Any applicants changing specialties

[CambieMD]

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I am in primary care right now but have applied to anesthesia. Are there others out there who have trained in other specialties. I am applying outside of the match.


CambieMD

 

[dbiddy808]

I'm a third year medicine resident and I will be starting as a CA-1 next July. Pretty much every program I interviewed at had a couple of people who had done different residencies.

 

[cak]

General surgery, starting CA-1 next year. I also applied outside of the match

 

[DrRobert]

I find it interesting that many people are transferring into anesthesiology after being in other specialties. The primary motivation seems to be money. The only thing is that anesthesia salaries will probably drop significantly over the next few years because of CRNA issues, malpractice issues, and ongoing Medicare/Medicaid reimbursement issues. Everyone should think long and hard before making such a dramatic transition. It would be a shame to finish residency only to be making the same amount as you were in your previous field.

 

[CambieMD]

I find it interesting that many people are transferring into anesthesiology after being in other specialties. The primary motivation seems to be money. The only thing is that anesthesia salaries will probably drop significantly over the next few years because of CRNA issues and ongoing Medicare/Medicaid reimbursement issues. Everyone should think long and hard before making such a dramatic transition. It would be a shame to finish residency only to be making the same amount as you were in your previous field.

DrRobert,

please do not hijack this thread with doomsday crap.
Yes, my changing specialties is all about the money. I spent 100k obtaining a medical education. I owe it to myself to find a field where I can be excited about getting up in the morning and not dreading the mountain of forms and various items of paperwork that patients are demanding yesterday. (Can you say run-on sentance).

CambieMD

 

[DrRobert]

DrRobert,

please do not hijack this thread with doomsday crap.
Yes, my changing specialties is all about the money. I spent 100k obtaining a medical education. I owe it to myself to find a field where I can be excited about getting up in the morning and not dreading the mountain of forms and various items of paperwork that patients are demanding yesterday. (Can you say run-on sentance).

CambieMD

I was not trying to hi-jack your thread, just pointing out some things. Apparently you are not concerned that you may be making the same salary as you are now and sacrificing 3 years of your life. It just seems like a huge risk.

 

[UTSouthwestern]

I was not trying to hi-jack your thread, just pointing out some things. Apparently you are not concerned that you may be making the same salary as you are now and sacrificing 3 years of your life. It just seems like a huge risk.

Trends in reimbursement do not focus solely on anesthesiology. Medicare/medicaid reimbursement falls across the spectrum (and we were able to receive an increase in reimbursement rates at the last review, by the way).

Most people change not just for money, but for lifestyle. I have friends in anesthesiology making twice the amount as primary care physicians doing half time work or locums work. The flexibility of this specialty, portability of your skills, and limited drudgery (paperwork, office overhead, employees, etc.) are equally attractive to persons wanting to practice medicine but not wanting to LIVE medicine all day, every day.

 

[DrRobert]

Trends in reimbursement do not focus solely on anesthesiology. Medicare/medicaid reimbursement falls across the spectrum (and we were able to receive an increase in reimbursement rates at the last review, by the way).

Most people change not just for money, but for lifestyle. I have friends in anesthesiology making twice the amount as primary care physicians doing half time work or locums work. The flexibility of this specialty, portability of your skills, and limited drudgery (paperwork, office overhead, employees, etc.) are equally attractive to persons wanting to practice medicine but not wanting to LIVE medicine all day, every day.

Good points UT. I was just pointing out the likely possibility that anesthesia salaries may not remain so high in years to come. As far as Medicare/Medicaid, I was reading in the ASA journal that anesthesia is the lowest reimbursed specialty in medicine, partly because there are not enough anesthesiologists in the AMA, which is responsible for lobbying Washington. Finally, anesthesia is near the top in malpractice insurance premiums, which will probably continue to rise indefinitely.

I am not trying to say the sky is falling, but simply choosing this specialty primarily for money may not be the wisest decision.

 

[Skip Intro]

Finally, anesthesia is near the top in malpractice insurance premiums, which will probably continue to rise indefinitely.

This is patently untrue. In fact, anesthesiology is probably the lowest of the surgicial/hospitalist fields and has even dropped in recent years, whereas the vast majority of other medical specialties have risen. For example, here in New York City the annual malpractice premium is down to $16,000/yr from about $25K ten years ago. The current OB/Gyn premium is about $170,000/yr.

