Anything GOOD about anesthesia?

[ncaawrstlr]

MS 3 here and I have strongly been considering a career in anesthesia for many years. I just turned in my electives for next year placing an ephasis on gas. However, this board makes me think that it would be a big mistake and a waste of my medical education. All I read is how we will have problems finding employment with the increasing demand for CRNA's, how pay is going to drop, and how the specialty is dying. Is there still a reason to go into anesthesia? Please, can someone give some positive comments for the future of this long respected specialty?

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[McSnappy]

MS 3 here and I have strongly been considering a career in anesthesia for many years. I just turned in my electives for next year placing an ephasis on gas. However, this board makes me think that it would be a big mistake and a waste of my medical education. All I read is how we will have problems finding employment with the increasing demand for CRNA's, how pay is going to drop, and how the specialty is dying. Is there still a reason to go into anesthesia? Please, can someone give some positive comments for the future of this long respected specialty?

I think you should go into primary care. They don't have any problems (the medical home will solve them all), the field is wide open, pay "should" be increasing, they don't have any problem keeping nurses and other staff, PAs and NPs are moving out of primary care for the lucrative field of anesth, EMR will reduce the amount of paperwork they will need to do, all of their patients are compliant with treatment plans and they are all very happy with their choice of profession.


If you are looking for the pain free field (no pun intended), you are not going to find it. All fields have their battles and problems. Pick the one you are most interested in and the one that you think you will be willing to do 20 years from now.

Money from all specialties will come and go, ebb and flow of payscale depending on the season.

 

[ncaawrstlr]

I think you should go into primary care. They don't have any problems (the medical home will solve them all), the field is wide open, pay "should" be increasing, they don't have any problem keeping nurses and other staff, PAs and NPs are moving out of primary care for the lucrative field of anesth, EMR will reduce the amount of paperwork they will need to do, all of their patients are compliant with treatment plans and they are all very happy with their choice of profession.


If you are looking for the pain free field (no pun intended), you are not going to find it. All fields have their battles and problems. Pick the one you are most interested in and the one that you think you will be willing to do 20 years from now.

Money from all specialties will come and go, ebb and flow of payscale depending on the season.

Well thanks for the reply, but anesthesia is actually what I am interested in and have been for quite a while. I like the physiology of the human body and how it reacts to stress, I enjoy doing procedures, and I don't particularly enjoy clinic. So thanks, but that is not the advice that I was looking for. I wasn't asking for advice on what to do with my life, rather I was wondering if anyone on here had anything good to say and encouraging for a person like myself who is planning a career in this field. I'm looking for optomists out there. Answers like yours are exactly what I am concerned about.

 

[2win]

MS 3 here and I have strongly been considering a career in anesthesia for many years. I just turned in my electives for next year placing an ephasis on gas. However, this board makes me think that it would be a big mistake and a waste of my medical education. All I read is how we will have problems finding employment with the increasing demand for CRNA's, how pay is going to drop, and how the specialty is dying. Is there still a reason to go into anesthesia? Please, can someone give some positive comments for the future of this long respected specialty?

Patients under general anesthesia don't talk at present time and most likely will be silent in the future. That's a positive comment.
Besides this - there are no positive comments.

 

[MDInvestor]

the easiest way is to make sure you want to do it. I asked myself the question "if pay drops to the level of a CRNA.. would I still be happy? would I still be happy if hours went up too?"

The answer for me is yes so im stress free about the future. If you want something that is a sure thing, find a field that isn't changing as we speak.

My view is that surgery or surgery-lite (ie urology) are the least at risk by nurses. Not many people would find it acceptable for nurses to be the primary surgeon to take out a prostate.

PCP will most likely be compensated a little more in the future based on all the healthcare proposals. Specialists will drop relatively more. The other option is healthcare bankrupting this country in 10-15 years.

 

[MDInvestor]

p.s. listening only to optomists is what CNBC and most investors did during 2001-2005 during the housing bubble while many people on many online boards were warning that it was unsustainable and ridiculous. Don't try to fool yourself by surrounding yourself with optomists. Always use critical judgement.

 

[lfesiam]

Everything is good about Anesthesia (for me atleast).

