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Why do anesthesiologists make so much $$?

Discussion in 'Anesthesiology' started by wrx, 05.15.06.

  1. wrx

    wrx Member

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    SDN Members don't see this ad. (About Ads)
    No offense to any of you guys, but why do anesthesiologists make so much $$? During my surgery + Ob/Gyn rotation, the anesthesiologists at all the hospitals I rotated through did jack-squat. They put the patient out then do their crossword puzzle, read a book, or chit-chat. And they start out at ~300k?! :eek: They make more than the damn surgeon doing the case! What am I missing here??
  2. DrBowtie

    DrBowtie Responsible?!?! PGY3 Moderator Emeritus

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    They get paid well for the training they have when things go wrong. Just like pilots.
  3. Hoya11

    Hoya11 Senior Member

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    I think its along the same lines as a radiologist...who wants to do it?
    Who wants to be the assistant guy and not have there own patients after all this school/training? Thats the way a lot of people see it and there is a lot of demand, so the market is good.
  4. ultm8frisbee

    ultm8frisbee Member

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    You really must be a pud. Why don't you learn a little bit about the profession thru a rotation before you insult Anesthesiologists on our forum. I see that you want to be an internist, +200K to write orders and manage blood sugars and blood pressure, consult when you don't know what to do. Now that seems overpaid to me.
  5. Dryacku

    Dryacku Member

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    It has nothing to do "who wants to do it" if nobody wanted to do it then they wouldnt be two of the most competitive residency right now.... think before you speak...

    secondly... they get paid so well because in 95 percent of codes on the OR table the surgeon will have no clue what to do... also because behind every case there maybe many pre procedures... blocks, central lines, ....

    finally i am interested in anesthesia simply because I love pharm and physio.. name other speciality that uses these subjects as much as anesthesia does?
  6. Monty Python

    Monty Python She's a witch Gold Donor

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    Several reasons:

    1. From Economics 101: the Law of Supply and Demand, combined with free market capitalism, consumer-driven level of usage, and insurance reimbursement schedules. It is what it is.

    2. Because one screw up in less than 30 seconds and you have a dead patient on your hands, or even worse, one still with a beating heart (potentially for decades yet) but brain-dead. That's called compensation commensurate with responsibility.

    3. Because if you're good, it looks like you're not really working, especially to the untrained eye.

    Why don't you complain about what ambulance-chasing malpractice attorneys make, simply by filing nonsense lawsuits which are cheaper to settle than defend (and prove to be spurious)? Those attorneys are making megabucks, working 9-5 M-F with two hour steak lunches, never on call, full weekends to devote to pastimes and family, etc.

    Or better yet, ask why the Mississippi River pilots (who get on the ocean-going ships at the mouth of the river, and direct their course upriver to the port of New Orleans or Baton Rouge) make $400,000+/yr, working 26 weeks out of the year, with essentially a trade school diploma. Compensation commensurate with responsibility.
  7. MacGyver

    MacGyver Removed

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    Unfortunately, lawyer salaries arent regulated by the federal government. Doctors are in the unfortunate position of having their income dictated by bureaucrats in Washington DC

    Pilots work in a free market, doctors dont

    The bottom line is that doctors incomes, especially specialty docs like gas, are going to plummet once universal healthcare takes over. Its just a matter of time. Some government bureucrat is going to see that gas docs average 300k and say "hmmmm..... govt could save a lot of money by cutting these guys down to say 120k. AFter all thats still in the top 1% of income earners so they have no right to complain"
  8. jetproppilot

    jetproppilot Turboprop Driver

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    GO TRIN GO...

    And thanks for the support...but most likely you are replying to some militant CRNA looking to stir the pot here.

    Thank God for professionals like you.

    And for the Newbies out there, I had the privelege of working with Trinity in my previous group.....a CRNA dude that exemplifies their profession.

    I wish my posting colleagues out there who have a distorted perception of CRNAs as a result of militant CRNA trolls on this site could work with you, Trin.

