI world, which we are, we have to recognize what ultimately and immediately led to our demise. I think 9/11 was a MASSIVE MI.


Right now I don't have to worry about that, per se. Not in NY/DC/CHICAGO, at least FT. LA is a target, I'm there a bunch. And will live there again. When I'm older, I think living in NYC would be amazing, and when I'm older and ready to die in a Nuke blast or "whatever the hell gets me, my time has come (I ain't there yet), I would LOVE to live in NY. Terrorists or not. It's taken a long time to want to go home after being in LOWER NYC on 9/11.


I do think there is more than a non-trivial chance of a terrorist attack in the US in the next decade and beyond, however, I just don't know where it will hit, any more than I can predict the market in a month. They could go to PHIL, KANSAS, MIAMI, who knows. But I know they are intent on hurting us, it's a fact. Agencies around the US are planning and preparing and defending and I have more than one relative involved in all of that.



Now now, PGG, play nice. :D I'll tell you what though, I'll stop worrying about terrorists, when you stop worrying about the decline of the American financial way. ;) Deal? I mean, it's no coincidence that when Bill Clinton left office, during his first interview he was asked about his biggest fear. I paraphrase, -- he said a nuclear attack on US soil. This coming from a man with the most TSI/SC knowledge of any human on the planet. Briefed every morning. He didn't hesitate a FRACTION of a second to answer that question, I recall it clearly. I wouldn't gage the next 30 years on his hunch, but then 9/11 happened, and as a PoliSci student during Undergrad who focused on Terrorism, as I said, the next one HAS to be bigger to accomplish goals. Bigger isn't an airliner, or a cruise ship or killing some peeps with an IED. Bigger is a Nuke, and we all know that. The question is, how are we willing to allow that to affect our everyday life. Mine is that I wouldn't feel comfy living in DC right now. That's about it. Do I know where "safe" is? Nope. So, I take the same precautions with my family as you do yours. Just a different means to an end if you think about it. :thumb up:

D712[/QUOTE]

Look, I realize the trauma experienced, in a unique way, by New Yorkers on 9/11. My brother, sister-in-law, and cousin were all downtown, that day. They do view things differently.

That being said, you seem to have more of an "inclination" towards buying into the FEAR.

While somewhat difficult to prove (as are many of the events of 9/11), my personal "inclination" is not to trust government. I think that our Founding Fathers (and much of history) warned us that fear is often USED by governments in order to consolidate power and to control a population, perhaps especially in times of extreme uncertainty and possible impending catastrophe.

TSA folks patting down granny at the airport? Could it all be a move to slowly condition the population into accepting small encroachments of our individual freedom? All in the name of "security".

I don't know. Perhaps I'm just a skeptic.

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couldn't disagree with you more man, let's leave it at that gas attack.
You find that I buy into fear and I find that your lack of trust in our govt (and surely
armed forces) is backwards. What can i tell you.

D712
 
Did you just call Argentina 1st world?

Argentina was a modern, prosperous country, if not 1st world than close to it and improving - 15 years ago. They had an abrupt economic collapse. If you read firsthand accounts of what happened there, the kind of 'we never thought it could happen to us' sentiment was nearly universal.

Today it's a poor, violent hellhole and I certainly have no intention of visiting.


Potato, potahto.

:) details. My point was that blaming the terrorists for our ills strikes me as a bit of a cop out.


If terrorists got their hands on a nuclear bomb they wouldn't waste it on San Diego or Philadelphia. NY or DC. But you can't live in fear of terrorists. You're more likely to choke on a glass of lemonade.

I don't mean to be too facetious about the dangers of terrorism, well maybe a little, but when I think of threats to this nation's security, economic / military / cultural strength and influence on the world, terrorism isn't in my top 10. (Not that I've made a list of 10 entries, just a figure of speech.)
 
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Argentina was a modern, prosperous country, if not 1st world than close to it and improving - 15 years ago. They had an abrupt economic collapse. If you read firsthand accounts of what happened there, the kind of 'we never thought it could happen to us' sentiment was nearly universal.

Today it's a poor, violent hellhole and I certainly have no intention of visiting.




:) details. My point was that blaming the terrorists for our ills strikes me as a bit of a cop out.


