Anesthesiology a "Lifestyle Specialty"?????

[bgabes]

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Hi...during my Surg rotation I became interested in Anesthesiology and also value a well balanced lifestyle but after doing a lil research I'm perplexed as to how gas became known as a "lifestyle specialty;" specifically AMA's "Physician Socioeconomic Statistics" (2003) says avg gas dr spent 62 hours a week in "proff activities," compared to a mean of about 58 for all physicians. Also, for most of the past 10 years gas drs have worked more hours than the mean for "all physicians..." does anyone know how Gas has earned a reputation of a "lifestyle specialty" despite these numbers?

 

[rs2006]

Hi
Fourth year med student here. That disclaimer having been given, I think the entire "lifestyle" specialty statement about anesthesia is driven by MONEY. I go to a school where approx 20% of my class is going into anesthesia. Usually in a GREAT year, anesthesia gets about 0.5-1.0% of my class. However, my school is also one of those schools which costs $200k/4 years so I gather that many of these people are simply going into anesthesia to pay off their debt and are using the term "lifestyle" as a euphemism for money-- they use "lifestyle" as word which simply means money which they willl use to buy their next porsche and pay off their student loans. Not that that is a bad idea, but I think it is a bit greedy and arrogant of them to have such an attitude. Many of my classmates also tend to "live it up" and live large during their years of medical school. While I am aware that I am in no position to be judging anyone else and that it is my responsibility to mind my own business and not care about anyone but myself, I find it quite bold and somewhat obnoxious to see that the same people that have been "flaunting their pseudowealth" (ie the loan money that they have taken out to live large during school) and stating that (during first year) that physicians make "tons of money" and that I will be "made of money if I go into anesthesia" (as fourthyears). Sorry for my rant. Differing views are more than welcome. Thanks

 

[JackPB]

There is a wide range of practices that an anesthesiologist may pursue. At the top end, a hardworking guy in a busy practice may work long hours every day and take lots of overnight call. He would likely make lots of money. On the other end, one might work 40 hours a week in a surgicenter. He'd make less, but can still make a good, Porsche-less living. Anesthesiologists have the luxury of being able to chose.

Perhaps a "lifestyle" specialty is best defined as one that has a favorable work/money ratio. If you gotta work for a living, anesthesiology is a pretty good gig.

 

[rs2006]

Hi again

I think the first thing that should be done is to define what "lifestyle" means. To me, the word simply means the number of hours worked per week and the amount of stress that comes along with that-- a 40 hour work week specialty with minimal call would be considered a "lifestyle" specialty to me-- ER, rads, psych, peds, int med (and most internal medicine/peds subspecialties), family, derm, ophtho-- if you notice, this includes MOST of the specialties EXCEPT the surgical ones.

The other side of all of this is money and I would consider anesthesia to be one of the ones that makes alot of money-- but I think it is also important to be aware that it is one of those specialties that for whatever reason tends to come and go in waves-- I have heard from some of the attendings at my school how in the late 1990s that it was VERY DIFFICULT to get people to go into the specialty for whatever reason-- these have all been discussed in numerous threads on this site.

Now the "lifestyle" of an anesthesiologist has remained the same during this time-- why didn't everyone run for it at that time? While I also understand that the field has undergone some technological revolutions over the past few years (bis monitor, pulse ox, better monitoring machines, etc) it is not as if halothane just got invented over the past few years. Not to be antagonistic to the above poster (I more than welcome posts which disagree with mine), but with all due respect it is possible to make alot of money in any specialty (ie you can be a family doc working 30 hrs/week or you can be one working longer hours and making much more).

I am also curious as to how people can consider anesthesia a "lifestyle" specialty when (at least when I did my surgery rotation) there is night call (While yes it can be done as shift work, it is still night work-- time away from family and personal life)-- when I did my surgery rotation appys still went to the OR at 3am and anesthesia was there along with the surgeon-- the anesthesiologist was the first in the OR and the last to leave (unless things have change since I saw surgery) again it seems to me that anesthesia is basically the life of a surgeon without rounds and continuity.

However, I do not want to come across as knocking the specialty in this post-- it is a fascinating field that is rewarding with a lot of cool stuff, but I think that anyone choosing a specialty should go into it with their eyes wide open-- they should know all the ins and outs and have the right to know the truth before they go into it as choosing a specialty is like a marriage. Again, I welcome any posts that disagree with mine. Good luck and sorry for this rambling post!

 

[UTSouthwestern]

There have been many, many posts on this topic before. When considering what type of lifestyle any physician will have, you have to factor in all of the things that may require time, ranging from in house work to being paged incessantly to office work and rounding.

From a time perspective, anesthesiologists may average 62 hours per week in house, but that is where almost all of their work is done. There is no clinic to run to unless you are in pain management, no constant paging for orders and admits, no dictating, etc. There are pluses and minuses to each stipulation of this specialty and you WILL work hard when you are at work, but the lifestyle name tag that has been attached to it primarily applies to level of income and protected time off in my opinion.