    And by the way, Trin speaks the truth of the River Pilot profession.

    Yeppers.

    400 Large annually for a job that requires some intricate training and ability, yes, but after the training phase is really, really, really cush.

    But one cannot aspire to be a river pilot since these jobs are owned and passed down within families. Yep, blatent nepotism.

    I'd trade my gig for that gig in a heartbeat.

    But no worry. I dont have a chance.

    My Dad/Uncle was not a river pilot so I can't, even if I wanted to.
  9. militarymd

    militarymd SDN Angel

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    The OP is probably a [​IMG]

    but I'll still answer.

    Anesthesiologists don't all make a lot of money....only the good ones that good hospitals want.

    I suspect that most don't make a very good salary. There are enough bad ones out there that many good hospitals are willing to subsidize groups in order to attract and keep quality anesthesiologists.
  10. wrx

    wrx Member

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    like I said, I didn't mean to offend any of you. This is just a (crude) observation during my time in the OR. I'm sure some of you during your surgery rotation had similar observations no? And yes, there's prob alot more that goes on behind the scenes. My question is, what am I not seeing?

    ultim8frisbee- take a f'in chill pill... I dont know what' i'm going into (internal is default). That's why I'm here.
  11. jetproppilot

    jetproppilot Turboprop Driver

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    :laugh: :laugh:

    OK, Bill Clinton.

    I love the clairvoyant unexperienced.
  12. jetproppilot

    jetproppilot Turboprop Driver

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    Yeah, OK bro.

    :barf:
  13. jennyboo

    jennyboo Senior Member

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    Sure. There IS a lot going on, but you can easily read the FAQ at the top of the forum (or go and do a rotation) to see it for yourself.

    But as for where the money comes from.... jet once made a pretty good explanation which I wouldn't be nearly so good at making, and in fact I'll probably get some of it wrong.... but, overly simply, you have:

    many procedures + low overhead (no office, malpractice not as high as some fields) = bigger margin.

    Ask any family doc what makes the money. You can spend months tweaking a patient's antihypertensives, but five minutes to clip some toenails or do a punch biopsy and you make several times as much, all at once. Procedures pay. Anyone who does procedures all day for a living is going to make more than anyone who prescribes meds all day. Plus, surgeons have to pay for running an office as well, which is not a small amount of money.

    But you're on the anesthesia forum, so don't be giving attitude. You might regret looking stupid. ;)
  14. jetproppilot

    jetproppilot Turboprop Driver

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    Jennyboo speaks the truth.

    For whatever reason, specialists make more money than primary care docs.

    And specialists who can do high volume make much more than primary care docs.

    I didnt make the rules.

    Don't hate the playa.

    Hate the game.
  15. wrx

    wrx Member

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    I have no problem looking stupid on this forum. Better here than in real life.

    For the anesthesiologists who I see in the OR all week, they can't possibly be doing that many procedures between cases. Yea, if you're doing a crapload of procedures outside the OR, I can understand that. But if you're in the OR all day and making 300-400k, that seems like alot of money for relatively little work. Especially in comparison to the surgeon who makes ~250k and is doing what I consider hard work.

    my observation still stands, until my elective proves me wrong... anesthesiology gets paid very well, if not too well.
  16. f_w

    f_w 1K Member

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    When it comes to $$/education, nothing beats the crane operators in Long Beach.
    It is a manual skill, still they run somewhere in the 200k league.

    And why ? because they determine the productivity of the harbour. 5 containers extra per hour (and no container dropped, no truckdriver crushed, no china broken) translates in $$ for the harbour that turn 200k per year into pocket change (their mafia affiliation doesn't hurt either, the harbour knows that if these guys walk off the job, walmart grinds to a halt and millions of people will have to get their cheap sh### from china elsewhere).
  17. jetproppilot

    jetproppilot Turboprop Driver

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    So whats your point, Slim?

    I've gotta buddy from med school who is a private practice dermatologist making 750k a year. Long days (6-7pm) but no weekends, no holidays, no nights.