My friend, don't let the Benjamins and the future get to ya.

Do you what you love.

Do you come home during your anesthesia rotation "happy"?

Do you look forward to going into work the next day?

 

[cfdavid]

p.s. listening only to optomists is what CNBC and most investors did during 2001-2005 during the housing bubble while many people on many online boards were warning that it was unsustainable and ridiculous. Don't try to fool yourself by surrounding yourself with optomists. Always use critical judgement.

Well stated man.

 

[SaintFrances]

As a MSIV awaiting to match into anesthesiology next week, I will agree that reading this board makes me apprehensive about the specialty at times. However, I would encourage you to find REAL PEOPLE actually practicing Anesthesiology to talk to as well. The advice seen on this board many times is coming from people who have an axe to grind or a chip on their shoulder. No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting.

Personally, I have met many great attendings, residents, and private practice docs that have a very realistic outlook on the future of anesthesiology. They present a balanced picture of the future which has not only many challenges, but rewards as well. All specialties have their positives and negatives and you need to work hard to gain as much insight as possible from *reliable sources* during your preclinical years and especially during your rotations third year.

Reading SDN is good entertainment and you may gain some insight into certain aspects of the specialty, but I would not rely on it as your basis for making a career decision.

 

[ncaawrstlr]

p.s. listening only to optomists is what CNBC and most investors did during 2001-2005 during the housing bubble while many people on many online boards were warning that it was unsustainable and ridiculous. Don't try to fool yourself by surrounding yourself with optomists. Always use critical judgement.

I hear ya. I definitely am not one to watch CNBC/MSNBC and think we live in a cookie cutter world. I am a conservative and agree 100% with you about this. I don't hide from the truth or seek out only what makes me feel good inside. Again, just looking for some encouragement to continue my dream of working in anesthesia because not much of that is going on. I am the only person in a class of 120 going into anesthesia. I am realist but would like opinions on all aspects of a career before I make a decision. Thanks for the reply.

 

[ncaawrstlr]

As a MSIV awaiting to match into anesthesiology next week, I will agree that reading this board makes me apprehensive about the specialty at times. However, I would encourage you to find REAL PEOPLE actually practicing Anesthesiology to talk to as well. The advice seen on this board many times is coming from people who have an axe to grind or a chip on their shoulder. No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting.

Personally, I have met many great attendings, residents, and private practice docs that have a very realistic outlook on the future of anesthesiology. They present a balanced picture of the future which has not only many challenges, but rewards as well. All specialties have their positives and negatives and you need to work hard to gain as much insight as possible from *reliable sources* during your preclinical years and especially during your rotations third year.

Reading SDN is good entertainment and you may gain some insight into certain aspects of the specialty, but I would not rely on it as your basis for making a career decision.

Excellent reply. I realize we may need to fight in the future and I am definitely up for the challange. I will talk to some more attendings and continue down my current path. Thanks for the advice.

 

[maceo]

The advice seen on this board many times is coming from people who have an axe to grind or a chip on their shoulder. No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting.
.

I think a lot of the conversations here are pretty spot on. People here have their fingers on the pulse. Im serious. ANyway, people listen to what they want to hear in the end.

 

[lfesiam]

As a MSIV awaiting to match into anesthesiology next week, I will agree that reading this board makes me apprehensive about the specialty at times. However, I would encourage you to find REAL PEOPLE actually practicing Anesthesiology to talk to as well. The advice seen on this board many times is coming from people who have an axe to grind or a chip on their shoulder. No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting.

Personally, I have met many great attendings, residents, and private practice docs that have a very realistic outlook on the future of anesthesiology. They present a balanced picture of the future which has not only many challenges, but rewards as well. All specialties have their positives and negatives and you need to work hard to gain as much insight as possible from *reliable sources* during your preclinical years and especially during your rotations third year.

Reading SDN is good entertainment and you may gain some insight into certain aspects of the specialty, but I would not rely on it as your basis for making a career decision.

right on saintfrances!

 

[ncaawrstlr]

the easiest way is to make sure you want to do it. I asked myself the question "if pay drops to the level of a CRNA.. would I still be happy? would I still be happy if hours went up too?"The answer for me is yes so im stress free about the future.

