7-Figure Anesthesia Salaries?

[chmd]

I always hear people saying get a job in BFE and pay off debt early on. Would being single and without a family be a hindrance to securing a BFE job? Also are BFE practices less likely to hire someone who only plans to stay <3yrs?

Being single and without ties to a semi rural or rural area would be a sign that you'd be more likely to leave and therefore would make you less hireable.

But you seem to miss that partners make the big money. You don't get to be partner until you've been somewhere for 1-3 years. Why would you be an employee somewhere for 2 years and the leave after making big partner dollars for only a year?

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[IkeBoy18]

Being single and without ties to a semi rural or rural area would be a sign that you'd be more likely to leave and therefore would make you less hireable.

But you seem to miss that partners make the big money. You don't get to be partner until you've been somewhere for 1-3 years. Why would you be an employee somewhere for 2 years and the leave after making big partner dollars for only a year?

I figured that I would be a flight risk given the circumstances. Thank you for the info, I know making partner could be three years but I wasnt sure if BFE paid better in general, partner or not. This info would make it less likely that I go to BFE.

 

[IkeBoy18]

It was a poorly paid attending position.
But a good experience overall for a number of reasons.

I definitely want to do my own cases at least the first 5 years out, and given the current landscape, I will probably end up in BFE just for that reason.

 

[Carbocation1]

According to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. Does this not bode well for the job market for future grads?

 

[deleted50478]

According to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. Does this not bode well for the job market for future grads?

No! It increases the likelihood that they will sell their contracts to an AMC and make the job market worse before they retire.
Younger people don't sell because they don't want to work for the AMC they'd sell to and they have more than the 5 years of income guarantee left in their careers.

 

[Carbocation1]

No! It increases the likelihood that they will sell their contracts to an AMC and make the job market worse before they retire.
Younger people don't sell because they don't want to work for the AMC they'd sell to and they have more than the 5 years of income guarantee left in their careers.

But won't this give more bargaining power to prospective employees?

 

[nimbus]

According to the AAMC careers in medicine page for anesthesiology, 70% of anesthesiologists are over age 45 and 40% are over age 55. Does this not bode well for the job market for future grads?

The numbers don't necessarily indicate what you think.

Remember the average anesthesia grad is 30 years old. A typical career spans from age 30-65, but many of the 40% over 55 are already only working part-time. The midpoint of an anesthesia career is age 47-48, but many people slow down shortly thereafter. So those stats don't really predict a shortage of anesthesiologists. If anything the recent expansion of program sizes is likely to cause an oversupply.

And people shouldn't kid themselves, young people would sell out too for the right price.

 

[deleted50478]

The numbers don't necessarily indicate what you think.

Remember the average anesthesia grad is 30 years old. A typical career spans from age 30-65, but many of the 40% over 55 are already only working part-time. The midpoint of an anesthesia career is age 47-48, but many people slow down shortly thereafter. So those stats don't really predict a shortage of anesthesiologists. If anything the recent expansion of program sizes is likely to cause an oversupply.

And people shouldn't kid themselves, young people would sell out too for the right price.

That's true, but the price would be much higher/less likely to be offered/less likely to happen.

 

[pgg]

It's reasonable to think that a lot of anesthesiologists who were on the cusp of retirement in 2008 when the markets crashed kept working to rebuild their portfolios.

The market has doubled since then. So ... maybe the blip in extra supply those not-retiring guys created may reverse in a hurry, when they decide they've got enough to retire again. Right about now-ish?

 

[Baller MD]

It's reasonable to think that a lot of anesthesiologists who were on the cusp of retirement in 2008 when the markets crashed kept working to rebuild their portfolios.

The market has doubled since then. So ... maybe the blip in extra supply those not-retiring guys created may reverse in a hurry, when they decide they've got enough to retire again. Right about now-ish?

Can't you say this for every specialty though? I heard rad guys saying the same thing to explain the ****ty job prospects in their field.

 

[amLOLdipine]

So, it's 2016 now. Can we get a situation update?


I've got my rain shelter all set up for the gloom & doom that's about to enter this thread.

 

[deleted126335]

Same as a year ago. The old guys are cutting back to part time or getting out of night call, but not walking away.
Too much uncertainty. Financial markets. Low interest rates. Concerns about getting health insurance. Kids needing economic help. Not knowing what else to do with themselves, etc.


How much is enough? A little more.
John D. Rockefeller.

 

[Ignatius J]

Same as a year ago. The old guys are cutting back to part time or getting out of night call, but not walking away.
Too much uncertainty. Financial markets. Low interest rates. Concerns about getting health insurance. Kids needing economic help. Not knowing what else to do with themselves, etc.