    I have an interventional radiology buddy who works his A S S off (yes, friends, some rads dudes work very hard) making close to 800 large.

    2 ENT buddies who fill their partner-owned surgery center with PETs, t&As, and FESSs...making seven figures....

    Another dude who guided me through my pre-med years with atta boys , plastic surgeon from my home town, who owns his own surgery suite, and sculps the female body for a living....cash only...up front, before the procedure....just under 2 mil a year. Dude works no weekends, no holidays, no nights.

    we all have our niche, Slim.

    And in your naive, unexperienced mind, you can try and equate knowledge level/responsibility/hours/stress-level/lifestyle with compensation.

    Save your rationalization for some other forum.

    Anesthesiologists, for the most part, work hard at work, sometimes taking care of the critically ill....and sometimes it is at 2AM on Christmas Day.

    Save it.
  18. stephend7799

    stephend7799 Senior Member

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    anesthesiologists dont make more than said surgeon for that particular case.. Very rarely will an anesthesiologists make more than the surgeon for that particular case.. The reason we make cumulative more money than SOME surgeons.. not all.. is because more of the anesthesiologists time is billable..
  19. Monty Python

    Monty Python She's a witch Gold Donor

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    I had my annual skin screening last week. Five minutes, plus another one minute to spray some nitrogen on two pre-cancerous spots on my forehead. Six minutes total contact time = $220 after hospital employee discount.
  20. jetproppilot

    jetproppilot Turboprop Driver

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    Actually, ignore my previous post. It was all B.S.

    The true reason we make big-bank is because we're rokstars.

    I'll betcha Mil/UT/Noy can't get through an airport without bodyguards protecting them from the paparazzi.

    Autographs only after the security line, folks.
  21. gasdoc1

    gasdoc1

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    I have been a lurker for a while, but this thread hit a nerve and I fealt I must respond.
    Personally, I dont think there are any doctors that make too much money, but there are plenty that dont make enough. In my doctor's lounge I have often heard the FPs and internists complain about the money that we make. Personally I think they do all doctors a disservice with this kind of talk. If anesthesiologists earned less, that would not bring up their respective incomes.
    My 2 brother-in-laws went to wall street straight out of college and they both earn at least 3 times my salary. Hell, their bonuses alone are more than my salary, and one of them is only 27 years old. They both work very hard, but they didn't make nearly the same sacrifices that we, as doctors have made.
    So instead of focusing on how much anesthesiologists get paid, try focusing your energy on how you can get paid what you are worth.
  22. jetproppilot

    jetproppilot Turboprop Driver

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    :laugh:

    ME, DUDE. ME.
  23. wrx

    wrx Member

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    alright, alright... my opinion is obviouly getting people very worked up...

    Someone delete this thread before I get death threats...
  24. jetproppilot

    jetproppilot Turboprop Driver

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    :laugh:

    This post is like David Duke going to the NAACP website and, after posting racial remarks, saying:

    "alright, alright....my opinion is obviously getting (colored) people very worked up..."

    "Someone delete this thread before I get death threats."
  25. ultm8frisbee

    ultm8frisbee Member

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    See you later punk.
  26. CanGas

    CanGas Member

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    Gonna have to call BS on this one. Here in Canada we happen to have a universal healthcare system since the 60's (which despite it's faults does work, check out our infant mortality and cancer care numbers). Jo blow rural anesthesist makes $220-300k cdn (currently at 0.91 USD). City anesthesist $300-450k. Academic centers (ie. biggest hospitals) in well to do provinces (BC, AB, ONT) can be salaried for $450-500k with 8+ wk vacation. Sure there are pressures to bring it down but you trying to tell my your HMO's are trying the same? Supply and demand my friend.

    P.S. There are 40 million uninsured Americans. There are ~32 million people in Canada. It blows my mind to think our entire healthcare system could be complely filled with uninsured people paying squat or being bankrupted.
  27. lvspro

    lvspro ASA Member

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    I'll take a molson golden, aye.

