Anesthesia vs IM

Discussion in 'Anesthesiology' started by msmith83, Feb 25, 2014.

  1. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    And the day nurses start doing surgery, that will be the day they will get equally reimbursed. Who's fault is it they passed law calling for equal pay for what they call equal work. It's not just a anesthesiology problem, it's going on in all practices where mid levels are encroaching. So once we as Physicians sound the alarm they can get a NP or MD for an equal amount of cost, who do you think they'll see? You know the answer.

    Please stop making this an Anesthesiology only problem. People like you posting negativity of the "battle is over" before we have even waged the war, is far from the truth.
     
  2. sheeed

    sheeed ASA Member
    7+ Year Member

    Joined:
    Nov 1, 2010
    Messages:
    68
    Likes Received:
    20
    Status:
    Resident [Any Field]
    I mean it's pretty clear to see that things are heading to an employment model. I wouldn't call blade a troll based of what he says. Of course things are still good to some practicing physicians you may have spoken to, but with direction we are heading will things still by the time we're applying for jobs?

    To blindly believe that things will still be all peachy would require you to ignore all the trends.
     
    BLADEMDA likes this.
  3. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    Your sadly mistaken,I wasn't expecting 300-400K. I love medicine, it's not solely about money. You sound highly discontent, I'm gladly ok with being behind the curtain than doing Lap-appys all day, or round all night. I'll gladly raise the table, no ego here champ.
     
  4. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician

    I'm sorry to have to tell you this but we can't win the war. The best we can do is hold the line against the enemy. Even then we lose ground every few years. When will the walls collapse leading to complete disaster? I don't know. The AANA propaganda machine is formidable opponent. You can wage battle all you want but the party line has been to just hold the line.

    FYI, CMS (medicare, Medicaid) pays us so little in reimbursement that if that becomes the norm an Anesthesiologist will earn slightly more than a CRNA but not enough to justify the cost of the education and increased training.

    Welcome to the forum. Welcome to Reality because this isn't the Disney World.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  5. Silent Cool

    Silent Cool Member
    Removed 10+ Year Member

    Joined:
    Jan 30, 2005
    Messages:
    2,773
    Likes Received:
    645
    Blade,

    Who owns these anesthesia 'companies' and where does the money come from? What is to stop an enterprising group of anesthesia docs from competing?
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  6. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    Folks who are just coming into this thread let me summarize all the negativity on here.

    News flash: you won't be a millionaire in medicine, and Mid levels think they can do what we do. End of story. Welcome to nightmare on elm st SDN style.
     
    wjs010 and LeverArm like this.
  7. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician
    You know that you been on SDN too long when Med Students start calling you a troll after 10,830 posts. The truth is a hard thing to read sometimes when it crushes your dream. I"m sorry for that but it doesn't change the truth.

    PGG, has a much better style of posting than I do. I readily admit that we can post the same content but he comes across so much better while saying the same thing. It must be those years dealing with RN Superiors in the military. God Bless you PGG.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  8. msmith83

    2+ Year Member

    Joined:
    Dec 22, 2013
    Messages:
    77
    Likes Received:
    4
    Any incite on how much the area in which one practices matters in all of this? Like a rural area may have more potential to have private practice opportunities?

    btw thanks to all the attending physicians and residents who have offered their advice on this board. I know a great deal of it may be negative but the sad truth is thats its probably mostly true. I greatly respect the honesty rather than just blowing smoke, these are things that we have to take into consideration like it or not. Many medical students are guilty of being naive or optimistic... and its understandable that many of us need to convince ourselves that it WILL be different. After all, most of us have poured so much time into it, are already >100k in debt, and have been dreaming of it for some time
     
    BLADEMDA likes this.
  9. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician

    Yes. You will be a Millionaire my young friend. Do a Fellowship. Land a $400K job. Save money. Invest. Live modestly. When you reach my age you will easily have in excess of $1 million and ZERO debt.

    If you want to be rich (I'm talking Yacht, multiple homes, Ferrari,etc) then do GI, Ortho or Neurosurgery.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
    LeverArm and AnesDiva like this.
  10. AnesDiva

    Joined:
    Oct 9, 2013
    Messages:
    14
    Likes Received:
    10
    Status:
    Medical Student
    This is a post I find helpful :)

    A few more states are about to let NPs open independent primary care practices with completely equal billing practicing etc privileges.