That is actually a good way to look at it. I would still love anesthesia if the hours went up or the pay dropped. However, if we were compensated the same as a CRNA I would not be happy and I doubt many other MD's would too. Our training is much more intense, time consuming, expensive, and all encompassing than a CRNA. Would you really still be happy knowing what you went through for your MD was considered equal to a nurse's salary? I think not but good advice anyway. Thanks for the reply.

 

[Southpaw]

However, if we were compensated the same as a CRNA I would not be happy and I doubt many other MD's would too. Our training is much more intense, time consuming, expensive, and all encompassing than a CRNA. Would you really still be happy knowing what you went through for your MD was considered equal to a nurse's salary? I think not but good advice anyway. Thanks for the reply.

I'm guessing you know how much CRNAs make. There are a ton of primary care MDs who would trade their salary in a flash with that of a CRNA, especially if they could also have their hours.

 

[ncaawrstlr]

I'm guessing you know how much CRNAs make. There are a ton of primary care MDs who would trade their salary in a flash with that of a CRNA, especially if they could also have their hours.

Of course I know how much they make. But PCP's don't administer anesthesia. If nurse practitioners were paid the same as an internal medicine doc who has his/her own practice they would probably have an issue with it as well. This is getting off topic. Any other advice of why someone who loves this field of medicine should feel encouraged to enter anesthsia? Again, I am 1 out of 120 in my class entering this field.

 

[G0S2]

I have an interest in and enjoy critical care. Anesthesia is the best training for that in my opinion and I plan on doing a fellowship. I'll be damned if midlevels start running SICU's.

 

[2win]

As a MSIV awaiting to match into anesthesiology next week, I will agree that reading this board makes me apprehensive about the specialty at times. However, I would encourage you to find REAL PEOPLE actually practicing Anesthesiology to talk to as well. The advice seen on this board many times is coming from people who have an axe to grind or a chip on their shoulder. No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting.

Personally, I have met many great attendings, residents, and private practice docs that have a very realistic outlook on the future of anesthesiology. They present a balanced picture of the future which has not only many challenges, but rewards as well. All specialties have their positives and negatives and you need to work hard to gain as much insight as possible from *reliable sources* during your preclinical years and especially during your rotations third year.

Reading SDN is good entertainment and you may gain some insight into certain aspects of the specialty, but I would not rely on it as your basis for making a career decision.

I think a lot of the conversations here are pretty spot on. People here have their fingers on the pulse. Im serious. ANyway, people listen to what they want to hear in the end.

I would be sympathetic with you buddy if I wouldn't read hypocrisy in your post - as
"No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting. "
Comment - If I would have a positive outlook regarding this speciality compared with other medical fields you wouldn't "doubt" the intenions? Isn't that right? So you "like" what you want to hear and judge others through your wishes...Beeing insincere with yourself doesn't bring to much in your life. Regarding the intensions in posting - what do you mean? Do you believe that we try to attract students in this field? Thanks God we have enough applicants - see the statistics so it is not necessary to use this board as a pumping tool for anesthesia. Take care in GL!
PS : and Maceo is right on spot!

 

[SaintFrances]

I would be sympathetic with you buddy if I wouldn't read hypocrisy in your post - as
"No offense to all the disgruntled anesthesiology attendings out there, but when I read your bitter comments, I have to take them with a big grain of salt as I do not know you personally, do not know your situation, and am often doubtful of your intentions in posting. "
Comment - If I would have a positive outlook regarding this speciality compared with other medical fields you wouldn't "doubt" the intenions? Isn't that right? So you "like" what you want to hear and judge others through your wishes...Beeing insincere with yourself doesn't bring to much in your life. Regarding the intensions in posting - what do you mean? Do you believe that we try to attract students in this field? Thanks God we have enough applicants - see the statistics so it is not necessary to use this board as a pumping tool for anesthesia. Take care in GL!
PS : and Maceo is right on spot!

Sorry to not be more clear, but I take EVERYTHING I read on SDN with a grain of salt - be it positive or negative. However, I find much more negativity on SDN than I do out in the "real world." I think this points to the fact that those who want to complain or have some venting to do will often use these forums to do so.