How much is enough? A little more.
John D. Rockefeller.

Or they just know anesthesiology is a good gig and don't want to walk away. We have a number of partners in my group where we just say "Goodness, hang it up already." But they don't.

 

[deleted126335]

Or they just know anesthesiology is a good gig and don't want to walk away. We have a number of partners in my group where we just say "Goodness, hang it up already." But they don't.

I think that finding purpose and meaning in life after medicine is hard for many of us. That is another reason people don't walk away completely.

 

[GA8314]

I have no problem with the older guys that hang on for whatever reason. As long as they continue pulling their weight. Guys expecting to coast for 5 years are a big problem for small groups. We have old guys that are coasting (big time) and a few that are total assets because they get things done. In a PP with equal partnership, it's very tough to have the latter type...... Especially the smaller ones. We enable these guys, however. Time for some assignment changes I think.

 

[deleted126335]

I have no problem with the older guys that hang on for whatever reason. As long as they continue pulling their weight. Guys expecting to coast for 5 years are a big problem for small groups. We have old guys that are coasting (big time) and a few that are total assets because they get things done. In a PP with equal partnership, it's very tough to have the latter type...... Especially the smaller ones. We enable these guys, however. Time for some assignment changes I think.

I have no doubt that as the money gets tighter the old guys who maintained their position by pressing the flesh with surgeons and administrators will be forced to pull their weight or be marginalized. Won't be quick enough for the young guys, but it is coming. I would love to hear from those whose group took a buyout five years ago and are no longer under the initial contract buyout. Those who plan to retire after the five year buyout are not salvageable.

 

[Ignatius J]

I think that finding purpose and meaning in life after medicine is hard for many of us. That is another reason people don't walk away completely.

Absolutely. Probably goes for any job. I, however, will not be hesitant about sprinting towards retirement when my opportunity comes.

Too many foreign places unseen, adventures not undertaken, and fairways not hit out of. I think I'll get along without medicine just fine. Only 30 more years!

 

[GA8314]

I have no doubt that as the money gets tighter the old guys who maintained their position by pressing the flesh with surgeons and administrators will be forced to pull their weight or be marginalized. Won't be quick enough for the young guys, but it is coming. I would love to hear from those whose group took a buyout five years ago and are no longer under the initial contract buyout. Those who plan to retire after the five year buyout are not salvageable.

Yeah, it can't come fast enough for a couple of them. Then, on the flip side we have some excellent older docs. I respect the hell out of them because they CHOOSE not to coast while others pull the weight. It's not an "aging anesthesiologist" thing with us. We just have a couple guys that just don't give a sh.t and it's really frustrating. We all know the type......

 

[Twiggidy]

Me most days....

 

[deleted162650]

Technically I'm making 8 figures. It's just that 2 of them come after the decimal point.

 

[Wiscoblue]

We have some younger guys who are whiny. Bitching about their call. Not hungry inspite of massive debt from med school. 8 weeks of vacation is not adequate for them.


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[deansrv72]

Absolutely. Probably goes for any job. I, however, will not be hesitant about sprinting towards retirement when my opportunity comes.

Too many foreign places unseen, adventures not undertaken, and fairways not hit out of. I think I'll get along without medicine just fine. Only 30 more years!

Most people hit into the fairway, or from the fairway, but unless one is in a fairway bunker, hitting out of the fairway doesn't seem to make much golf sense. That being said, there are never too many fairways to hit in/out/from...

 

[sevoflurane]

I think that finding purpose and meaning in life after medicine is hard for many of us. That is another reason people don't walk away completely.

I agree with this. I am sure I can retire very comfortably in the next 7-8 years.
The question is do I want to. The answer is no, but with a 50% FTE stipulation.
I think having the right group setup is key- young eager beavers, middle of the road viagra guys and older silverback folk who just like to do a regular day. This polarity in a group is healthy and symbiotic.
Currently we have guys that hardly work to guys that are super eager beavers.
Everyone is happy. It's a good setup, and when you get to that silverback age... all you are doing is paying for fancy vacations and toys while maintaining a nest egg and keeping some connection to anesthesia.

 

[ERRES2288]

I agree with this. I am sure I can retire very comfortably in the next 7-8 years.
The question is do I want to. The answer is no, but with a 50% FTE stipulation.
I think having the right group setup is key- young eager beavers, middle of the road viagra guys and older silverback folk who just like to do a regular day. This polarity in a group is healthy and symbiotic.
Currently we have guys that hardly work to guys that are super eager beavers.
Everyone is happy. It's a good setup, and when you get to that silverback age... all you are doing is paying for fancy vacations and toys while maintaining a nest egg and keeping some connection to anesthesia.