    My biggest fear is what you allude to: that someday in my life it just won't make any financial sense at all-- bordering on irresponsible-- to go the MD/DO route even if it's what one wants to do. It's happening all over in medicine.
     
  11. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    There, seems like you have gotten In touch with your inner unicorn. Like I said, we on SDN would appreciate your pros and cons, and making 400K doesn't sound like a death sentence when the median fx income in USA is 55K. Yay for unicorns.
     
  12. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician
    My posts are honest. You choose to read a lot of negativity into them. I've posted the salary range on this thread multiple times. But, remember due to the glut of CRNAs and AMC employers the trend for salary is DOWN.

    FYI, why choose a field which pays 1/2 another field in medicine? If that is your decision then do it like the Docs who pick Family practice. Don't come back whining on SDN in 5 years when the AMC is paying you $275K while the Ortho dude is STILL earning $650K under Obamacare. Please make your choice with yours eyes OPEN.

    Anyone reading this thread should NEVER post that he/she wasn't told the TRUTH By me on SDN. That's one excuse you can't make for the decision.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
    BorntobeDO? likes this.
  13. wolverine09

    7+ Year Member

    Joined:
    Dec 17, 2009
    Messages:
    39
    Likes Received:
    3
    Status:
    Medical Student
    Blade, personally I enjoy reading your posts. Do you think a republican in the white house in 2016 would help us/change things in the right direction?
     
  14. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    Even If they paid 1 million a year for specialities like IM, surgery, you could not pay me enough. Money isn't everything. I'd prefer being happy and financially stable than miserable at 1 million a year. Paying my loans off and being stable is all I ask.

    Thank you for the clarification. I'll take back my troll designation of Mr. Nicholson.
     
  15. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician

    I'd be happily miserable for $1 million year and so would 90% of your classmates. Please look at the most competitive matches in medicine and then rank them by salary.
    Any correlation between INCOME And difficulty in matching? I'm betting an 85% correlation or more. http://en.wikipedia.org/wiki/Correlation_coefficient

    Med Students are smart and KNOW where the money is. Do you?
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  16. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    90% of medical students don't match ortho, plastics, ENT, Cards, derm. Let's be realistic, people chose what they'll be happiest in, while making a descent income.
    Mr. Nicholson, you've been in the game long enough to know that specialty income is like wall st, you gotta get in while the market is hot. And just like wall st. Specialties trend up, and down. Remember when Medicare was implemented? I don't know how old you are, but physicians were crying "doom and gloom" and it turned out to be very profitable years. Remember when Ortho was laughed at? Remember when Anesthesiology was practically begging for people to join the specialties in the 90s? Guessed who laughed all the way to the bank.

    I'm no fortune teller, but if you go into a specialty looking at numbers and not happiness you're setting yourself up. Hey, radiology looks good now, let's see what happens 5 years from now. Hey, cardiology looks good now, wait until everyone and their mother starts encroaching on their territory of stent placements. The list goes on and on my friend. So if Anesthesiology takes a pay cut, but still pays a descent income I'll be happy, as opposed to chasing money, only to find out all the ponies and unicorns left the barn 5 years earlier :(
     
    LeverArm likes this.
  17. LeverArm

    2+ Year Member

    Joined:
    Sep 5, 2009
    Messages:
    126
    Likes Received:
    21
    Status:
    Pre-Medical
    Not so much GI speaking to many, although they do fairly well. True of Ortho and Neurosurg but the problem with those, especially the latter is you will never have the kind of time to enjoy any of it. One of the benefits of anesthesia in my opinion is although the pay may be lower than certain fields, the hours are more negotiable depending on what you value more. It is the most common reason I heard from former surgical (including highly competitive subspecialties) residents switching into anesthesia. Correct me if I'm wrong, but it is still the most common switched into field and the least switched out of.
     
    Critical Mass REACHED likes this.
  18. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    Oh no, why would anyone want to switch out of a surgical specialty! It's not like they'll get called in from home at 2am, or your dad's funeral because the patient sneezed and now has a bowel evisceration.

    You stand correct, I met quite a few people who decided to go behind the curtain "ENT, Peds, 2nd&3rd year Gen surg residents, Urology, PLASTICS, IM etc. I didn't meet any surgeons who were former anesthesiologist. Excellent point.
     
