1) For physician's practicing in the ACT model, how does one gain a sense of satisfaction from their career if they are not personally performing each case themselves?
As other posters have said, it depends how you derive your satisfactions from your job. And I hate to say it, at end of the day it is just a job. There are going to be parts you absolutely love and there are some parts you would not care for. Are you okay with a patient not giving you any credit for taking care of them? Will you feel a little “weird” when your very difficult anesthesia patient who walks by and does not recognize you? You will not be their IM, you will not be their surgeon.
2) Does a lower tier university or a community anesthesiology program provide a strong foundation for one's career? Would fellowship opportunities be limited? I ask because I would prefer to be in a certain geographic region and would possibly choose a lower ranked program to achieve this.
I personally believe in anesthesia is a very “doer” field. More cases you do, more competent you become. Some community programs may not see enough certain type of cases. You may not gravitate towards certain types of jobs. Let’s say I’ve only seen 3 kidney transplants, will I want to go to a place that does 3 every day?
From what I know about fellowships? Most people who want one, will get one. Not to say there is no self selections, for people who wants to go into pain or cardiac. But most people will get whatever they want for fellowships.
3) Does anesthesiology provide more opportunity for one to pursue activities outside of work? This may be anecdotal, but out of the physicians I have worked with, the anesthesiologists tended to have hobbies (scuba diving, skiing, hiking etc.) that I enjoy.
This depends on how you define your IM practice. If you’re just a hospitalist, then you can have a fixed schedule vs If you’re doing IM with your own shop, and you see 20-60 patients a day and still do your own inpatients. But if you do well, you can probably achieve financial independence sooner.
But you may touched upon something that you may not have considered before. Every field has its personality. IM, (generalist) may enjoy patient interactions more than anesthesiologists. They may enjoy ? reading a long novel more. Because they enjoy a long relationship with the book. Anesthesiologists are more into satisfaction of finishing an activity, a day of skiing?, more.
I know, somewhat vague and stereotyping.
4) As one ages, how practical is it to continue working in anesthesiology? How does one cope with the overnight call? I have seen that many IM docs are able to cut back hours, but otherwise work as long as they would like as the career is less physically demanding.
Depends on your practice. Some physicians at certain age just don’t take calls. You can buy yourself out or just don’t make as much. Or you build an anesthesia practice and you become the super senior partner the overlord, and have your minions take calls. Wahahahaha. <I am the minion, not the overlords>
5) Does anesthesiology allow one to move geographic areas fairly easily? I imagine this is more difficult in IM as one would develop a patient base in private practice. However, this may become easier if the trend of being an employed physician continues.
You don’t have a patient base as anesthesiologists. Neither will you if you do hospitalist work.
6) If you were to have gone into IM, which specialty would you have chosen and why?
Interventional Cardiac/GI - most procedural based. Compensation.
Vs
Pulm/CCM - procedures and intellectually stimulating. I do enjoy “some” family/patient interactions. Counseling on end of life matters, oddly, fascinate me a lot.
Good luck.