If terrorists got their hands on a nuclear bomb they wouldn't waste it on San Diego or Philadelphia. NY or DC. But you can't live in fear of terrorists. You're more likely to choke on a glass of lemonade.

I don't mean to be too facetious about the dangers of terrorism, well maybe a little, but when I think of threats to this nation's security, economic / military / cultural strength and influence on the world, terrorism isn't in my top 10. (Not that I've made a list of 10 entries, just a figure of speech.)

Well, we each prepare for what we worry about. What's frustrating is that the MOMENT you mention terrorism and ANY lifestyle change, people think that you walk around fearing it your whole life. Sigh.

As for terror targets, you're wrong about Philadelphia. One of the federal agencies a close relative works for walked me through the "target zone" that is most planned for - as we stood in his office in Philadelphia. It basically covers the area in and around the Liberty Bell, Independence Hall, etc. He talked to me a bit about the info, the blast area of certain weapons and buildings and how they would be affected. It's a target and this agency is working to do what they can to prepare, which is what we pay them to do.

Or, it could be Des Boise, Idaho.

No idea.

I'm more likely to choke on lemonade than what precisely? GEt killed in an attack? I'm not necessarily concerned with that, as opposed to living in a US whereby a) friends and family members were directly affected or killed (you think 9/11 affected New Yorkers? Imagine a bomb. b) post Nuke America (however small the nuke is), c) you think we're in a financial mess today? Are you CERTAIN/CONFIDENT that in the next 30 years, America won't be struck by a Nuke? Would you like to discuss that over lemonade? I don't think that idea is AT ALL alarmist. I don't own a bunker, (or a gun for that matter), I'm not a member of the militia, looking into decommissioned Nuke bunker homes, or have an excess of canned tomato paste in my house. However, I think it's really silly to think the terrorists are done with the US in our lifetime.

Lemonade anyone?

I don't "blame" the terrorists for our ills, as in, "We'd be great if you big bullies didn't harm us..." rather, it was the precipitating factor in my eyes. Of course you have to be pre-disposed and all that, but that's how I see it. We were prime for it. To say it had no dramatic and immediate effect I think is shortsighted. Because it was a sucky situation it does us good in pointing fingers at bankers and law makers and upside down loan borrowers and FORGET about the terrorist attack that JUST preceded it all? Why do that? It was part of the landscape and it's not a cop out at all, it was an event that changed policy, the financial and economic climate. It's not a cop out. It's empirical data.

Argentina, and the rest of South America for that matter, has ALWAYS been defined as a Third World and developing country at best. Factually and by definition.

D712
 
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Well, we each prepare for what we worry about. What's frustrating is that the MOMENT you mention terrorism and ANY lifestyle change, people think that you walk around fearing it your whole life. Sigh.

Oh believe me, I'm familiar with that phenomenon. The fact that my family is well armed :), has a lot more than the FEMA-recommended 3-day :rolleyes: food supply at my house, has a generator and other 'uncommon' stuff laying around, has a plan beyond waiting for the gov't to show up and hand out MREs and bottled water during a crisis, etc, has gotten me labeled as a crazy survivalist wacko once or twice. Even on this board, I've been asked why I'm "afraid" enough to own and carry a gun.

I did change my life in the aftermath of 9/11. Specifically, I left DC in 2003 and I'll never go back. It was an easy sacrifice to make, since I hate cities and traffic ... but part of the reason for our departure was we decided to not be around the next time someone blew something up in DC.

But no, I don't worry about terrorism any more than I worry about crashing my car. I still pay my ins premiums though.

As for terror targets, you're wrong about Philadelphia.

I've heard it named as a potential target because of its historical significance. I just don't buy it though - a terrorist group will go for NY or DC. Maaaaybe LA, but only because Hollywood is there and it's a coastal city.

Seriously, you put 10 terrorists and 10 American 5th graders in a room with a map, and I bet more 5th graders could find Pakistan on that map than terrorists could find Philadelphia. Hell, I bet most of those 5th graders couldn't find Philadelphia.


Are you CERTAIN/CONFIDENT that in the next 30 years, America won't be struck by a Nuke? Would you like to discuss that over lemonade?