  19. Baller MD

    7+ Year Member

    Joined:
    Jul 21, 2008
    Messages:
    1,007
    Likes Received:
    504
    Status:
    Medical Student
    Dude can't you just disagree without sounding like a total dick to Blade?
     
    ToldYouSo, Telekinesis, dmk5n and 4 others like this.
  20. pgg

    pgg Laugh at me, will they?
    Moderator Physician Faculty 10+ Year Member

    Joined:
    Dec 14, 2005
    Messages:
    11,621
    Likes Received:
    6,769
    Status:
    Attending Physician
    There are some really exceptional people here with a wealth of experience, clinical and nonclinical.

    When I think "clinically brilliant" there's a long list of members that come to mind, some still active, some who haven't posted in years, but all people who really exemplify what physician anesthesiologists bring to the table. When I think "knows his **** about the business side of private practice anesthesia" the list is a lot shorter ...

    I don't want to try to make a list, mostly for fear of forgetting someone who really deserves to be listed :) but Blade knows his **** about the business side of private practice anesthesia. Anyone who dismisses him as a troll is really missing an opportunity to learn something.


    Heh, thanks. Actually, one of the reasons I decided to stick out a few extra years in order to collect the .mil retirement cheese, instead of getting out when my service obligation ends, was our conversations about private practice anesthesia, job security, reimbursement issues, trends toward employment and supervision models. But having non-clinician bosses has made me more mindful of the words I use to tell them they're wrong. Not easy. It helps that I've moved up the chain a couple notches since the days when my department head was a CRNA (an arrangement that mostly worked out fine believe it or not).
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
    BorntobeDO? and ToldYouSo like this.
  21. BLADEMDA

    BLADEMDA ASA Member
    10+ Year Member

    Joined:
    Apr 22, 2007
    Messages:
    16,791
    Likes Received:
    2,973
    Status:
    Attending Physician
    If you already know everything then place me on ignore. However, if you have a question about a specialty go ahead and ask it. FYI, radiology doesn't look good and hasn't looked good for years. They can't find jobs even with fellowships. Interventional rads is the best choice in Radiology but the field is saturated.

    Anesthesiology won't be enjoying another period like the 2000s. That was an anomaly unlikely to be seen again under obamacare.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  22. inspirationmd

    Physician 7+ Year Member

    Joined:
    Mar 17, 2011
    Messages:
    348
    Likes Received:
    64
    Status:
    Attending Physician
    What do you think the future prospects are in Emergency Medicine and Critical Care from both a private practice and academic standpoint? Both are heavily in demand right now with some ridiculous salaries being offered depending on the locale secondary to nationwide shortages. You think that may change? How prevalent have you seen burnout be and what do you recommend as a back-up?
     
  23. msmith83

    2+ Year Member

    Joined:
    Dec 22, 2013
    Messages:
    77
    Likes Received:
    4
    Anyone have an opinion on private practice in rural areas and whether this problem may not be as prevalent?

    I plan on staying in the south, most likely GA, Alabama, or SC
     
  24. ihearttriangles

    5+ Year Member

    Joined:
    Jul 29, 2010
    Messages:
    78
    Likes Received:
    18
    Status:
    Resident [Any Field]
    While I do find it rude that a med student would call Blade a troll I must admit that I like his/her spunk. I have long thought that one of Anesthesia's main problems was that it tends to attract very chill, easy-going people. Which in a lot of ways is cool but also makes for a weak resistance force. You need your warriors to be spunky and irreverent sometimes if they are gonna take on a-hole surgeons and bitchy nurses.
     
  25. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    I apologize if I have offended SDN's most sacred member Mr. Nicholson.

    Mr. Nicholson, I can't ask you any questions, because your usual answers are the same from what I've read. If I want to listen to the world is crashing speech all day, I'll just tune into Fox News.

    But, I'll take back my troll remark.

    And for the gentleman or women who talked about this magic list of SDN gods that has now shrunk to only include Mr. Nicholson for the most part, what do you think happened to those gods? I bet there all unemployed right now, so poor they couldn't afford the internet anymore. Or, they where just annoyed by the type of people on here who constantly cry about impending doom, and decided it was time to get off SDN.

    SDN reads like a sad little novel where children are killed, and animals burned alive. I wonder how many "brilliant" people were talked out of medicine because of the cynical things they read on here. People who would of fought to advance the field, and protect the field.

