Skip Intro said:
You bill for more... TEE, Swan-Ganz placement/monitoring, central lines, etc. Of course, this was '96-97. Reimbursement structures may have changed since then and perhaps you can no longer individually bill for each thing you do.
-Skip
Money in anesthesia is more dependent on where you live and what patients you take care of (age, % of private insurance vs medicare/medicaid, etc) THAN ANYTHING ELSE. SO, if you are a cardiac anesthesiologist (fellowship trained) and you find a practice that does alot of less-than-65-year-olds, you're golden. But those institutions are rare, since 90% of CABG patients are 65 or older, at least in my experience.
Doing everything on a CABG (A line, SWAN, etc) gives you about 800 bucks, whether the case lasts 2 hours or 12 hours, so alot depends on how fast your surgeon is. You can do three twenty minute tonsillectomies on your neighbor's four year old triplets and make about the same amount of money.
My opinion is not to do any fellowship unless you are keenly interested in whatever you are fellowshipping in, and you oilfield-heir father can pay you the 300K you would've made working instead of fellowshipping.
Something alot of you are unaware of is that hospitals HAVE to have anesthesia, right? Cuz the OR is typically a money-maker. Many, many groups are augmented financially by the hospital if their payer mix does not generate enough money to keep desirable anesthesiologists around. Example: Need an anesthesiologist to do hearts for a new heart hospital? You're gonna have to guarantee him/her about 400-450k to find one, at least in the southeast. So the hospital will cough up the difference, i.e. (anesthesiologist's guarantee) - (amount billed). Yes, they are losing money on the anesthesia side, but no worries, since they are rolling in profits from the cath lab, ICU stay, etc. They wisely see the big picture: "Hmmmm, we can make money with a heart program... we'll make a ton of money in the cat lab, but we'll lose a little money in the OR."
BOTTOM LINE: Fellowship is not the determining factor (usually) on how much money you make. It is your location in the USA and what your patients use to pay you with (medicare=bad reembursement; workmans comp=good; Aetna/Blue Cross/other insurance companies=good, for the most part.)
This concept should be put in the anesthesia FAQs as it is asked over and over again.
SEE, residencies could do a much better job preparing residents for the real world. You go into practice knowing NOTHING about what comprises a practice, which can make you a sitting duck if you unknowingly associate with shady partners.
One could learn Anesthesia Business One-Oh-One with morning conferences scattered throughout residency, so at least emerging residents have a clue as to what they are getting into. ANy residency directors out there? Our residencies completely ignore this very important fact of life of the real world.
She literally was making cash-money far faster than they could spend it. (I can't even imagine what it must've been like to be their accountant; as a PhD-level researcher he was making about $120K/year himself.) She worked primarily at University of Maryland in Baltimore, but also occassionally covered cases at Hopkins.