I thought we already discussed that - I said I wouldn't establish a career or buy retirement property in NYC or DC. I don't think LA is really at risk, but I wouldn't live there because, among other reasons, I don't like it's #1 and #2 natural resources, people and traffic. :)


Argentina, and the rest of South America for that matter, has ALWAYS been defined as a Third World and developing country at best. Factually and by definition.

By definition, sure, it's a geographic question. I can read a map. :)

Argentina, even just before its collapse around 2000, was a nice, safe, reasonably prosperous country, with a nontrivial middle class and an OK outlook. They had a series of problems starting sometime around 1950 - but there was a time when Argentina was one of the richest countries in the world. Richer than pre-war European economies.

In the 1990s they had a few economic bumps, and supposedly turned the corner on a looming financial disaster. Things looked good, but the prosperity turned out to be just a house of cards - today it's a totally different place than it was even 15 years ago.

Argentina has absolutely NOT always been the poverty-stricken hellhole it is today.

Regardless. My point was simply that we've seen outwardly healthy looking economies go straight to hell (sometimes in a shocking hurry), and maybe it's a little hubris-y for Americans to think it can't happen here. No, we're not Argentina or Greece or the Soviet Union ... but 2008 was a nearer miss than a lot of people realize, and it's not like we're better off now than we were then.
 
If I were running a terrorist network and I wanted to give pause to the American people or incite "terror" I would not go for high stakes big targets for the next attack.

I would specifically carry out multiple lower risk "common" locations so everyone felt at risk in the country. Think about it - why go after a high protected target when they could drive vans with bombs into public schools all across the country or just walk in and open fire at some mall. If 50 of these attacks occurred all around the same time in random "safe" areas of the country with maybe 1 symbolic target it would be terribly damaging and most likely a lot more successful.

My point is that to me it's not even worth worrying about because it cannot be predicted and unless you're someone really special you cannot do anything about it. But as PGG said there are some prep things you can do - but when your number is up - it's up.
 
Seriously, you put 10 terrorists and 10 American 5th graders in a room with a map, and I bet more 5th graders could find Pakistan on that map than terrorists could find Philadelphia. Hell, I bet most of those 5th graders couldn't find Philadelphia.

Oh no, terrorists are statistically NOT the impoverished and illiterate, quite the opposite. They would have NO problem finding Philly. First off, it's about YAY SW from Ground Zero. These terrorist orgs are run like frigging IBM, very very very very very well planned and organized.

By definition, sure, it's a geographic question. I can read a map. :)
Third World is NOT a geographic question. It's a socio-economic-political one.
You realize Saudi Arabia is/was (can't recall if it changed recently) a third world country. Yet it's FLOATING IN MONEY. If a regime brings in insane money, then keeps it all and doesn't give any wealth to the populace, that's not much help is it? If just so happens that South American countries all have a HUGE problem (for certain reasons) with consolidating democracy - and moving beyond the developing stage. Argentina included.

I think I understand your POV though! :thumbup:

D712
 
If I were running a terrorist network

Always a great opening salvo... ;)

I would specifically carry out multiple lower risk "common" locations so everyone felt at risk in the country.
It's public knowledge that terrorist organizations have been looking into your soft-target approach, the Commission put out a report to that effect recently. I agree, Nuke in DC or
100 bombs in middle america, scattered, both devastating to the US.

D712
 
4. I'm too old to change specialties. My only regret is not understanding how billing/reimbursement worked when I was a medical student and then a Resident. That knowledge would NOT have changed my specialty but would have changed my practice location.

In that case, considering the amount of medical students on SDN who have yet exposed themselves to the business/financial aspects of medicine, could you briefly teach us all about how billing/reimbursement works? Just the most important aspects of which would be extremely helpful, to give us an idea of what we should expect in the real world. We would greatly appreciate it.
 
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BLADEMDA,

If you were an M3 medical student right now, getting ready to apply to programs, which specialties would YOU consider matching into (ranking each specialty starting from 1 being most desirable), considering that GOP loses both the White House and the Senate for the next 30 years? (Yes, extremely pessimistic.) Please explain why. That would be most helpful.

Another question - if Pain is just a year or two of fellowship, and won't be affected as much by Obamacare as general anesthesia, would you recommend all anesthesiologists to go into pain? What other fellowships do you recommend?
 