    Keep talking like this and the future of physicians will be made of baby lambs waiting to be preyed upon, and die. Not me.
     
  26. countingdays

    countingdays ASA Member
    5+ Year Member

    Joined:
    May 16, 2009
    Messages:
    1,147
    Likes Received:
    33
    Status:
    Attending Physician
    Rural locations are not bring spared. AMC's are taking over everything.
     
    #176 countingdays, Mar 6, 2014
    Last edited: Mar 6, 2014
  27. countingdays

    countingdays ASA Member
    5+ Year Member

    Joined:
    May 16, 2009
    Messages:
    1,147
    Likes Received:
    33
    Status:
    Attending Physician
    With the end of private practice anesthesia taking place at an ever accelerating rate, I'd be happy to be making 275k in 10 years. I'm not confident that 275k will be widely available. I hope so, but I'm not too sure. Salary will be dictated by supply and demand and monopoly control of an area by AMCs make it difficult or impossible to switch into a higher paying job near your home.

    400k is overly optimistic for new grads in cities, and not just coastal cities. Most are getting 250-300 and no chance that partnership will raise their incomes in the future.
     
    Critical Mass REACHED likes this.
  28. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    Sounds like a good gig to me when IM makes 150-200. Or Peds making 100-150. I call that right there optimism. As opposed to, quit now, medicine is dead, anesthesiology is dead. Thank you, I enjoy that forecast.
     
  29. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    Ignore the noise. Recognize the VASTLY different interests folks have and how those interests effect their perception of the fields. I'm an anesthesiologist, pain fellowship, and I get to do both. I don't make anywhere near the upper levels of incomes, but I am very happy with my job. Everyone is different and entitled to their own opinion, but to me it's kind of disgusting when people in the medical fields talk about yachts and mansions. I can see how people would be unhappy if money is of such primary importance (ie. "I'd be miserable for a million a year"). My opinion is no more valuable than anyone else, but to me this is an unhealthy soul-less way of living life.

    I make several multiples of what the average American makes. I consider myself rich, though I'm definitely not by some of the standards on here.

    Yes, take finances and economics into consideration. Then I suggest you do what will make you happy.
     
    #179 Pooh & Annie, Mar 6, 2014
    Last edited: Mar 6, 2014
  30. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    Thank you for the positive outlook, we need more people like you on here to suppress some of the loudest unhappiest people. If I wanted the yacht, I would of joined wall st. I don't know what the older generation of folks that went into medicine thought. But, I can tell you none of my classmates are naive enough to think they're going to be driving around Bentleys, buying a million dollar home etc. Majority simply ask to be able to make enough to pay off loans and live a financially stable lives, while doing what they love.

    Thank you !
     
  31. Dwindlin

    Dwindlin ASA Member
    7+ Year Member

    Joined:
    Jan 30, 2009
    Messages:
    2,534
    Likes Received:
    205
    Status:
    Attending Physician
    This count as an iBank reference? My gut says it does. @pgg ruling?


    Sent from my iPhone using Tapatalk
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  32. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    I have no idea where you're going with this question my friend.
     
  33. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    Also, I'm still in contact with everyone I did residency with. They are ALL sincerely happy with their jobs/lives, believe it or not.
     
    Critical Mass REACHED likes this.
  34. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    That's awesome. Well, there is about 20 people in my class of 130 going into anesthesiology. These 20 are some of the brightest in our class. I'm sure this trend will only continue, flushing out people who really don't care for the field, protecting it's future.
     
  35. IkeBoy18

    IkeBoy18 ASA Member
    10+ Year Member

    Joined:
    Jul 13, 2005
    Messages:
    677
    Likes Received:
    66
    Status:
    Resident [Any Field]

    wow thats quite a bit.. im sure there isnt 20 people in my whole class of almost 300
     
    Critical Mass REACHED likes this.
  36. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    It was more than the usual 10-15 every year.
     
  37. countingdays

    countingdays ASA Member
    5+ Year Member

    Joined:
    May 16, 2009
    Messages:
    1,147
    Likes Received:
    33
    Status:
    Attending Physician
    You are assuming that Anesthesiologists will be deciding the future of our specialty. You are mistaken. Our future is being sold to AMC suits on a daily basis by the previous generation of anesthesiologists. Your only decision will be to take it or leave it, and after 9-10 years of training, leaving it isn't a viable option.
     