Regarding "intentions" of the posters...I have no way of knowing their intentions or for that matter their backgrounds, their work environment, or even if they are actually physicians. Hence, I take everything I read here with a grain of salt.

 

[SaintFrances]

I would be sympathetic with you buddy....

I am not looking for your sympathy but thanks anyway.

 

[2win]

I am not looking for your sympathy but thanks anyway.

No problem - I wish you the best. Anesthesia is a great field and if we play well our card well it is possible to have a financial edge over other fields. To be pragmatic I think is an advantage in a bear market. Hope that you'll choose and match in any field that you like.

 

[pd4emergence]

MS 3 here and I have strongly been considering a career in anesthesia for many years. I just turned in my electives for next year placing an ephasis on gas. However, this board makes me think that it would be a big mistake and a waste of my medical education. All I read is how we will have problems finding employment with the increasing demand for CRNA's, how pay is going to drop, and how the specialty is dying. Is there still a reason to go into anesthesia? Please, can someone give some positive comments for the future of this long respected specialty?

My advice is to talk to the attendings and residents at your institution. Do as many anesthesiology electives as you can and get as much exposure as you can. Even doing that MS4's make a huge decision with really very little information. It is not a sign of failure to match into something and then figure out that you made the wrong decision. On a personal note, I like what I do. I feel I got lucky and made the rights decision. There are times where politics and business get in the way. But, that is going to happen in every specialty. There are many more things to practicing medicine than just seeing and taking care of patients. In addition to taking good care of patients, you also have to be good at the other things to be successful. My personal opinion is that you shoud not let the whole CRNA vs MD debate shape your decision. You will be happier doing what you enjoy and making less than doing something you hate and making a ton. I work with CRNA's now and it works out fine. I miss doing my own cases at times and will probably find a job doing md only work or in academics at some point. Just by take. Good luck.

pd4

 

[marr]

the easiest way is to make sure you want to do it. I asked myself the question "if pay drops to the level of a CRNA.. would I still be happy? would I still be happy if hours went up too?"

A profound statement for anyone considering Anesthesia as a career. I don't think to many applicants have considered this and are blinded by the money and the lifestyle.

 

[climbingdocs]

I agree with SaintFrances.
Also,
1. if you look at anesthesia forum, you can see that people actually have times for interests (brewing beer, running marathons etc) and they do seem happy overall. I would look at the whole picture.
2. I hear about doctors changing their speciality to Anesthesia, I have not heard of the other way around.
It also depends on people's personalities, some people are just naturally more happy then others.

 

[ssmallz]

1. Happy patients - life as an intern in medicine is filled with ungrateful, unhappy, and downright rude patients who want nothing more than to do what makes them happy whether that be walking out of the hosptial @ 3am, eating sugary foods w/diabetes, or just being too lazy to do anything about that rash untill its eating their butt alive. These are things I don't have to deal with in anesthesia. 95%+ of the patients I deal with on a daily basis are generally mellow and aren't rude or abusive toward me. This is a huge plus. I'm sure it has to do w/the fact that their scared and I'm about to give them drugs that will make them happy but my life is much better for it. When I wake them up in the PACU they are nicely sedated and usually fairly comfortable and happy to go home. This is a plus to make and makes my job that much better

2. No rectal, paps, and pelivics. We do much cooler procedures instead - I just hated doing that stuff in medical school and internship and I'm very happy to never have to do another again. I like the fact that I get to do intubations, a - lines, IVs, centrals, spinals, and epidurals on a daily basis. We get to do a lot of fun procedures and even though the newness of them has worn off, I still get a happy feeling when I pop that labor epidural in on the first try, or I successfully put a large bore IV in my pt for volume resucitation.