-Skip

 

[seattledoc]

Hi all,
It seems to me that the bigger risk is staying in a field that is currently poorly reimbursed, overworked, and not keeping one content. Certainly if you try out anesthesia or another field and you're indifferent, then a switch would be nutty. On the other hand, if it interests you and gives you more hope for an interesting career then 3 years of low pay and the possibility of a lower salary seem a small price to pay. I think the chances of anesthesia being reimbursed at primary care rates are pretty low.

I look at the demographics of our country and the anesthesia work force and have to wonder how we are not going to be faced with equal or even greater workforce shortages in the future. The workforce is fairly top heavy when it comes to the average age of the MD's and CRNA's. (Thanks to the 1990's anesthesia doldrums) CRNA's are graduating right now at a rate that keeps up with demand at best. The country is only going to get older, and that will likely mean more surgery. Where is the mechanism that is going to cause the wages to tank? Government intervention? Are they going to nail primary care or anesthesia? Which costs more, i.e. which is the larger pie slice of the American healthcare cost?
Seattledoc

 

[Jeff05]

I find it interesting that many people are transferring into anesthesiology after being in other specialties. The primary motivation seems to be money. The only thing is that anesthesia salaries will probably drop significantly over the next few years because of CRNA issues, malpractice issues, and ongoing Medicare/Medicaid reimbursement issues. Everyone should think long and hard before making such a dramatic transition. It would be a shame to finish residency only to be making the same amount as you were in your previous field.

1. the primary motivation is NOT money. the reason is you know how much you're potentially going to make before starting training in your specialty. that primary care pgy1 didn't suddenly realize halfway thought the year that he's gonna make 120/yr. in my opinion, the motivation is losing interest in the original choice secondary to lifestyle, work content/dynamic, patient interaction, non-clinical activity, etc. and then, potentially, an re-evaluation of how much money one would like to make.

2. salaries will not drop. they have never dropped. crna's have been around forever. the deficit of anesthesiologists will not be corrected for years to come (i have posted on SDN on this, with references.) generally, new projections (look it up on MDconsult) predict a 200,000 physician deficit by 2020.

3. malpractice...that was covered by a previous poster. malpractice is actually average as far as procedural subspecialties go.

 

[cak]

I would just like to point out that no one at the beginning of this thread, including the original poster, ever mentioned anything about salary. People change specialties for a plethora of reasons, and for me personally, salary is at the bottom of my list for reasons to switch. DrRobert, it's not fair to jump to conclusions or pass judgement on the person who started this thread. It was an innocent question and if I were you I would read it again.

 

[MS3NavyFS2B]

I find it interesting that many people are transferring into anesthesiology after being in other specialties. The primary motivation seems to be money. The only thing is that anesthesia salaries will probably drop significantly over the next few years because of CRNA issues, malpractice issues, and ongoing Medicare/Medicaid reimbursement issues. Everyone should think long and hard before making such a dramatic transition. It would be a shame to finish residency only to be making the same amount as you were in your previous field.

I find it interesting that your conclusions are based in incorrect information. CNRA issues will have no effect on salaries...talk to any hospital lawyer--I have, and hospitals would MUCH rather an MDA. Malpractice? well...nope, since pure anesthesia kills are quite rare, and--according to published data--MDAs are sued infrequently with relatively low premiums (I'm sure you can look this up)

It would be a shame to make conclusions with incorrect premises.

As one of my resident's said today...we're laughin' alright--all the way to the bank. With hours like 6-2, the only reason to get home at 6:30 is because your teetime at 2:30 was delayed.

 

[MS3NavyFS2B]

I would just like to point out that no one at the beginning of this thread, including the original poster, ever mentioned anything about salary. People change specialties for a plethora of reasons, and for me personally, salary is at the bottom of my list for reasons to switch. DrRobert, it's not fair to jump to conclusions or pass judgement on the person who started this thread. It was an innocent question and if I were you I would read it again.

I thoroughly agree with cak.

Unlikely doomsday scenerio's are not welcome. Nevertheless, I suppose we really don't have to worry about such scenerios anyway, since Bush was reelected (albeit to my chagrin).