Best States for Anesthesiology?

[JLarry8900]

Jlarry greater CHICAGO market sucks. Have to cross into Indiana or Wisconsin for 400.

Yeah, I'm not targeting Chicago for post-residency practice. My goal is Indiana, but I am intrigued by living on the lake in Milwaukee. Just wondering if gaswork is accurate, since I never see anything above 300K for Milwaukee on that site.

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[JLarry8900]

And just to be clear, Wisconsin allows CRNAs to practice independently, correct? Does Indiana allow this?

 

[deleted171991]

And just to be clear, Wisconsin allows CRNAs to practice independently, correct? Does Indiana allow this?

http://www.aana.com/advocacy/stateg...ral-Supervision-Rule-Opt-Out-Information.aspx

 

[amyl]

See my post in the depressing job thread

 

[Twiggidy]

But, for the sake of this discussion let's just assume that you have no family or friends anywhere. Your only interests outside of the OR involve sitting in your basement posting to SDN and keeping current on all the latest internet porn trends.

 

[Wiscoblue]

And just to be clear, Wisconsin allows CRNAs to practice independently, correct? Does Indiana allow this?

Yes CRNAs can practice independently in wisconsin. And so does indiana. But many hospitals do require supervision. There are several md only practices in Milwaukee. 400k start plus benefits. Check out team health in Racine they're always looking. So is Infinity (AMC).

 

[JLarry8900]

Yes CRNAs can practice independently in wisconsin. And so does indiana. But many hospitals do require supervision. There are several md only practices in Milwaukee. 400k start plus benefits. Check out team health in Racine they're always looking. So is Infinity (AMC).

It looks like Indiana still requires supervision, actually. How would one go about getting one of the positions you mentioned? Is it just a "in the know" type thing? I've honestly just been looking at gaswork and they don't seem to have any of these positions. Thanks for any help.

BTW, would you guys recommend a fellowship?

 

[BIGphysician]

Texas obviously

 

[deleted50478]

Texas obviously

Texas is not good anymore. Several private practices sold out a large portion of urban TX.

 

[nycitygas]

Texas physician market as a whole is terrible unless you are emergency medicine or a hospitalist...

 

[nycitygas]

edit

 

[Wiscoblue]

Emergency medicine in Austin had a big sellout last year. All ERs are consolidated under same management company.

 

[nycitygas]

Emergency medicine in Austin had a big sellout last year. All ERs are consolidated under same management company.

Yet somehow the local rate is $225-300/hr

 

[BIGphysician]

Texas physician market as a whole is terrible unless you are emergency medicine or a hospitalist...

Then where to next?

 

[Wiscoblue]

Yet somehow the local rate is $225-300/hr

You probably have better info about Austin EM. My best friends wife is an ER doc in Austin and he's a neonatologist. I'm just stating what they told me last year when I visited them. Sounded like Austin used to be a great place for Anesthesiologists not any more though.

 

[BIGphysician]

You probably have better info about Austin EM. My best friends wife is an ER doc in Austin and he's a neonatologist. I'm just stating what they told me last year when I visited them. Sounded like Austin used to be a great place for Anesthesiologists not any more though.

So where is a good spot? Alaska??

 

[amyl]

2005

 

[bashwell]

2005

If I only had a time machine.

 

[anbuitachi]

australia?

 

[bashwell]

australia?

Definitely a good place to practice!

 

[JLarry8900]

This is really stupid of me to ask, but since CRNA's have already been allowed to practice independently for more than 10 years in Wisconsin, and Indiana still hasn't allowed that, would it be better to practice in Indiana or Wisconsin, if one wants to avoid CRNA creep. My thinking would be that CRNA's have already done their damage in Wisconsin, while Indiana still hasn't felt it as strongly, but likely will in the future (assuming independence is allowed).

 

[Wiscoblue]

It gives employers the ability to bill QZ and not be targeted for not following direction rules. Gives the employing docs the option to supervise more rooms.

Nothing has changed yet but I see the possibility of having crnas working side by side without supervision doing the ASA 1-2 cases while MDs do the 3-5 cases.