3. Instant gradification - Pts bp in the OR is 70/40, push a lil neo and its back up. Too high? I can lower it just as quickly. Pt in pain in the pacu? block em and its all better w/in 10 mins. Labor pains gettin you? Epidural in and 5 minutes later patient is sleeping. We do things in anesthesia that takes minutes not months and thats something that I really enjoy. If your pt has a high BP or sugar, in medicine you change their drug regimen and then wait 2 weeks or a month to see if your treatment works. That sux, I like instant feedback

Those are just a few of the reasons I like anesthesia, there are plenty more that I won't go into here but needless to say, despite some of it's shortcoming, anesthesia is still a great specialty to go into

 

[Licoricestick]

Well thanks for the reply, but anesthesia is actually what I am interested in and have been for quite a while. I like the physiology of the human body and how it reacts to stress, I enjoy doing procedures, and I don't particularly enjoy clinic. So thanks, but that is not the advice that I was looking for. I wasn't asking for advice on what to do with my life, rather I was wondering if anyone on here had anything good to say and encouraging for a person like myself who is planning a career in this field. I'm looking for optomists out there. Answers like yours are exactly what I am concerned about.

Speak to actual people in the field - ask them why they got into anaesthesia, but more importantly why they stay in the field.

Can you actually see yourself doing anything else? There is no point in saying "well I'm so worried that problem x, y or z is going to encompass anaesthesia in the next 10-15 years that I won't go into the field" if you really would hate being a surgeon or a physician or in primary care (and lets be honest, if you're interested in anaesthesia things like dermatology and psych would probably have you wanting to kill yourself).

I'm a first year Australian anaesthesia trainee (which means that I'm actually third year out of medical school). In Australia we are just now confronting the possibility of nurses taking on sedation and anaesthesia roles (British system has historically meant that anaesthesia was exclusively performed by doctors). Does it worry me? Absolutely (but I'm not trying to start that debate here). Does it mean I want to give up tubes, lines, the ability to acutely alter physiology, the responsibility for making sure that the patient is still alive and healthy after (and sometimes despite) the surgeons have played with the one part of anatomy they are qualified to deal with? Definitely not. Why? Because the bottom line is that I am a proceduralist who is impatient (I like seeing immediate results - I don't want to wait 3 months to see if the HbA1C comes down) and much prefers to fiddle with physiology rather than anatomy so if I weren't in anaesthesia or a related field (pain/critical care) I'd probably quit medicine because I can't see myself being a surgeon or an ER doctor or anything much else.

I would be concerned that you seem unable to make up your mind without positive comments from a heap of annonymous people you don't know on an internet forum! A forum like this inevitably becomes a place for people to rant about issues because they can do it safely and annonymously thus "getting it out of their system" and being able to turn up to work the next day without wanting to do physical harm to others.

 

[Jeff05]

the reason you find more negativity here is that people are more comfortable venting on an anonymous forum.

do you actually think that attendings and residents would ever tell a rotating medical student exactly what they're feeling? as a senior resident i am only now starting to hear how attendings really feel...

i have worked in many settings during residency - big city academic, city, offices, suburban private: and i think the concerns and tone of this board really shadow what is actually spoken about and said behind closed doors.

there are many positives, but don't foul yourself - all the negatives being discussed are REAL and once you half the paycheck, not as fun to deal with.

Sorry to not be more clear, but I take EVERYTHING I read on SDN with a grain of salt - be it positive or negative. However, I find much more negativity on SDN than I do out in the "real world." I think this points to the fact that those who want to complain or have some venting to do will often use these forums to do so.

Regarding "intentions" of the posters...I have no way of knowing their intentions or for that matter their backgrounds, their work environment, or even if they are actually physicians. Hence, I take everything I read here with a grain of salt.

 

[igottaquestion]

there are many positives, but don't foul yourself -

good advice for any field.

 

[CambieMD]

I can tell you from experience that you should select your area of specialization based on what you like, who you are and what interest you.
If you don't like anesthesia find something else to do.

Anesthesia is a perfect fit for my personality and I find it mentally stimulating. My best defense against the encrouchment of others into the field is being the best anesthesiologist that I can possibly be.


Cambie

 

[ProRealDoc]

I can tell you from experience that you should select your area of specialization based on what you like, who you are and what interest you.
If you don't like anesthesia find something else to do.

Anesthesia is a perfect fit for my personality and I find it mentally stimulating. My best defense against the encrouchment of others into field is being the best anesthesiologist that I can possibly be.


Cambie

How much stock do the bean counters put on this though?

