Smart man on that one.
Its simple math for any of the people that know how businesses evaluate moving into a segment. They do a simple NPV analysis.
If the NPV is positive after a specified period time, they decide to undergo the business opportunity (most want to be NPV positive by 8 years).
Even at 3M or so with a 7% discount rate, Anesthesiologists aren't NPV positive (considering post tax money) for >25 years AT CURRENT MEDIAN WAGES.
The assumption that salaries will improve considering CRNA collaborative pressures which is getting more militant by the day, Medicare differentials in salary (33% of private), AMCs moving into the Anesthesia space due to consultants/PE boys wanting to improve profits and CEOs of hospitals wanting to get rid of all anesthesia subsidies with strong negotiations doesn't portend well for increasing salaries in the future.
How low do salaries go before its too risky to do anesthesiology? 250K seems too low at 3M net worth unless you are only taking care of ASA 1 or 2 patients with a nice schedule. Unfortunately, 250K with call will probably be the norm in the next 5 to 10 years with increased production pressures coupled with "collaboration" with CRNAs on the lower hanging fruit. Even at 300K/year, that would be too high risk at that level of exposed assets.
I rather do a lower paying specialty that is low risk at that point such Palliative care for 210-220K/year or so with zero risk.
P.S. You liberals who live in NY, CA and IL will be enjoying a MARGINAL TAX RATE over 50-55%+ when you consider a fed tax, state tax, local tax, medicare, SS, etc. at 250K cut off (especially since all the public workers pensions in those states are COLLAPSING and will require HIGHER local tax rates in the coming years). So the difference between 250K to 350K post tax is only about 45K in those states.