Are you all partners? Is it eat what you kill? How do you divide the money so everyone stays happy?

 

[sevoflurane]

Are you all partners? Is it eat what you kill? How do you divide the money so everyone stays happy?

Yes. Partners or in partnership. Everyone gets treated the same from day one.
Base salary + incentivized income after 3pm and for various call positions.
Base salary cut down based on part time status... ie base salary reduced 50% if you are 50% FTE.
No group is perfect, but fairness is at the center of our group.

 

[Consigliere]

Yes. Partners or in partnership. Everyone gets treated the same from day one.
Base salary + incentivized income after 3pm and for various call positions.
Base salary cut down based on part time status... ie base salary reduced 50% if you are 50% FTE.
No group is perfect, but fairness is at the center of our group.

Nice setup. Very, very rare.

 

[Mman]

Yes. Partners or in partnership. Everyone gets treated the same from day one.
Base salary + incentivized income after 3pm and for various call positions.
Base salary cut down based on part time status... ie base salary reduced 50% if you are 50% FTE.
No group is perfect, but fairness is at the center of our group.

lots of ways to skin the cat but fairness solves almost all woes. We prefer to pay everybody the same but you gotta work the same calls as everybody unless you pay them yourself to take your call for you.

 

[deleted162650]

Nice setup. Very, very rare.

Not that rare depending on what part of the country you are in. Many of the practices out West are still very fair with equal partners/fair tracks and production based income (in one flavor or another).

It's very hard to not be happy in a practice like this.

Oh, and lack of CRNA's helps too.

 

[Consigliere]

Not that rare depending on what part of the country you are in. Many of the practices out West are still very fair with equal partners/fair tracks and production based income (in one flavor or another).

It's very hard to not be happy in a practice like this.

Oh, and lack of CRNA's helps too.

When you say "out West" I can only assume you are referring to CA and maybe 1 or 2 other states so yes......very, very rare. California and Indiana are two of the only states I know of that really don't use CRNAs. Anyone know of any others?

 

[pgg]

I don't know how it is on the coast, but there are plenty of CRNAs in rural California.

Including some CRNA-only "groups" ...

 

[Apollyon]

In my rural hospital, we have 2 CRNAs (both experienced, both really good, and know their limits). We are not critical access, but I don't know why (as we qualify, both for volume, and for location/distance). Neither one of these guys is anywhere near $225K.

I found out why we are not critical access - it's because we are on a US route (not a state road). True story!

 

[Stank811]

Nice setup. Very, very rare.

Not that rare in my experience...clearly there is regional variation

 

[caligas]

I don't know how it is on the coast, but there are plenty of CRNAs in rural California.

Including some CRNA-only "groups" ...

Kaiser uses independent CRNAs in Cali

 

[abolt18]

When you say "out West" I can only assume you are referring to CA and maybe 1 or 2 other states so yes......very, very rare. California and Indiana are two of the only states I know of that really don't use CRNAs. Anyone know of any others?

Utah

 

[deleted162650]

Kaiser uses independent CRNAs in Cali

All the Kaisers in SoCal I'm aware of supervise their CRNA's. And they are phasing them out.

When you say "out West" I can only assume you are referring to CA and maybe 1 or 2 other states so yes......very, very rare. California and Indiana are two of the only states I know of that really don't use CRNAs. Anyone know of any others?

I was referring more to the fact that there are many equitable partner jobs with production based compensation. MD only is just icing on the cake. I know it's regional though but when 90+% of the jobs within 200 miles of me are set up this way it's hard to say they are very very rare. And back when I was looking at the end of residency I found similar jobs in WA, OR, and CO too.

 

[Ignatius J]

When you say "out West" I can only assume you are referring to CA and maybe 1 or 2 other states so yes......very, very rare. California and Indiana are two of the only states I know of that really don't use CRNAs. Anyone know of any others?

Texas too. Some cities anyways.

 

[chocomorsel]

Utah

Nevada and Arizona

 

[Wiscoblue]

Are you kidding me? Indiana is full of CRNAs. And they practice unsupervised side by side with docs. 10 rooms, 10 'providers'. I'm sure nurses get the chip shots and docs get the crappy cases. Indiana is a great state to practice for the legal environment, though.

My group here in Wisconsin has a blended point production. So I could hire a guy to split my job when I turn 60. I've only hit 7 figures twice, around 10 years ago when I was real hungry. Reimbursements are dropping and cardiac caseload is too. But I've made my pile and now it's just about paying for vacations and enjoying life till I go half time.