    +pad+
  28. vegas

    vegas Member

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    Okay, this issue has been revisited over and over. It's getting quite boring IMHO! Isn't there an ignore button around here somewhere...or someone just redirect this dude to those threads, I'm just too lazy to do it myself.
  29. MacGyver

    MacGyver Removed

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    Considering that the AVERAGE canadian doctor across all specialties barely makes 120k, My guess is that your data must be anecdotal and not representive of gas docs in Canada at large.

    And now, I have some proof to back up my claim that Canadian MDAs get paid squat.

    http://www.cas.ca/members/sign_in/newsletter/v17_04/default.asp?load=04

    Working 40 hours per week, $64/hour comes out to just over 130k PER YEAR. THATS IN CANADIAN DOLLARS, BEFORE TAXES, WHICH MAKES THE COMPARISON TO US MDAS EVEN WORSE.
    Of course, this is just referring to one province, but there's no way in hell you are going to tell me that the other provinces pay MDAs DOUBLE that amount.

    So if you want to claim mthat gas docs REALLY average 200-300k, then I want a link, because nothing i've seen suggests that canadian docs make anywhere CLOSE to that amount
  30. Hoya11

    Hoya11 Senior Member

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    Wow the gloves come off when the discussion turns to money huh?

    Just because a residency is competitive doesnt mean a lot of people want to do it, ie plastics, derm, urology... and besides anesth is NOT that competitive, almost any US Grad who passes the boards able to command 300k+. You cant say that for almost any other residency, and yet year after year it is not super-competitive.
  31. lvspro

    lvspro ASA Member

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    After the traditional specialties, IM, peds, surg, psych, OB/GYN, it had the largest number of applicants, which indicates that a lot of people want to do it. The competitive part you mentioned is partially true, but over the last 3-5 years, we have seen a change in the accepted applicant demographic. It used to be a ton of IMG's, but is becoming popular with US grads. Also, said US grads are not the bottom feeders, but are quite competitive ie, 215, good 3rd yrs, strong LOR's etc. This indicates a trend towards being a more competitive specialty, but still not one that is unattainable by your reasonably good US candidate.

    +pad+
  32. fakin' the funk

    fakin' the funk ASA Member

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    hehe. a li'l corner of the OR and a stool, i'd say that overhead is pretty low! :D
  33. chicamedica

    chicamedica 1K Member

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    funny, cause 10 people at my school didn't match anesthesiology this year (first time that ever happened in a long long time). They all passed the boards btw. ;) True it's prob not as competitive as derm or plastics (dont know about urology), but that may be simply because there are more spots in anesthesiology. Everyone and their mother wanted to do anesthesiology this year.
  34. CanGas

    CanGas Member

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    Sorry my friend but you are so far off it is not even funny. There is no way the "AVERAGE Canadian doctor across all specialties barely makes 120k". I'm probably the most business oriented in my class so I have to say I'm not pulling these numbers out of my ass. Know a interventional cardiologist who is going to AB, starting $750k. Same for Thoracic surgeons.

    How about I just stick with British Columbia as the government makes this data easily available. First some RAW data then some details.

    Check out: http://www.hlth.gov.bc.ca/msp/paystats/IRM/practitioner.pdf
    Total Number of Practitioners, Services and Expenditure by Specialty
    This gives gross FFS billing data. Take the gross expenditure and divide by # of practitioners to get a rough average. Be aware that this is only FFS billings and does not take into account private practice, other sources of billings (workers comp, insurance, ect) and does not cover the salaried MD's. Also does not account for those working part time.