  38. HollATme

    2+ Year Member

    Joined:
    Nov 24, 2010
    Messages:
    109
    Likes Received:
    12
    I would not pursue anesthesiology if I had to do it all over again. However, I'm making amends by pursuing a fellowship that will take me out of the OR and allow me to enjoy what I do and provide actual patient care by owning my patients.

    Go ahead and think that your "lack of naivete" and "spunk" will help you out in your future pursuit of an anesthesia career. If you think that's gonna save the profession from the nurses, you'll be in for a rude awakening. By that point in time, nurses will continue to blur the lines when it comes to anesthesia (and likely other fields).

    I'm not saying one's life goals should be a yacht and a mansion - and I don't believe that was Blade's point either (however, of course, such examples get readily eaten up by those lacking actual life/career experience). His point had more to do with considering EVERYTHING. There are now more licensing exams, harsher clinical competency requirements, and this huge hoopla on case logs. We are essentially paper pushers ensuring everything is documented appropriately as that appears to be more important than ensuring a proper residency educational experience. I don't mind working late or giving CRNAs breaks or doing a BS lap appy/chole at 5am. I really don't. I just mind the fact that mid-level services dictate the flow of cases and, quite frankly, how WE provide care. Tack on the fact that you could be watching a patient exsanguinating and the surgeon flat out tell you it's only 100cc of the blood. Of course, I don't buy it, and I do what's needed.

    We are supposed to be overseeing everything in the OR and often times we don't have anyone backing us up like the surgeons have the scrub tech and OR nurse. Of course, now that I've gotten to know the OR nurses it's changed and they're present at the bedside (often per my own request) as the patient is being induced. Now imagine out in practice where you're running around signing charts to 2-4 or potentially 5-6 rooms - do you honestly think you'll be there for induction for each of those cases you are "supervising?" No. Hell no. At that point, it's a leap of faith on the CRNA. Hope you got yourself some good ones assigned else you may be putting out fires to something you may not know anything about because quite frankly you rushed on over while in the middle of preopping your next 2-6 patients and the CRNA may not have a clue either.

    Of course, you're the supervising physician. You're the one responsible for the care and the patients.

    250K is not enough for that. 400K pre-tax ain't enough either. Academia is funny. It provides this "blanket" that "protects" you from a real world perspective. It's nice knowing how the real world is --- and Blade is correct in his assessment of the state of anesthesia. I've had a lot of former PP attendings sell out and come here to work in academia essentially for a better lifestyle and a steady flow of income. They have told me various stories from their PP experience. The types of things you'll experience out in PP will astound you. Surgeons will dictate the care and you'll have to anesthetize the patient, else your colleagues will quickly toss you out for canceling a case. You are essentially the surgeon's bitch, and that's not just in the OR - but also in the periop setting. If there's a bad event, they'll all quickly point the finger at you. Not the surgeon, but you. Your colleagues will be the first to pull the trigger. Now soon we have to take care of these patients post-op? Better pay me twice then, as an anesthesiologist and an intensivist.

    Of course, that's not gonna happen.

    ----------------------------------

    Here's my top 10 career choices - in no particular order

    1. EM - shift work, work 40-50 hrs, no call, decent pay for being a glorified triage nurse (i guess we're glorified CRNAs, ha!)
    2. Urology
    3. ENT/facial plastics
    4. Plastics - go reconstruction - you get to do all the boutique stuff plus do some real good pro bono, and actually be able to do these cases
    5. OMFS - of course, requires you to do dentistry - but honestly, they make bank and while their hours can be erratic, it's still a helluva lot better than what we got
    6. Neurosurg/Spine
    7. Orthopedics/Spine
    8. Rad onc - no nurse would touch this with a 10 foot pole
    9. PM&R - pay may not be great, but you have a more laid back residency experience, and being an attending is nice too. I've spoken to several. Plus, there's the backdoor route to Pain
    10. Critical Care - more laid back, very sick patients - a lot of it is like a puzzle, and very rewarding when you see a patient doing so well they can be transferred out or even sometimes directly sent home. I can be a real doctor, get paid like one, and do shift work while at the same time not working almost 45-50 weeks per year.