BLADEMDA,

If you were an M3 medical student right now, getting ready to apply to programs, which specialties would YOU consider matching into (ranking each specialty starting from 1 being most desirable), considering that GOP loses both the White House and the Senate for the next 30 years? (Yes, extremely pessimistic.) Please explain why. That would be most helpful.

If I was M3 again....
1. Ortho
2. Ortho
3. Ortho

But that's just me:D
 
BLADEMDA,

If you were an M3 medical student right now, getting ready to apply to programs, which specialties would YOU consider matching into (ranking each specialty starting from 1 being most desirable), considering that GOP loses both the White House and the Senate for the next 30 years? (Yes, extremely pessimistic.) Please explain why. That would be most helpful.

Another question - if Pain is just a year or two of fellowship, and won't be affected as much by Obamacare as general anesthesia, would you recommend all anesthesiologists to go into pain? What other fellowships do you recommend?

I've said it before and I'll say it again. Go into whatever specialty you enjoy practicing and don't worry about the future because no one here can predict the future of medicine or anything else for that matter. The reality is that you will spend the majority of time at work for the next 30+ years so be happy at with what you do on a day to basis. No matter what specialty you pick, you will be well compensated and will certainly be able to live comfortably even if you do FP or pedi. IMO it is much more important to be happy at work and enjoy doing what you do than to be well paid and burnt out by the time you are 5 years in. This is the same answer I would give to any anesthesia resident asking which specialty to choose.

Don't like dealing w/chronic pain pts? Hate clinic? You're gonna hate pain no matter how much $$ your makin. Don't like the stress of dealing w/sick kids? Pedi might not be right for you. Even if your dream group is only hiring pedi guys right now, don't do pedi if it ain't right for you because you will be doing the difficult cases in your chosen specialty and you will be unhappy if you don't enjoy that
 
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Sorry if this has been addressed and I missed it (it just seems this thread went off topic for a bit and I don't want to search to find my answer) but I am honestly concerned about the future of anesthesia. I am not asking hypotheticals as in what do you think will happened many years down the line but rather in 5-6 years from now when a 3rd year student like myself would potentially be completing his or her training. Or even more specific, how much of an impact is the CRNA and other issues having at this present moment. As in compared to just a few years ago, what has been the trend in anesthesia? I am genuinely considering a career in anesthesiology but this fear is holding me back and I am really having a hard time deciphering between rumor/speculation and reality.

I would love to hear from someone who is in it and especially has been for at least some time as to their honest view. Will/is anesthesia going to take a hard hit with a combo increasing number of CRNAs (with increasing roles/autonomy) + recent trends in legislation + other issues.

Any input would be greatly appreciated!
 
I've said it before and I'll say it again. Go into whatever specialty you enjoy practicing and don't worry about the future because no one here can predict the future of medicine or anything else for that matter. The reality is that you will spend the majority of time at work for the next 30+ years so be happy at with what you do on a day to basis. No matter what specialty you pick, you will be well compensated and will certainly be able to live comfortably even if you do FP or pedi. IMO it is much more important to be happy at work and enjoy doing what you do than to be well paid and burnt out by the time you are 5 years in. This is the same answer I would give to any anesthesia resident asking which specialty to choose.

Don't like dealing w/chronic pain pts? Hate clinic? You're gonna hate pain no matter how much $$ your makin. Don't like the stress of dealing w/sick kids? Pedi might not be right for you. Even if your dream group is only hiring pedi guys right now, don't do pedi if it ain't right for you because you will be doing the difficult cases in your chosen specialty and you will be unhappy if you don't enjoy that

How would you truly know you enjoy it with nothing more than maybe a month in a medical school elective? What if you are equally interested in more than 1 field and a decision needs to be made fairly soon? Shouldn't lifestyle and future job prospects be taken into account?
 
How would you truly know you enjoy it with nothing more than maybe a month in a medical school elective? What if you are equally interested in more than 1 field and a decision needs to be made fairly soon? Shouldn't lifestyle and future job prospects be taken into account?

Lifestyle can be divided into 3 parts, hours worked, stuff you do at work, and $$ earned.

The amount of hours worked should certainly play a part in your decision because for the most part that's likely going to be stable in the future. $$ OTOH are too hard to predict. Years ago anesthesia was terrible and everyone thought PCPs would dominate, these days anesthesia is up and PCPs are down. Will this trend hold true in the future? Don't know and no one does.