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[chocomorsel]

Are you kidding me? Indiana is full of CRNAs. And they practice unsupervised side by side with docs. 10 rooms, 10 'providers'. I'm sure nurses get the chip shots and docs get the crappy cases. Indiana is a great state to practice for the legal environment, though.

My group here in Wisconsin has a blended point production. So I could hire a guy to split my job when I turn 60. I've only hit 7 figures twice, around 10 years ago when I was real hungry. Reimbursements are dropping and cardiac caseload is too. But I've made my pile and now it's just about paying for vacations and enjoying life till I go half time.


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I would prefer to work side by side instead of supervising them. There a few places in Indiana that have physician only models. And others that are independent CRNA models. I know of two.

 

[sethco]

When you say "out West" I can only assume you are referring to CA and maybe 1 or 2 other states so yes......very, very rare. California and Indiana are two of the only states I know of that really don't use CRNAs. Anyone know of any others?

A lot of groups in the DFW area do not use CRNAS. I have never supervised a CRNA and I hope it remains that way

 

[deleted171991]

A lot of groups in the DFW area do not use CRNAS. I have never supervised a CRNA and I hope it remains that way

How about the rest of Texas?

 

[Mad Jack]

That's true, but the price would be much higher/less likely to be offered/less likely to happen.

Doubtful. 2 and 3 million dollar buyouts with guaranteed high salary for the next two to three years are hard to pass up when you know you can book for another practice immediately when your obligatory time with the AMC is up. It's basically seven figures of free money you can invest and let grow.

 

[Mman]

How about the rest of Texas?

I think the Austin area is MD only for the most part.

 

[Ignatius J]

How about the rest of Texas?

Big cRNA presence in Houston and decent presence in Austin.

Very little if any in San Antonio. Just at the med school and millitary places. The 2 big private practice groups in SA are physician only.

 

[Howard888]

Austin has 2 big groups: one who sold to Mednax a few years ago and one that's an equal partner group still fighting the fight. Both use CRNAs. Needless to say one job is way better than the other, but that partner job is tough to get into (know they're still interviewing and hiring though as they interviewed a classmate of mine recently)

Houston is dominated by USAP and CRNAs with a couple small partner owned group outliers.

San Antonio is still partner owned but terrible set up. MD only and follow surgeons around all day from facility to facility.

Dallas has huge USAP presence plus a bunch of little partner owned groups. Some CRNAs, some MD only.

Texas is a mix bag state for sure

 

[criticalelement]

I would prefer to work side by side instead of supervising them. T.

I wouldn't because working side by side with them you will be expected to supervise them anyway only you will not be immediately available to bail them out and you know nothing about thier patients and do not have a physician/patient relationship. It is really a dumb model for all involved.

 

[pgg]

I wouldn't because working side by side with them you will be expected to supervise them anyway only you will not be immediately available to bail them out and you know nothing about thier patients and do not have a physician/patient relationship. It is really a dumb model for all involved.

Wrong again.*

I've worked in this model in two very different places - the military, and at a rural California hospital.

In terms of hassle, stress, and liability, it is far preferable to supervision or direction, whether the CRNAs are employed by your group or the hospital.

The worst I can say about it is that sick patients get triaged to the physicians, so the CRNAs get the low hanging fruit and easier days. But it's nice to not be responsible for anything they do. It's 180 degrees in a better direction than supervising/directing where your signature is on the chart somewhere and you're responsible for what another person does when your back is turned.

When things go wrong in their rooms, if you respond, your liability isn't any greater or lesser than if you were responding to a code elsewhere in the hospital. You're not magically bootstrapped into responsibility for the entire case.

And finally ... in arrangements like this, where a surgeon has a CRNA on Monday and an anesthesiologist on Tuesday, they tend to notice and appreciate us.


* Completely independent CRNA practice is a dumb model, I think we all agree on that. But given the facts that the people have voted, the politicians have legislated, and the CRNAs have independent-ized ... the best outcome for us is exactly that "side-by-side" model where they do their cases and we do ours. With some aggressive scheduling triage to keep the sentinel events down to a tolerable level, it's the smartest model of the choices left.

 

[criticalelement]

Wrong again.*
.

IM wrong again. WHich must mean you are right.. Must be a nice feeling to be right.

 

[pgg]

It seems I basically disagree with you on every possible topic. It's like you're the anti-me from a shadow universe.

 

[deleted171991]

It seems I basically disagree with you on every possible topic. It's like you're the anti-me from a shadow universe.

I bet that you two guys would have a great time over a couple of beers. I remember how I used to be pissed off by various people at various times, and now I enjoy most of their posts, because I know that their core is good, and so is mine, and that we might have had different experiences, or I just might be too green, or the opposite, and that we can agree to disagree.