 

[NotAMD]

How much stock do the bean counters put on this though?

that is the central question causing fear in new applicants/matches minds...

will it REALLY turn into a mainly nursing field? honestly, is all of this medical education and training really necessary to do this job?

I think that anesthesia as a job is easily overlooked and underappreciated, sure.

but look at the objective evidence so far, what has really happened?

CRNAs are around now, same as any other field with PAs, etc..

The Idea being we SUPERVISE them, not such a bad thing.

In rural / extremely underserved areas they have more independence, not such a bad thing.

Are you going to trust a CRNA in an advanced heart case with arrythmias?
Are you going to trust them to read an EKG/Echo prior to surgery
Trust them with neonates?
Running an ICU or Balloon pump patients?
Putting in Central lines/epidurals/regional blocks?
Run a code?
Figure out an intraop problem independently?
Develop deviations from an anesthetic plan appropriately

I think the "bean counters" in the end do know these things.

An analogy: How do you think interns would do without attendings helping/leading them? you could get by and do the basic things but come on you just dont have the experience/training of attendings.

When major academic hospitals have CRNAs running things or even any private hospital in a non-rural location have no anesthesiologists then I would be worried.. but i do think we are being paranoid a bit... we are locked into the surgical world and relied on to do procedures routinely that others think are mindblowing (lines, intubations)

My view as a new resident is accept that CRNAs will be like PAs/CA-1 level providers. The powers that be do understand there needs to be a higher level, and there is a shortage now of that higher level.

 

[AK_MD2BE]

that is the central question causing fear in new applicants/matches minds...

will it REALLY turn into a mainly nursing field? honestly, is all of this medical education and training really necessary to do this job?

I think that anesthesia as a job is easily overlooked and underappreciated, sure.

but look at the objective evidence so far, what has really happened?

CRNAs are around now, same as any other field with PAs, etc..

The Idea being we SUPERVISE them, not such a bad thing.

In rural / extremely underserved areas they have more independence, not such a bad thing.

Are you going to trust a CRNA in an advanced heart case with arrythmias?
Are you going to trust them to read an EKG/Echo prior to surgery
Trust them with neonates?
Running an ICU or Balloon pump patients?
Putting in Central lines/epidurals/regional blocks?
Run a code?
Figure out an intraop problem independently?
Develop deviations from an anesthetic plan appropriately

I think the "bean counters" in the end do know these things.

An analogy: How do you think interns would do without attendings helping/leading them? you could get by and do the basic things but come on you just dont have the experience/training of attendings.

When major academic hospitals have CRNAs running things or even any private hospital in a non-rural location have no anesthesiologists then I would be worried.. but i do think we are being paranoid a bit... we are locked into the surgical world and relied on to do procedures routinely that others think are mindblowing (lines, intubations)

My view as a new resident is accept that CRNAs will be like PAs/CA-1 level providers. The powers that be do understand there needs to be a higher level, and there is a shortage now of that higher level.

Beautiful post. As an MS3 that is going into Anesthesiology, reading this forum sometimes makes me worry about the future of the specialty. However, in the end analysis, you have to do what you love.

 

[ProRealDoc]

that is the central question causing fear in new applicants/matches minds...

will it REALLY turn into a mainly nursing field? honestly, is all of this medical education and training really necessary to do this job?

I think that anesthesia as a job is easily overlooked and underappreciated, sure.

but look at the objective evidence so far, what has really happened?

CRNAs are around now, same as any other field with PAs, etc..

The Idea being we SUPERVISE them, not such a bad thing.

In rural / extremely underserved areas they have more independence, not such a bad thing.

Are you going to trust a CRNA in an advanced heart case with arrythmias?
Are you going to trust them to read an EKG/Echo prior to surgery
Trust them with neonates?
Running an ICU or Balloon pump patients?
Putting in Central lines/epidurals/regional blocks?
Run a code?
Figure out an intraop problem independently?
Develop deviations from an anesthetic plan appropriately

I think the "bean counters" in the end do know these things.

An analogy: How do you think interns would do without attendings helping/leading them? you could get by and do the basic things but come on you just dont have the experience/training of attendings.