You don't have know exactly what you want after doing it for a month but you should have a pretty good idea of where you want your career to go. Start with vague questions like do I like taking care of patients long term or short term? Do you want to work in a clinic or a hospital? Are you ok if you have to work in the middle of the night? Do you like doing your own procedures or not? Do you want to take care of sick or healthy patients? Once you have an idea of those answers you should be able to cross most specialties off your list. Once you've narrowed it down to 1 or 2 do a month in those specialties, you should be able to figure out which one you like more. Very few specialties really overlap one another and most that do are sub specialties where you don't have the make the decision until you are finishing residency.

I would be very wary of looking at $$ or job availability as a medical student because you're trying to forecast a market at a minimum of 3 years into the future and then forecasting it for the next 30 years. Medicine is cyclical and if you don't like what you do you will never be happy. No matter what you do in medicine you will always have $$ to put gas in the tank and take care of the basic necessities of life. Don't try to chase $$ for material things because it will just make you unhappy if you don't like what you do.
 
Krauthammer predicted the complexity of the law eventually would doom it to failure, which would lead to a single-payer system within a decade.
“This is a new reform that when it kicks in within a couple of years will make the practice of medicine a nightmare,” he said. “If it's not repealed, I guarantee you that within a decade we will have a single-payer system. And if I had to choose between Obamacare and a Canadian or British system, I'd choose the single-payer system. At least it would be rational.”


Read more: http://www.mysanantonio.com/news/local_news/article/Columnist-If-health-care-reform-act-is-fully-3392700.php#ixzz20c505vDV

Pushing my opinion of single payer aside (it is negative), How will it affect any medical specialty? Hell, it works(kinda) in other countries and they still get paid.
 
In fact - isn't it true that Canadian physician salary is pretty much a parity to US physician salaries?

Pushing my opinion of single payer aside (it is negative), How will it affect any medical specialty? Hell, it works(kinda) in other countries and they still get paid.
 
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A product of 1989 legislation, the Physician Fee Schedule went into effect on January 1, 1992. (And William Hsiao, PhD, whose study of Resource-Based Relative Value Systems was the foundation for the change from charge-based payment methodology, is still teaching at the Harvard School of Public Health today.)

The national anesthesia conversion factor (CF), unadjusted for geographic practice cost differences, was $13.68 in 1992, and the general CF for other services was $31.00. Twenty years later, the national anesthesia CF is $21.49, and the general CF is $34.04 – at least for the period ending on February 29, 2012. In mid-December, Congress passed the “Middle Class Tax Relief and Job Creation Act,” setting a zero percent update and postponing the scheduled 27.4 percent CF reduction mandated by the Sustainable Growth Rate (SGR) for just two months. If Congress cannot agree on a longer-term deal averting the SGR cuts, Medicare payments will drop as scheduled on March 1st. Anesthesiologists, nurse anesthetists and anesthesiologist assistants should all be listening for calls from the national associations, ASA in particular, for grassroots lobbying to eliminate the SGR and to block the cuts.

Readers who look at the numbers closely will notice two apparent anomalies. First, if there has been a zero percent update, why is the 2012 national CF $21.49, up nearly 1.7 percent from the 2011 CF of $21.05? The answer is that there have been technical changes to the structure of the Fee Schedule. Medicare payments for physician services have not been updated for inflation. The final Fee Schedule regulation for 2012 increases payment, however, for anesthesia and a number of other services by changing values as recommended by the AMA/Specialty Society Relative Value Update Committee (RUC), in budget neutral fashion. Anesthesia also benefits from the continuing transition to new data for the practice expense component of the CF.

Second, the percentage change in the anesthesia CF between 1992 and 2012 is quite a bit larger than the increase in the general CF. This does not mean that anesthesia has fared better under the Fee Schedule than other types of services. No other specialty’s Medicare payments plunged as sharply as anesthesiology’s upon implementation of the Fee Schedule – from $19.27 in 1991 to $13.68 in 1992, a drop of 29 percent. After 1992, the relative values for different types of services were adjusted at different times using varying methodologies and data. Despite the larger percentage increase over the past 20 years, it is still the case that Medicare payments for anesthesia lag those for other services relative to commercial payments.
 