    I would not do radiology. Too saturated. Why even bother doing it for IR - it's 6 years. None of them are happy and they always end up getting suckered into doing something.
    Note - I did not list IM residency. I personally felt it to be extremely painful. However, if you can bear through it, then the options are almost limitless. Go be a cardiac slave for the next 3-4 years, or scope your way to a million, or run an allergy clinic and make bank without ever seeing pts in the hospital or taking call, or go into rheumatology working derm hrs and run a little boutique option on the side to supplement. Palliative is not a bad gig either, and may be a need considering the rationed care that obamacare will bring forth. Critical care - personally felt the medical side to be more challenging than the surgical side.

    Bundled payments will not be in favor of anesthesia.

    I went into anesthesia without knowing all the politics that goes on. I wasn't privy to SDN until it was late for me. I went into anesthesia because, like you, "everyone seemed super chill and nice and they taught and zomg!!! the procedures!!!!!!1111" It didn't hurt that I enjoyed the OR setting, but then again, I was simply a fly on the wall (not literally) but I wasn't the one providing the anesthesia. There's a lot more to it than just pushing prop, roc/sux, fent and tube. You'll get a healthy dose or 2 of the politics starting out in residency with all that spunk you got.

    The perceived lifestyle is just that. It's a perception, an illusion. Don't think for a second anesthesia is a lifestyle specialty. Is there any wonder why a good bit of anesthesia residents jump ship from the OR into pain (and now critical care?) You guys talk as if anesthesia is some perfect specialty where everyone jumps right in but never leaves. There's plenty of folks who switch out of anesthesia. One of my EM attendings in med school did that. He thought it was the best decision he ever made. Might be right.
     
  39. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    Another sad case, retire please. I skimmed your history on here, and you're another one of those that went into it for the wrong reasons.
     
  40. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    I don't think it requires much "interpretation" to determine the motives of some people. If posts seem honest and straightforward, I take the poster at their word.

    There are lots of opinions on the field, as there should be and always will be. Ultimately, I have to rely on my own experiences and the info I get from people I know. Here's what I consider hard data:
    I'm happy. Since becoming an attending, I've bought all kinds of goodies that VERY few people would be able to afford. I pay $4000 monthly toward my loans. I contribute the max to my retirement. I'm looking to buy a place but I currently live in a kick ass high rise downtown in a desireable and expensive city. And I have lots of extra money to buy things I absolutely do not need. (No kids, no alimony, big debt).
    In a group of about 25 anesthesiologists, all except one or two are very happy. And we are well below the income upper percentile for anesthesiologists.
    All my co-residents work elsewhere, and range from happy to very happy. NONE are disappointed.

    I am fully aware of the future uncertainties. That being said, I don't believe JACK when people say "this is what's going to happen". Those people don't know ANY MORE THAN YOU OR I DO. The determining factors of the future are way to complex and variable. I'm fortunate to be part of a well-run department that continues to adjust to changes, and despite reimbursement changes, we continue to adapt and stay very important to our hospital. I don't see that changing.
     
    Critical Mass REACHED likes this.
  41. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    It also surprises me how great people think all these other fields are. I work very closely with ER docs, cardiologists (EP/interventional), GI docs, various surgery types, etc... EVERY SINGLE GROUP (maybe with exception of the urologists) has a grass is greener attitude toward other specialties, including anesthesiology.
     
  42. gasdoc77

    5+ Year Member

    Joined:
    Dec 7, 2012
    Messages:
    305
    Likes Received:
    265
    Status:
    Attending Physician
    I am inclined to lean in a slightly more negative direction. I came from a major city where a mega successful group sold to an AMC for a lump sum and said screw anyone who isn't a partner (even if a day shy)and all the future docs. I appreciate that the current residents want to keep hope alive and in fact need to. However, it truly is dog eat dog and spreading like wildfire. The pie is only so big and too many hands are in it. Everyone wants to be compensated for their profession, and that compensation comes in many forms. However, trainees who think that practicing based upon principals will provide fulfillment will later learn that every day they find themselves bending those principles to keep the machine running. The machine operates on the principle of money and will use the lowest common denominator in an effort to maximize its bottom line. Unfortunately, patients are often a medium to feed the machine. I am simply here to safely guide them through to the best of my ability.
     
    BorntobeDO? likes this.
  43. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    We have had 2 local groups get hosed or battered. You HAVE to ask questions and know what you're getting in to, which I'm sure you all already know.
     