When major academic hospitals have CRNAs running things or even any private hospital in a non-rural location have no anesthesiologists then I would be worried.. but i do think we are being paranoid a bit... we are locked into the surgical world and relied on to do procedures routinely that others think are mindblowing (lines, intubations)

My view as a new resident is accept that CRNAs will be like PAs/CA-1 level providers. The powers that be do understand there needs to be a higher level, and there is a shortage now of that higher level.

CRNAs may never run things, but then again, they don't need to. All they need to do is displace enough MDs/DOs to the point where you won't be needed anymore. As others have comments, they can increase the supervisory ratio to 1:7 and you'll be working for a CRNA salary.

You have not learned how powerful monetary incentives can be. Your assumptions are mostly right on point but you gotta remember that there are only a finite number of academic centers where the above is true. What about the private practice world?

The idea that you supervise them is good until they legislate you out of your supervisory role. What do you think they spend a lot of time and money doing nowadays?

Will you always be employed? likely. However, I advocate for involvement in the business and politics to ensure a stable future. I don't make assumptions that because I am physician that a CRNA won't legislate me out of existence. That would be stupid and naive on my part and I worry that many newcomers like yourself think you are too high and mighty to not be displaced by an aggressive, politically-minded midlevel.

To top it off, add Obama's healtcare-for-all mentality and you are staring at a not-so-bright picture of your future.

 

[NotAMD]

CRNAs may never run things, but then again, they don't need to. All they need to do is displace enough MDs/DOs to the point where you won't be needed anymore. As others have comments, they can increase the supervisory ratio to 1:7 and you'll be working for a CRNA salary.

You have not learned how powerful monetary incentives can be. Your assumptions are mostly right on point but you gotta remember that there are only a finite number of academic centers where the above is true. What about the private practice world?

The idea that you supervise them is good until they legislate you out of your supervisory role. What do you think they spend a lot of time and money doing nowadays?

Will you always be employed? likely. However, I advocate for involvement in the business and politics to ensure a stable future. I don't make assumptions that because I am physician that a CRNA won't legislate me out of existence. That would be stupid and naive on my part and I worry that many newcomers like yourself think you are too high and mighty to not be displaced by an aggressive, politically-minded midlevel.

To top it off, add Obama's healtcare-for-all mentality and you are staring at a not-so-bright picture of your future.

do you know any private hospitals ( in reasonable areas) doing surgeries that do not have ANY anesthesiologists? or a ratio of more than 4:1? I dont...

and how could you possibly ever be paid at a CRNA wage? whats that like 120k TOPS? Hospitalists make more than that, and it just doesnt make sense to me that an anesthesiologist would ever be less valuable than a hospitalist to a hospital under any cirumstances (surgeries bring in money)... so i think you can consider hospitalist pay your minimum

and how does increasing the ration of supervision (6:1, 7:1) drop the individuals pay? just means more work..

also, talk to recent grads, any trouble finding a 200-250k job right now? none that I have talked to...many are hesitant to take fellowships because they dont want to give up the money..especially if your willing to live in a cheap area and then you have high salary low cost of living..

and what stops nurses from legislating against IM docs or midwives against OBs? they are just as likely to say OB docs are not needed as anesthesiologists.. its just an unreasonable fear to hold that the whole idea of anesthesiology as a medical specialty will end... demand may decrease as midlevels are permitted to do more but there is always a doctor at the end of the line

 

[Jeff05]

CRNAs make 150k on average in this area. many make 180k. out west they make up to 250. you must remember that BILLING is the same for CRNA or MD.

what you do not realize is that anesthesiology IS different from other medical specialties. The CRNA lobby IS different from other lobbies because they have mounted an unprecedented offensive. Midwives are NOT lobbying to prescribe medications and DO c-sections.

and recent grads are NOT hesitant to do fellowships. most are hesitant NOT to do them. people know what's coming and want to be able to have a special skill. fellowship competition is at an ALL TIME HIGH this year.

do you know any private hospitals ( in reasonable areas) doing surgeries that do not have ANY anesthesiologists? or a ratio of more than 4:1? I dont...

