These are all great questions. Something you'll find about the specialty is that the answers to the questions is VERY variable, depending on your location and what group model you practice under.
I'd say most anesthesiologists work about 45-50 hours a week, but the distribution is variable day to day. I have 3 partners. 2 of us are on days during the week, one guy is on nights, and one guy is on vacation. So we work 2 weeks days, one week nights (which includes your 48 hour weekend call), then a week off.
During the week, one dude is late MWF, meaning he stays til 5pm when the night guy gets there. He is the "late" dude. The other MD stays until the late guy can handle the days occurrences in the OR and OB, typically until 1-3pm.
Our night week is long because it includes the weekend, but what we've done is consolidate our misery into one week, giving us 2 weeks of day work only, and the other week (in the 4 week cycle) is the off week.
How a group prefers to cover the hospital is limited only by your imagination. As long as everything is covered, your schedule is left up to you (meaning the doctors in the group). Do the MDs like to consolidate their work stretches, giving everyone bigger blocks of off time? Do you prefer to have a day off every 4 days but take less weeks of vacation? Again, a group can be creative.
Salaries are very varied. The lowest salary out of my anesthesia buddies is 270k, a friend of mine who is the sole MD at a 4 room surgery center. He is usually home by 2pm. No weekends, no call, no nights, no holidays.
The highest salary is 750K, a buddy of mine in a small town with 2 partners, he is on call every third night but his call nights are not bad. He works most post call days until around noon. He works every 3rd weekend, takes alot of night call (albeit from home and gets sleep most of the time).
Most anesthesiologists in the south are in the 350-400 range.
Its hard to answer your question about stress since I think this is largely personality based and dependent on how comfortable you are with your job. I remember working with an attending when I was a resident who had a high stress level no matter what the situation was (he's a chairman now
).
Anesthesia has "stressful" situations arise on a fairly regular basis...crash c sections, difficult airways, obese patients who desaturate in 10 seconds despite adequate oxygenation, procedures like IJs/subclavians/epidurals/regional blocks made difficult by the obesity thats prevalent in this country, etc etc. If you are comfortable with anesthesia, though, and deft with procedures, these situations are more of a pain in the ass than stressful. And as your career progresses, administrative/scheduling/intra-group conflicts become the most stressful stuff. Urgent/critical situations become just part of the job.
I'd rather deal with a CANT INTUBATE, CAN HARDLY VENTILATE situation over resolving a CRNA scheduling issue (
Dialogue from one of our CRNAs:"Dr Jet, Janet decided to pencil herself out of the schedule on Friday...but it wasnt authorized...we cant have this happening....can you talk to her?") any day of the week. I know how to handle/resolve the former. I'm still searching for answers on the latter.
But referring solely to clinically stressful situations, its probably one of the more stressful specialties, compared to the primary cares, psychiatry, etc. But you learn to deal with situations and they become not stressful anymore.
The pros of being an anesthesiologist is that its a cool job, you take care of patients, you get to perform cool procedures regularly, you become deft at critical care (if your case load dictates) , and you not only become deft at hemodynamic manipulation, you can do it YOURSELF. Follow me on this, because this part of the job is VERY gratifying and often overlooked.
Lets take a pulmonary critical care doc, for example. Very smart dude. Knows pulmonary physiology, vent management, knows pharmacology. But you know what? Our medicine trained critical care colleagues dont know ANY of the technical aspects. They know how nitroglycerin works, and they know how to write an order that says "titrate NTG to 130 systolic"....and the ICU RN does the rest. Most medicine trained MDs know when a pt needs intubation, but they arent great at airway management; know when they need an A-line but arent great at placing them; know when they need a central line but arent great at them. Most medicine MDs can float a SWAN but its a big ordeal for them.
All the above can be done by an anesthesiologist while thinking of the recent stock run-up of Whole Foods, or daydreaming of his Robalo center console boat. Things that are stressful to medical trained MDs are knee-jerk actions to an anesthesiologist. Pt in the ICU is coding??? The medicine dude is either freaking out, or he is calmly waiting for support to arrive to carry out what he knows needs to be done. The anesthesiologist knows how to command the airway, slam in a TLC if central circulation access is paramount, and bolus drugs to manipulate the hemodynamics. All while thinking "I'm feeling like spaghetti for dinner tonite...".
How many times have you arrived in the ICU with a CABG and seen, say, a transient hypertensive episode? Medicine dude says to the RN "start a NTP infusion." No need for that if youre an anesthesiologist. Take a 10mL syringe, pull out a couple hundred mikes of SNP outta the bottle, and squirt it into the central line. Problem solved. NOW tell the RN she MAY need nitroprusside, so be ready if the BP rises again.
Point being, we not only know what needs to be done, but we can
perform what needs to be done in seconds.
Other pros are salaries in the top 10% of all MDs, with a great lifestyle to boot.
The cons of being an anesthesiologist, in my opinion, is that your group provides 24/7 coverage, which means you work your share of nights, weekends, and holidays. Nights suck. Period.
Malpractice for anesthesiologists is reasonable. In my area its around 27-30K annually.
In academia, you may see specialists that do only hearts, OB, etc. This is not the norm in the private world. You are the jack of all trades, and depending on what day it is and where you are on the "list", you are the designated OB dude one day (usually in addition to handling some OR cases), you handle the big cases when you are call-dude another day (hearts, thoracotomies, etc), etc.
All in all, if you have to work for a living, being an anesthesiologist is a great job. The pros far exceed the cons.