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Medicare pays $21 per Unit

Average Private Payer pays around $66 per unit.

Do the math on this Slim. This means that in 2017 once ObamaCare is in full swing the vast majority of your patients will be paying you $17 per unit (Cuts are coming to Medicare real soon) while the few remaining private payers are $70 per unit.

Now, what happens once the Medicare Option becomes a reality as the govt. realizes it needs more revenue to pay for ObamaCare? What happens once the health care system goes OBAMACARE for all in the near future? Can you live off $17 per unit?

It's ugly in Anesthesias because our Medicare Conversion factor is 1/3 the private rate while the other specialties get 3/4 the private rate.

The $17 unit CF is CRNA level pay right now.
 
For everyone that is doom and gloom please look at this months A&A and read the articles looking at the history of anesthesia and notice how the same arguments regarding mid levels and physicians were occurring in the 1920s....healthcare is changing and we will adapt and evolve and will be just fine

I am zero percent worried about CRNAs...he are producing a far weaker product than our residency programs
 
CA-1 here. For the love of god stop obsessing about money all the time. Anesthesia is great, even if I end up making 150k per year with a couple weeks vacation. Blade needs to relax

Anesthesiologists are way way way overpaid as it is. Especially those who supervise, whether its residents or CRNAs or AAs. I've seen all these attendings say how hard it is as how they all deserve more pay. But please, give me a break. Anesthesia, while
Complex, is very master able in 3 years of residency. So sack up and work hard and be happy making what you make. As residents we make very little and do most of the actual work
 
CA-1 here. For the love of god stop obsessing about money all the time. Anesthesia is great, even if I end up making 150k per year with a couple weeks vacation. Blade needs to relax

Anesthesiologists are way way way overpaid as it is. Especially those who supervise, whether its residents or CRNAs or AAs. I've seen all these attendings say how hard it is as how they all deserve more pay. But please, give me a break. Anesthesia, while
Complex, is very master able in 3 years of residency. So sack up and work hard and be happy making what you make. As residents we make very little and do most of the actual work

Wow. That's quite a comment Slim. We are overpaid but the CEO earning $100 million a year or the Pro-Athlete getting $60 million is worth every cent.
 
CA-1 here. For the love of god stop obsessing about money all the time. Anesthesia is great, even if I end up making 150k per year with a couple weeks vacation. Blade needs to relax

Anesthesiologists are way way way overpaid as it is. Especially those who supervise, whether its residents or CRNAs or AAs. I've seen all these attendings say how hard it is as how they all deserve more pay. But please, give me a break. Anesthesia, while
Complex, is very master able in 3 years of residency. So sack up and work hard and be happy making what you make. As residents we make very little and do most of the actual work


$150K per year? You are so clueless I won't even respond further.
 
I agree, those individuals are overpaid as well. But that's not what we are talking about, is it?

If you could stay on point, that would be great.

I have a degree in accounting and worked for a large accounting firm before starting med school. Pretty sure I know how to budget. I drive a corolla. I have a home, which I have a morgage on. I have a wife and a 3-year old. And somehow, earning around 90k per year between the two of us, we manage to have a pretty nice life. After I finish residency, if I make 150k per year our family income will be right around 200k per year. I don't need a BMW or a mansion. I'm happy with my life.

It's fools like Blade who need so much more to justify happiness.

And even now as a resident, I make loan payments each month for my school loans.

So sure, if I get an anesthesia job for 300-400k per year that would be amazing. It means more savings. Which would be fantastic. But at the end of the day, how much do you really need?
 
I agree, those individuals are overpaid as well. But that's not what we are talking about, is it?

If you could stay on point, that would be great.

I have a degree in accounting and worked for a large accounting firm before starting med school. Pretty sure I know how to budget. I drive a corolla. I have a home, which I have a morgage on. I have a wife and a 3-year old. And somehow, earning around 90k per year between the two of us, we manage to have a pretty nice life. After I finish residency, if I make 150k per year our family income will be right around 200k per year. I don't need a BMW or a mansion. I'm happy with my life.

It's fools like Blade who need so much more to justify happiness.

And even now as a resident, I make loan payments each month for my school loans.