and how could you possibly ever be paid at a CRNA wage? whats that like 120k TOPS? Hospitalists make more than that, and it just doesnt make sense to me that an anesthesiologist would ever be less valuable than a hospitalist to a hospital under any cirumstances (surgeries bring in money)... so i think you can consider hospitalist pay your minimum

and how does increasing the ration of supervision (6:1, 7:1) drop the individuals pay? just means more work..

also, talk to recent grads, any trouble finding a 200-250k job right now? none that I have talked to...many are hesitant to take fellowships because they dont want to give up the money..especially if your willing to live in a cheap area and then you have high salary low cost of living..

and what stops nurses from legislating against IM docs or midwives against OBs? they are just as likely to say OB docs are not needed as anesthesiologists.. its just an unreasonable fear to hold that the whole idea of anesthesiology as a medical specialty will end... demand may decrease as midlevels are permitted to do more but there is always a doctor at the end of the line

 

[CambieMD]

CRNAs make 150k on average in this area. many make 180k. out west they make up to 250. you must remember that BILLING is the same for CRNA or MD.

what you do not realize is that anesthesiology IS different from other medical specialties. The CRNA lobby IS different from other lobbies because they have mounted an unprecedented offensive. Midwives are NOT lobbying to prescribe medications and DO c-sections.

and recent grads are NOT hesitant to do fellowships. most are hesitant NOT to do them. people know what's coming and want to be able to have a special skill. fellowship competition is at an ALL TIME HIGH this year.

What is the take home message of your post?

Cambie

 

[Gern Blansten]

What is the take home message of your post?

Cambie

1-CRNAs get paid a lot and want to oust us
2-They have a huge lobby compared to other nursing groups
3-fellowships are competitive due to 1 and 2

 

[ProRealDoc]

do you know any private hospitals ( in reasonable areas) doing surgeries that do not have ANY anesthesiologists? or a ratio of more than 4:1? I dont...

and how could you possibly ever be paid at a CRNA wage? whats that like 120k TOPS? Hospitalists make more than that, and it just doesnt make sense to me that an anesthesiologist would ever be less valuable than a hospitalist to a hospital under any cirumstances (surgeries bring in money)... so i think you can consider hospitalist pay your minimum

and how does increasing the ration of supervision (6:1, 7:1) drop the individuals pay? just means more work..

also, talk to recent grads, any trouble finding a 200-250k job right now? none that I have talked to...many are hesitant to take fellowships because they dont want to give up the money..especially if your willing to live in a cheap area and then you have high salary low cost of living..

and what stops nurses from legislating against IM docs or midwives against OBs? they are just as likely to say OB docs are not needed as anesthesiologists.. its just an unreasonable fear to hold that the whole idea of anesthesiology as a medical specialty will end... demand may decrease as midlevels are permitted to do more but there is always a doctor at the end of the line

Are you a med student who just matched into anesthesia? You don't seem to have a grasp on some of the basic issues affecting anesthesia. If you don't know, I suggest you become more familiar with the reality of anesthesia because right now you seem pretty clueless.

 

[Hockeyguy]

Here is one positive thing about I am finding out about Anesthesiology as I become a senior resident. The field is huge. If you do choose to go into it you will have a ton of paths to choose from. You can do hearts and do TEE and place invasive monitors etc everyday. You can work at a busy academic institution and do a liver Tx at 3 in the AM on the guy with a difficult airway and pulm HTN. Or you can work 9-5 in a surgery center making 200k never working a night or weekend. You could be an ICU doc with one additional year training - and be damn good at it. Hate the OR? Be a pain dude. Make 600k puttin needles in dudes with back pain or doing vertebroplasty on cancer patients with compression fractures. Specialize in regional and do some sweet blocks saving people from a GA. Do a fellowship in "simulation" and be a prof at whatever med school you like. One of the most underappreciated things about Anesthesiology is how diverse our specialty really is. It is not without problems for sure but IMHO it is also one of the last fields that with five years of training you can do a ton of stuff.Good luck in whatever you choose. If I couldn't do this I would take a hard look at vascular surgery - those guys are doing some cool stuff these days and they have plenty of patients. Ortho doesn't seem like a bad gig either when you come out the other end.