 

[jetproppilot]

Hi again

I think the first thing that should be done is to define what "lifestyle" means. To me, the word simply means the number of hours worked per week and the amount of stress that comes along with that-- a 40 hour work week specialty with minimal call would be considered a "lifestyle" specialty to me-- ER, rads, psych, peds, int med (and most internal medicine/peds subspecialties), family, derm, ophtho-- if you notice, this includes MOST of the specialties EXCEPT the surgical ones.

The other side of all of this is money and I would consider anesthesia to be one of the ones that makes alot of money-- but I think it is also important to be aware that it is one of those specialties that for whatever reason tends to come and go in waves-- I have heard from some of the attendings at my school how in the late 1990s that it was VERY DIFFICULT to get people to go into the specialty for whatever reason-- these have all been discussed in numerous threads on this site.

Now the "lifestyle" of an anesthesiologist has remained the same during this time-- why didn't everyone run for it at that time? While I also understand that the field has undergone some technological revolutions over the past few years (bis monitor, pulse ox, better monitoring machines, etc) it is not as if halothane just got invented over the past few years. Not to be antagonistic to the above poster (I more than welcome posts which disagree with mine), but with all due respect it is possible to make alot of money in any specialty (ie you can be a family doc working 30 hrs/week or you can be one working longer hours and making much more).

I am also curious as to how people can consider anesthesia a "lifestyle" specialty when (at least when I did my surgery rotation) there is night call (While yes it can be done as shift work, it is still night work-- time away from family and personal life)-- when I did my surgery rotation appys still went to the OR at 3am and anesthesia was there along with the surgeon-- the anesthesiologist was the first in the OR and the last to leave (unless things have change since I saw surgery) again it seems to me that anesthesia is basically the life of a surgeon without rounds and continuity.

However, I do not want to come across as knocking the specialty in this post-- it is a fascinating field that is rewarding with a lot of cool stuff, but I think that anyone choosing a specialty should go into it with their eyes wide open-- they should know all the ins and outs and have the right to know the truth before they go into it as choosing a specialty is like a marriage. Again, I welcome any posts that disagree with mine. Good luck and sorry for this rambling post!

All the above are good posts, and I respect your opinions.

I've been in practice nine, almost ten years now. I cant really say whether or not anesthesia is a "lifestyle" specialty, since I guess its all in your perspective.

In my practice, we work 2 weeks of days, one week (including your 48 hour weekend, then Mon-Fri 6pm-6am) of nights, then a week off.

If you are the late guy during the week (either Mon Wed Fri, or Tues Thurs) your day is busy. If you're the short guy, you're also busy but you go home aroune 12-2pm.

Our night call is variable, but with a busy OB unit we;re usually up a cuppla times in the middle of the night. I hate night call. Always have, always will. Just part of the gig.

But we get 13 weeks of vacation since we've structured our scheduling the way we did.

All in all, I'd say our lifestyle is pretty good, but doesnt touch derm.

An ortho buddy of mine's wife is a dermatologist who works Mon Wed Fri...does alot of botox etc...300k annual. Now theres a lifestyle gig.

 

[Atropine]

Haha, stop it I soiled myself--you're too funny! That's the first time I've ever heard someone say Internal Med is a lifestyle specialty. Making barely above 140k while seeing 30-40 patients/day and working 50-70hrs per week in clinic is premature burn-out waiting to occur. They all want you to declare them disabled or they come in with some supratentorial disorder but insist otherwise. If you're unlucky enough to not have a contract with a hospitalist group, rounding on your 10-15 inpatients during lunch and after clinic sucks... You're on-call q3-7 and you will be paged incessantly by nurses about sleep meds and stool softeners(why do these patients insist on taking a sh_t at 3am? I don't know but I'll provide the funds if anyone's willing to do the study). You'll be paged at night when you're not on call by your patients because 'everything' is absolutely urgent to them. And you'll bend over each time baby because it's all about groveling for the benjamins... J/K internal medicine rocks! You should go into it....

 

[threepeas]

although most important points have been made here's my .02.
1. variety of work schedules are available to suite the individual practioner
-friend at surgicenter m-F 7a to 3-5p, no call, no weekends, decent $$$ while her family is young
-busy trauma center were i work as a PA while in school: the boss who is >60yo M-F 50hrs, one lady works 2 twelves and one 24 ($300K for 48 hours-not bad) and other assorted schedules
-another friend in midwest works 50-60hrs/wk with 4 calls per month makes >450K
others due their fulltime job and moonlight to make extra $$$, or work 2 part time jobs.
ie flexibility
2. most practices allow one to be home during the evening so you can have dinner w/ the fam, homework and sports for the kids. also most weekends off.
3. when you are not at work you are completely off-no pager, etc.
4. vacation-most jobs have >6 weeks vacation
5. $110-130/hr job rate (60hrs/wk @ 300K for 46wks [ER is close])
6. job is portable-you can move at a drop of the hat. no practice to leave or start
7. in "most" fields to make this $$$ you have to hustle more, work more hours, deal with a practice which includes typical headaches associated with running a business, etc.

i think lifestyle specialties offer flexible hours, good pay, and no pager while at home, and except for derm no traditional practice to run.

that's about it....