    Critical Mass REACHED likes this.
  44. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    Urology is starting to get concerned now with the new recommendations for prostate cancer. Their money maker, which was found to be aggressively overly treated. I can go down that list, and list concerns for each.
     
  45. Psai

    Psai Snitches get zero vicryl
    Physician 2+ Year Member

    Joined:
    Jan 2, 2014
    Messages:
    11,128
    Likes Received:
    22,554
    Status:
    Resident [Any Field]
    You need to watch your tone. You are a newcomer here and it's incredibly rude to talk down to these attendings who have posted here for years as if their point of view is useless simply because it doesn't match your worldview. I'm glad that we have all these experienced doctors telling us how it is as they see it so that we can walk in with our eyes open. Everything you think you know comes from what you read and what you hear. They're living it.

    You're sitting at your computer "liking" all the posts that are saying the things you want to hear but in the real world, you'll have to deal with the stuff that you're trying your best to ignore now.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  46. Ronin786

    Ronin786 ASA Member
    7+ Year Member

    Joined:
    Mar 27, 2011
    Messages:
    1,238
    Likes Received:
    649
    Status:
    Fellow [Any Field]
    I agree with this post. There are always two sides to things, and it's good to hear both of them. Belittling people's opinions does nobody any benefit.
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  47. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226
    Having a difference of opinion is not crime. There are multitudes of opinions in the world, and you pick which ones to ignore and which ones to accept. That's how opinions work. I'm choosing to ignore opinions coming from people who I feel are disrespecting their field and medicine in general "that is my opinion on how to handle it."

    Makes no sense that any physician would devalue their role, and my opinion of these people are that they went into it for the wrong reasons and are now advising people against it.

    I was advised to stay and go on to NP school, I had a lot of negative opinions thrown at me even from some physicians that medicine is dead. I'm so glad I found positive influences who were able to paint the pros & cons. I was told not to go to college, because it was a waste of money when I could of became a LPN for cheaper. Glad I had others who encouraged the pros and cons of going to college for my BSN.

    So far from what I have learned is, avoid negative influences that can't even appreciate both sides of any debate. People really do use SDN to guide some of their life long decisions to their detriment from only hearing from the loudest screamers of negativity without providing both sides of the debate.

    This is a forum, I don't honor former titles, but you better believe if this was a hospital setting, the tone would be different. You don't see titles and names on forums. So if I offended any attending's, I apologize. But, that still doesn't change how I feel about them, and what they portray on here.
     
  48. Pooh & Annie

    Pooh & Annie Member
    10+ Year Member

    Joined:
    Jul 15, 2005
    Messages:
    1,374
    Likes Received:
    569
    Status:
    Attending Physician
    "Watch your tone"? Have you read these forums? As long as you're not threatening death or selling something there's no limit to what people say to each other here.
     
  49. HollATme

    2+ Year Member

    Joined:
    Nov 24, 2010
    Messages:
    109
    Likes Received:
    12
    Oh you sure told me sistah!

    So, essentially, BECAUSE this is a semi-anonymous forum, you feel it is okay to say what you're saying. You said that in real life, you'd never show such attitude to your superiors. Oh sistah, you're gonna have a lot of fun in residency! Hell, I would guess to venture that if you actually practiced as a nurse you were probably one of those snarky ones who questioned every order a physician placed. Not that there's anything wrong with asking questions, but there's a way to do it, and then there's a way to do it.

    Don't take heed to people's warnings. Annie Pooh may have it good, but having it good is relative. If you are single or married with no kids and work for a great group in a city you like, and take home $200K, that may not be all that bad - for her. It may not be all that great for someone else. Everyone's situation is different. You're simply ignoring that part of the equation. Quite honestly, I could give 2 sh!ts what you decide to do. Just go out and be informed, that's all this is about.
     
  50. Critical Mass REACHED

    Joined:
    Dec 21, 2013
    Messages:
    163
    Likes Received:
    226

    I stopped reading after your subliminal racial undertones of "oh sistah"

    Nice try though, you seem like some idiot who assumes all nurses are black, female, and thinks people actually go around saying "oh sistah." Racist prick, please quit now. Now I see why your hate your job, NO LIKES you.

    Thanks for trying though.
     
    LeverArm likes this.

Share This Page