So sure, if I get an anesthesia job for 300-400k per year that would be amazing. It means more savings. Which would be fantastic. But at the end of the day, how much do you really need?

Slim,

How much was your education and sacrifice worth? What is the fair market value for your services? You are welcome to give all your money away when and if you earn it. But, please leave the rest of us out of your personal decisions.

As for this field not being "hard" you are either foolish, ignorant or both. Every day I go to work hoping and trying to avoid any complications which could have dire consequences for my patients. The more patients/anesthetics I do the more I worry something will go wrong.
 
And I'm about as anti-CRNA as you can get. It saddens me that we allow people without proper training to perform anesthesia. And they publish bs studies to so equality, poorly designed studies. Lies in fact. But bottom line is that CRNAs make about what MDs should be making. Anesthesia is a great field. Fun procedures, intricate cases. But it's mostly just algorithm driven. One of the reasons I love it. An algorithms can unfortunately be taught to unskilled laborers. Which is why I still feel anesthesiologists who do strictly OR cases are overpaid.

I'm a realist. And if I didn't love what I did, I never would have gone that route
 
And I'm about as anti-CRNA as you can get. It saddens me that we allow people without proper training to perform anesthesia. And they publish bs studies to so equality, poorly designed studies. Lies in fact. But bottom line is that CRNAs make about what MDs should be making. Anesthesia is a great field. Fun procedures, intricate cases. But it's mostly just algorithm driven. One of the reasons I love it. An algorithms can unfortunately be taught to unskilled laborers. Which is why I still feel anesthesiologists who do strictly OR cases are overpaid.

I'm a realist. And if I didn't love what I did, I never would have gone that route



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And I'm about as anti-CRNA as you can get. It saddens me that we allow people without proper training to perform anesthesia. And they publish bs studies to so equality, poorly designed studies. Lies in fact. But bottom line is that CRNAs make about what MDs should be making. Anesthesia is a great field. Fun procedures, intricate cases. But it's mostly just algorithm driven. One of the reasons I love it. An algorithms can unfortunately be taught to unskilled laborers. Which is why I still feel anesthesiologists who do strictly OR cases are overpaid.

I'm a realist. And if I didn't love what I did, I never would have gone that route

ObamaCare will fix the problem of overpaying Anesthesiologists for doing "unskilled labor" in the O.R. You will indeed have the privilege of earning current CRNA pay for Anesthesiologist level work in the future.

Clearly, you hit your head a few too many times as a child.;)
 
I went to my state med school. Tuition about 19k per year. No college loans.

Sacrifice? Med school is still just that, school. I studied and worked hard. But still had Christmas vacation. I enjoyed med school, loved my internship, and feel really comfortable with anesthesia so far.

Anesthesia can at times be stressful. But if adequately prepared, it's smooth sailing most of the time. I like the hard cases. Maybe it's ignorance because I'm still technically in training and liability is on my attending. But I try to take full responsibility for my cases.

Guys in my program mostly got pretty high paying job offers this year. Still with 4-6 weeks vacation per year. Mostly Pp, some academic. Most of us feel anesthesiologists are overpaid, but it's a great thing to be overpaid. I'm not noble; I would never turn down more money. But I
Do recognize what the value of the work really is...
 
I would say anesthesiologists should make around 150-200k per year and CRNAs around 70-80k
 
I went to my state med school. Tuition about 19k per year. No college loans.

Sacrifice? Med school is still just that, school. I studied and worked hard. But still had Christmas vacation. I enjoyed med school, loved my internship, and feel really comfortable with anesthesia so far.

Anesthesia can at times be stressful. But if adequately prepared, it's smooth sailing most of the time. I like the hard cases. Maybe it's ignorance because I'm still technically in training and liability is on my attending. But I try to take full responsibility for my cases.

Guys in my program mostly got pretty high paying job offers this year. Still with 4-6 weeks vacation per year. Mostly Pp, some academic. Most of us feel anesthesiologists are overpaid, but it's a great thing to be overpaid. I'm not noble; I would never turn down more money. But I
Do recognize what the value of the work really is...

