Anesthesia Field

[anbuitachi]

Sort of true, but also sort of not. The ER is typically a glut of terrible payer mix (some combo of uninsured, Medicaid, hospital transfer dumps for poor insurance). Ask a surgeon, they typically hate ER consults for this reason - on average, the reimbursement will be awful. ERs are almost always seen as a total money hole, hospitals have no choice but to keep them running if not for coeric purposes. Plus for a solid surgical patient hitting the ER there are 10 or more drug seekers, frequent flyers, psych holds and non-emergent patients. Hospital admins MUCH prefer referrals from the community including PCPs, Urgent Care and (in some cases) free standing ERs.

Furthermore, if you think the AMC situation is suboptimal in Anesthesiology check out the horrendous situation they have in ER. It's much worse, Google the Summa situation sometime. Or just check out the EM forum.

Do they make more per hour? Yes, but in all honesty most ER shifts are insane busy running around seeing 30-40 patients per 8 hours (at a community center) plus overseeing PAs and NPs. Despite working less the burnout rate for Emergency Medicine consistently ranks at the highest of all specialties by a pretty wide margin. Finally, contrary to every other specialty the ER is the slowest in the mornings and busiest in the evenings so the majority of shifts will be afternoon/evening/nights.

I've been doing some moonlighting in a community ER during fellowship for some extra $, and I'm so glad after each shift that it's not my specialty. For the crap they have to deal with (literally NO ONE wants a consult from the ER making you a very unpopular provider, and almost everyone tries to pawn a consult to FM/IM), no wonder their burnout is high. I expect in the future they will be expected to work more shifts for the same salary or play more of a "collaborative" model with NPs/PAs.

It seems that way right? But the national average is only 1.6 patients PER hour. So yes some are busy, but most not as busy as you think.

Judging by that, it seems that EM is the way to go actually. I don't mind irregular hours at all! Seems like this specialty is getting more and more competive as years go...

I think right now EM is more competitive than anesthesiology. As far as hours go, anesthesiology is highly irregular too. Obviously it varies where you work, if you work for a place w very little call then the schedule will be more regular, but most jobs these days have a good # of calls and our calls tend to be either 24 hours, or late calls going til late nights. Just this weekend, on Sunday 24 hr call we had 14 general call team cases not including emergency intubations which we cover too, 4 of which were ASA 5E, kept the call team (1 attending, 2 resident) up 24 hrs. As a resident, i have 12 calls next month (7 overnights) even though i have 2 days of vacation, so i would call my hours pretty irregular too

People often say EM is super busy (like above poster) but you dont work 24 hrs, and you work half the month, and are paid generously, and people are starting to see this, which is why popularity is skyrocketing. Also residency can be 1 year shorter, and often doesn't need fellowship.

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[pgg]

The main difference between EM and anesthesiology is the way EM is seen by the ubiquitous bean counters: as a profit center, because it refers patients to the hospital. Anesthesiology is just a cost center. That's a huge difference, and that's why hospitals are willing to pay almost double for an EM doc (on an hourly basis).

You'd have to pay me double to get me to agree to their kind of shift work - disproportionately tilted toward evenings, nights, and weekends.

I'll take my consistent 6:30 - 7:00 AM starts and 3:00 - 6:00 PM exits. Even as a cog in the machine, it's better for the soul than the undead hours they work.

A couple times per month I tolerate working overnight. I'm not that old now, and I don't know what kind of practice I'll be part of in 10 years, but wherever I end up, I will look hard at how often I'll need to be working when it's dark outside. And I'll happily take less money to avoid a brutal call schedule.

 

[AdmiralChz]

Gonna pull a BLADE here:

Source: Report reveals severity of burnout by specialty

 

[anbuitachi]

It's funny because people keep talking about how bad the lifestyle is for surgery yet there is only 1 surgical field in the top 10 (urology)

 

[anbuitachi]

You'd have to pay me double to get me to agree to their kind of shift work - disproportionately tilted toward evenings, nights, and weekends.

I'll take my consistent 6:30 - 7:00 AM starts and 3:00 - 6:00 PM exits. Even as a cog in the machine, it's better for the soul than the undead hours they work.

A couple times per month I tolerate working overnight. I'm not that old now, and I don't know what kind of practice I'll be part of in 10 years, but wherever I end up, I will look hard at how often I'll need to be working when it's dark outside. And I'll happily take less money to avoid a brutal call schedule.

You have a sweet job. Your hours seem to be far shorter than the average (61hr per Association of American Medical Colleges), unless those hours refer to 7 days a week.

Id take evening jobs and have every other day off. sounds sweet

 

[BLADEMDA]

You have a sweet job. Your hours seem to be far shorter than the average (61hr per Association of American Medical Colleges), unless those hours refer to 7 days a week.

Id take evening jobs and have every other day off. sounds sweet

"sounds sweet" until you hit your 50s.

 

[anbuitachi]

"sounds sweet" until you hit your 50s.

hopefully when you are in 50s, you are senior enough to not be loaded with bad shifts, just like most 50s yr old attendings here are no longer taking many 24 hr calls

 

[Arch Guillotti]

hopefully when you are in 50s, you are senior enough to not be loaded with bad shifts, just like most 50s yr old attendings here are no longer taking many 24 hr calls

For a lot of us it isn't that easy. In private practice if you aren't working you aren't getting paid. If you want someone else to take your shift you need to pay them.

Sometimes I will switch with a partner but I don't work anything other than my normal schedule.

 

[Ezekiel2517]

You have a sweet job. Your hours seem to be far shorter than the average (61hr per Association of American Medical Colleges), unless those hours refer to 7 days a week.

Id take evening jobs and have every other day off. sounds sweet

There's no way that average work week hours figure is accurate

 

[anbuitachi]

There's no way that average work week hours figure is accurate

Why not? I dont know about rest of the country but at least here, that # seems spot on. But I'm in academic and some older anesthesiologists dont take call so they work less than that, but its balanced out by younger attendings working 80+ weeks