 

[davvid2700]

Our night call is variable, but with a busy OB unit we;re usually up a cuppla times in the middle of the night. I hate night call. Always have, always will. Just part of the gig.

I agree. If you are an anesthesiologist with a reasonably busy Ob department and a few vascular surgeons, your nightcall will suck something huge. Between epidurals, stat c sections intubations on the flooor and bolusing epidurals and the cases that come to the OR on nights and weekends you will know at that point that anesthesia is NOT a lifestyly specialty. Not to mention PACU disasters.

The stuff that comes to the OR at night are not fun. Declot this. debride that, amputate that, d and c, all full stomachs etc. Nothing is straightforward

 

[Heeed!]

Haha, stop it I soiled myself--you're too funny! That's the first time I've ever heard someone say Internal Med is a lifestyle specialty.

I found that funny too, although I did retain sphincter tone.

 

[rs2006]

Hi everyone

Fourth year medical student here. It will be interesting to see how long anesthesia remains a "lifestyle" specialty with so many people going into it. While many may chuckle at the assertion that some of the specialties I listed in my previous post COULD be considered as lifestyle specialties I think it is important to remember that LIABILITY is also a major consideration-- IM, Peds (and their specialties), psych, ophtho, derm (et al) for the most part have lower LIABILITY (defined as how frequently they get sued) than anesthesisa (please correct me if I am wrong-- I am only a medical student) and one could also extend this to say that these specialties could be considered "lifestyle" specialties because they do not have to spend their time away from work worry about lawsuits which is something to think about these days... Also, another thing to think about is the fact that baby boomers are aging and in approximately 5 years they will start to turn 65 and will soon be eligible for medicare. This may not sound like anything to anyone reading this, but I think this is significant given that medicare is cash strapped today-- who knows how it will be able to handle the increased demand for services? My guess is that physician salaries are going to have to be cut (yes, and that means mine too!) so if you are really going into anesthesia for the money you may end up miserable (In my school, about 50-70% of the people going into anesthesia did not even rotate through it before going into it!). This increased demand for services may increase the push towards services provided by midlevels (PLEASE DONOT turn this into a CRNA vs MD debate!!!!!), but who knows. As always I welcome posts from people who have views that differ from mine as I do not know everything. Good luck and sorry for this rambling, long post.

 

[fishtolive]

anesthesiologists in some large groups pay only a hair more than a GIM guy but make more per year...monitoring my friend, it's a beautiful thing.

true death rate from anesthesia is quite small (1/200-300K I believe) although you are going to be named when the surgeon f's up or there are positioning probs/corneal insult.

didn't a recent ASA newlestter say the average liability cost went down this year? attendings care to verify?

 

[avanb803]

Wow rs2006, the glass sure is half empty with you! 🙂 Bottom line is that I'm not too worried. A lot of specialties have been predicting doom and gloom for as long as I can remember. They still predict it and everyone is doing just fine.

 

[svaefinga]

I agree. If you are an anesthesiologist with a reasonably busy Ob department and a few vascular surgeons, your nightcall will suck something huge.

you forgot to add neurosurgeons...

 

[jetproppilot]

you forgot to add neurosurgeons...

Tell me about it. Four hour craniotomy with temporal lobectomy last night.

 

[Atropine]

Hi everyone

Fourth year medical student here. While many may chuckle at the assertion that some of the specialties I listed in my previous post COULD be considered as lifestyle specialties I think it is important to remember that LIABILITY is also a major consideration-- IM, Peds (and their specialties), psych, ophtho, derm (et al) for the most part have lower LIABILITY (defined as how frequently they get sued) than anesthesisa (please correct me if I am wrong-- I am only a medical student) and one could also extend this to say that these specialties could be considered "lifestyle" specialties because they do not have to spend their time away from work worry about lawsuits which is something to think about these days...

Chuckle, chuckle, chuckle.... I'll be your huckleberry.
Actually, average malpractice insurance rates for anesthesiology plummeted over the years and currently are at least equivalent, and in most cases, lower than IM. Why? For many reasons, not the least of which is a concerted effort by the specialty over the years to reduce errors and improve safety. Anesthesiology recognized long ago that most mishaps are due to human error. This is in stark contrast to other specialties(including IM, ER, Psych etc...) which really haven't made any significant strides in improving safety and instead concentrate mainly on practicing CYOA medicine(CT scans head to toe, Lumbar punctures, Basic metabolic panel 400, 30 consultations the minute you walk into the hospital... exaggerated but doesn't that sound vaguely familiar?) and "finger pointing" when badness occurs.
Your frequent posts over the past month strike me as strange--as a fourth year, your posts in multiple forums regarding what are the 'best' lifestyle specialties makes me think you haven't applied at all or applied shotgun to all the ROAD specialties in the hopes someone will nibble. Are your chances of matching low? Sour grapes anyone?