My job is just as valuable as the Orthopedic Surgeon or Vascular Surgeon at the head of the table; in fact, without good anesthesia their jobs wouldn't be possible. Patients are now receiving the safest anesthesia care ever in the history of the world. Operations are now possible on even the sickest and oldest among us (not to mention babies in utero) all because of Anesthesiology.

So, what are my servives worth? A heck of a lot more than $150K in a society where new College Graduates with an Engineering degree (Bachelor's only) start at $125K.

At $150K the best and brightest won't enter the field but will choose other careers paying at least twice that amount. That's a fact you can bank money on.
 
I would say anesthesiologists should make around 150-200k per year and CRNAs around 70-80k

Really? Would you be willing to come in and do cases @ 2 am for 150k? How bout 18hr days for 150k? 24hrs in house in the hosptial? What about the high stress of stat intubations and difficult cases? How bout 60hrs/week and sometimes nights and weekends? PCPs make 150k b/c their in clinic and work 9-5 w/light home call. What we do is worth way more, on sheer hours and lifestyle perspective.

Live in the real world before making such comments. Your accountant experience isn't the real world when it comes to medicine. Live in a world where a 5pm day turns into a 7pm day b/c we got a few add ons or you have to leave your wife for a 1am case after working till 9pm b/c it needs to get done. How bout coming back to work @ 730 am after that 1am case b/c it's a busy day in the OR. Thats the real world of anesthesia buddy. Live it for a while and then tell me whether or not 150k is fair compensation for what we do.
 
I would say anesthesiologists should make around 150-200k per year and CRNAs around 70-80k

70-80k is about what RNs are paid where I'm from (COL not too high, but higher than average). Are they also overpaid? If not, do you still think it would make sense for an anesthesiologist to be making about twice as much as them?
 



My Dentist works 35 hours a week. No Holidays. No Nights. No weekends. Cash Business. He never did a Residency. He easily clears $175K per year and puts away another $50K per year in retirement.

I think my job is worth at least double the reimbursement of his job considering the hours worked, stress involved, Residency requirement of 4-5 years. Medical Degree, night time work, holidays, weekends, etc.
 
70-80k is about what RNs are paid where I'm from (COL not too high, but higher than average). Are they also overpaid? If not, do you still think it would make sense for an anesthesiologist to be making about twice as much as them?

Easily. Family practice earns double the salary of the average RN as it should be.
Anesthesiology being a more stressful and difficult specialty than Family practice should earn double Family Practice.

The free market pretty much got it right on the money.

RNs are free to get APNS and earn over $100K per year. Some APNs, called CRNAS, earn over $125K per year working less hours than that foolish Anesthesiologist who will work 50 hours plus including holidays/weekends for just $25K more.

Double the Education in Healthcare usually means at least double the pay (if not more).
 
Every time I hear a medical student tell me my job isn't that hard, it makes me bone-weary tired.

I'm not sure what to make of a CA1 who holds the same opinion 5 months in.
 
Real life example of medical school debt

Kevin | Education | April 4, 2011


by Pierce Hibma

Want to really understand the reality of US medical education debt? Then allow me to pull back the curtains to expose the financial monster that awaits me after I earn my MD.



I am a third medical student at a private medical school in the Midwest. Fortunately, I was able to graduate from college without any financial debt thanks to an athletic scholarship. Unfortunately, I, like many other medical students, pay for my entire medical education and living expenses through student loans.

The average medical school debt today, according to the Association of American Medical Colleges is $156,456. I can only wish that was true for me. Perhaps the best way to understand the burden of a current medical student’s debt is by example. Here is an approximation of my real-life medical school debt assuming I select forbearance during residency and repay the loan over 15 years:

Annual cost of tuition: $48,000
Annual cost of attendance: $67,500 (Includes costs of books/supplies, loan fees, health insurance, licensure fees, living expenses, and transportation allowance)

Total balance after medical school: $270,000
Amount subsidized: $34,000
Amount unsubsidized: $236,000

Interest incurred during 3 years of residency: $100,000
Total balance after residency: $370,000

Monthly payment after residency: $3,370 (180 total payments)
Interest incurred after residency: $237,000
Total repayment: $607,000

These financial conclusions were reached via the Association of American Medical Colleges’ Medloans Calculator. Again, these numbers are approximations and many different repayment plans exist, but it certainly highlights the massive financial burdens placed on today’s medical students
 
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