    Specialty Practitioners Services Expenditure
    General Practice 4,629 23,684,535 $760,104,435 = $164,204 each (again, part -timers bring down the average)
    Ophthalmology 180 1,336,285 $86,852,450 = $482,513 each
    Dermatology 64 563,619 $18,004,307 = $281,317 each (and you know they are making more than that at >50 visits/day)
    Radiology 263 2,619,269 $149,724,574 = $569,294 each
    Anesthesia 412 2,165,973 $86,167,538 = $209,144 each (and remember in BC alot of rural communities are run by GP-Anesthetists working anesthesia part time 1-2 days per week so they will bring down the average)

    Subtotal: 8,271 65,949,206 $1,956,374,356 = $236,534 average for all INCLUDING GP's

    For exact details the BC government publishes the billing data for EVERY individual MD billing FFS in BC.
    http://www.hlth.gov.bc.ca/msp/legislation/pdf/bluebook2005.pdf

    Again, does not take into account salary, private, and overhead but take a look through to see how well your claim to $120k stands up.

    I try to only make statements and claims I can back up with hard data. There's my data direct from the BC government.

  35. MacGyver

    MacGyver Removed

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    come on man thats a joke. A typical US doctor BILLS for over a million dollars per year, but yet the AVERAGE INCOME is only 150k in the states. So dont show me aggregate billing data because that says NOTHING about average salaries.

    Unlike you, I have real income data, not abstract billing data which is meaningless because of overhead costs.

    As I said, the average canadian doctor income across all specialties is somewhere around 120k in Canadian dollars, which is something like 100k in US dollars, and thats BEFORE TAXES, which are higher in Canada. Read it and weep.

    http://cahspr.ca/conference04/proceedings/Slade_pres.pdf

    Attached Files:

  36. CanGas

    CanGas Member

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    Well I will refute this and I think I will stop with that as it seems to me you are interested more in my reaction than the data. I find it interesting that you don't believe me even though I am working in that system and I DO know what my staff are making (remember, I know what their names are and can look them up in the Blue Book, I have also asked them directly) and they don't pay overhead because they are Anesthetists. I also know what the graduated R5's made last year in their first year of practice, again no overhead. My numbers are true while your's are misleading.

    You say "dont show me aggregate billing data because that says NOTHING about average salaries" but the "real income data" you show is nothing but aggregated data from Census Canada and other sources. Declared income? Please, the majority of Anesthetists in Canada are incorporated so that is a useless number. Besides, if you read the bottom of the slide where you get the average $120k income number you will notice that that data includes interns and residents, something which looks to have been accidentally cut from your screenshot. Ahem, I don't know about others but my salary will sure bring down the average.

    So for those of you Canadians going into Gas, my original numbers stand.

    Jo blow rural anesthesist makes $220-300k cdn (currently at 0.91 USD). City anesthesist $300-450k. Academic centers (ie. biggest hospitals) in well to do provinces (BC, AB, ONT) can be salaried for $450-500k with 8+ wk vacation. Numbers will vary somewhat on the Province.

    Does not matter for you USA folks as politics means that you generally can't practice in Canada and I can't get board certified in the US.

  37. cfdavid

    cfdavid Removed

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    As a general response, very few people that make lots of money in this world actually get paid for what they "do", but rather from what they know.
  38. jwk

    jwk AA-C ASA-PAC Contributor

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    Plenty of Canadian docs seem to come south of the border for the $$$ (several at my facility, all cite $$$ as a factor). I wonder how many US docs go north?
  39. Mman

    Mman Senior Member

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    Very well said.
  40. SouthSideSteve

    SouthSideSteve

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    Like Jet I'm not seeing a problem with the above...
  41. Atropine

    Atropine Junior Member

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    How come orthopedists make so much money when I can do the same thing with a hammer and chisel from Ace Hardware?
    How come gynecologists make so much money when all they do is stick fingers up a girl's #$%@^?
    Why do gastroenterologists make so much money for looking at someone's sh_t all day long?
    Why do radiologists make so much money for mumbling in a dark room(possibly without any pants on)?
    Why do oncologists make so much money when all they do is poison patients and never cure anybody?
    Why do Rad-Onc docs make so much money when all they do is sit on their ass and press irradiating buttons all day long?
    Why do dermatologists make so much money when they don't know anything and just inject steroids all day long?
    Why do psychiatrists make so much when all they do is lock the crazies up and f_ck them up more with their drugs?
    Why do internal medicine docs make so little taking it up the rear from all other docs?

    Sh_t... What's wrong with me? I changed my mind--moderator please delete this post and delete my membership.
  42. ultm8frisbee

    ultm8frisbee Member

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    :thumbup:
  43. Sammich81

    Sammich81 Senior Member

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    Hahahahahahahaha. Although I have to say you really would have to pay me upward of seven figures to be looking at doodie all day long. Or be the catcher for all the other specialties. The other day (I'm on a medicine rotation as an MS3) we had to admit a neurosurgery bounce back...dude the guy was like 3 weeks post-op....clean up your own messes, damn! I don't know what the heck to do for neurosurgery complications.
  44. MacGyver

    MacGyver Removed

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    You keep saying this without giving me any links for proof. Unlike you, I actually gave real income numbers, not BS billing data.

    BTW, you ignored my first link showing that canadian gas docs make as little as $64 per hour, which comes out to about 130k canadian

    I've got links, you dont. Therefore I win. :D
  45. MacGyver

    MacGyver Removed

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    Oh look what I found, another piece of evidence showing that canadian docs get paid squat relative to US docs. Its a little dated, but considering that real income for both canadian docs and US docs has declined in recent years, its still acceptable.

    CMAJ, 3/21/00, 162:6

    So thats 116k canadian for SPECIALISTS alone, with GPs removed from the average. And you are going to sit there and claim that gas docs AVERAGE over twice the amount for all specialists? I got one word for that: BS

    Attached Files:

  46. jetproppilot

    jetproppilot Turboprop Driver

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    Yeah, I gotta go with Mac on this one.

    Remember my previous post on this thread about my interventional radiology buddy makin' 800 large?

    He's from Canada.

    He's never heard of the numbers quoted by the poster being made by canadian doctors.
  47. f_w

    f_w 1K Member

    Joined:
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    SDN 5+ Year Member
    Actually, 2 years ago I looked at some jobs north of the border. It is not the same money as in the US, but certainly more in 'Cangas' range than in 10 year old mac gyver data. True, canadians move south, but mainly in the specialties. PCPs don't look at that much of a gradient, and for them the limitations in high-tech toys available to canadian specialists are not so much of a disincentive to staying.

    One thing to note is that practice overhead in canada is far lower than in the US. Malpractice premiums are lower and due to the single payor system, administrative expenses are minimal. The slide set Mac linked to quotes 25% overhead for specialists. So even if you took the average payout from the provincial goverment in new brunswick at 250k, at an overhead of 25% you are still looking at a 185k pre-tax (the flaw is that the billings for a specialist are bound to be far higher, looking at specialist practice opportunities up there you often look at 350-500k in average billings)
  48. nimbus

    nimbus Member Gold Donor

    Joined:
    01.13.06
    Messages:
    542
    SDN 7+ Year Member
    Anyone else notice there was $220,000,000 expenditure to 134 pathologists in McGyver's link? Was this all for professional fees or does this include lab tests not compensated to pathologists?
  49. doc2b34

    doc2b34 Anesthesiology

    Joined:
    01.04.02
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    Location:
    Sunnyvale, CA
    Status:
    Medical Student
    SDN 7+ Year Member
    You Go Boy!!!!!!!!!!!

    WRX is a med student and already judging, don't do that. :smuggrin:
  50. daelroy

    daelroy Senior Member

    Joined:
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    Messages:
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    SDN 7+ Year Member
    I'm going with CanGas on this one. Think about our salary survey's in the U.S. We all know people earn far more than is reported on those surverys. Physicians and other health care professionals purposely underreport their income for several reasons not to mention keeping trial lawyers and the IRS away. Those surveys also include academic salaries which are nearly half of those in private practice. And then many of those surveys take their information from W2's which we know are manipulated by accountants to report the least income possible to enjoy the most tax benefits.

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