 

[amyl]

There is no difference between opt out states and non opt out states. All states are effectively opt out. just go where you want to be....

 

[BIGphysician]

Well seems like no one state is that great. What about if you just cared about making money and having nice hours?

 

[Twiggidy]

There is no difference between opt out states and non opt out states. All states are effectively opt out. just go where you want to be....

Exactly. If you have a job that's miserable, at least live somewhere you enjoy.

 

[Twiggidy]

Well seems like no one state is that great. What about if you just cared about making money and having nice hours?

I think you should take cost of living into account when asking that. Someone may tell you that you can make 400-500k working modestly hard CA but then compared to make 300k in the midwest or south where you'd be considered rich, now that CA job doesn't look so hot. That's why (IMO**) it's getting difficult to find jobs in these "US Most Affordable Cities" because doctors are getting good pay in a low cost of living area.

 

[amyl]

Yup my friend makes 325 in Washington DC and can't afford to buy w house

 

[anbuitachi]

but i thought the more expensive places tend to pay less anyway, b/c they are so saturated w/ doctors.. like NYC

 

[amyl]

It's a matter of supply and demand.... Lots of people want to live in dc, Nyc, Chicago, etc and will take a pay cut to do so. On the other hand, you will get paid extra to go someplace that sucks

 

[IkeBoy18]

It's a matter of supply and demand.... Lots of people want to live in dc, Nyc, Chicago, etc and will take a pay cut to do so. On the other hand, you will get paid extra to go someplace that sucks

Aside from the the rest of the doom and gloom, Ill def have to prepare myself to make even less as Ive only lived in major cities my whole life (houston, atl, nyc, dc) and I dont have any plans to work anywhere but another large city. After med school in a small town, Columbus, oh, Im not interested in living in another one.

 

[psychbender]

Aside from the the rest of the doom and gloom, Ill def have to prepare myself to make even less as Ive only lived in major cities my whole life (houston, atl, nyc, dc) and I dont have any plans to work anywhere but another large city. After med school in a small town, Columbus, oh, Im not interested in living in another one.

I'm the exact opposite. I absolutely hate cities, and would never willingly work in a large city again.

 

[G0S2]

Texas is not good anymore. Several private practices sold out a large portion of urban TX.

Still good in San Antonio, for now.

 

[IkeBoy18]

I'm the exact opposite. I absolutely hate cities, and would never willingly work in a large city again.

I understand that. The traffic and chaos can be a dealbreaker. I think big city living works when you find a small community in a big city. That way you dont have to deal with the major big city problems. Or live out in the burbs with access to the city. Or as youve suggested, completely avoid it all together.

When you say "again," which city did you experience?

 

[Richanesthesiologist]

I have narrowed down my choices to 4 states: Washington (not Seattle but maybe Tacoma, Everett, or Bellingham), Tennessee, Alaska, and South Dakota. One commonality between all these states is the lack of a state income tax, which can range up to 10% and equate to taking a $30000 cut out of your income annually (think of it as a lease on 3 Range Rovers). These states also have low malpractice costs (Florida would also be nice if it wasn't for their high malpractice costs). Alaska and South Dakota also seem attractive because of a lack of a sales tax and their innate beauty, while Tennessee property taxes seem low. It's all about keeping your money away from Uncle Sam.

 

[tartesos]

I have narrowed down my choices to 4 states: Washington (not Seattle but maybe Tacoma, Everett, or Bellingham), Tennessee, Alaska, and South Dakota. One commonality between all these states is the lack of a state income tax, which can range up to 10% and equate to taking a $30000 cut out of your income annually (think of it as a lease on 3 Range Rovers). These states also have low malpractice costs (Florida would also be nice if it wasn't for their high malpractice costs). Alaska and South Dakota also seem attractive because of a lack of a sales tax and their innate beauty, while Tennessee property taxes seem low. It's all about keeping your money away from Uncle Sam.

Vouch for Tn


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[deleted162650]

I have narrowed down my choices to 4 states: Washington (not Seattle but maybe Tacoma, Everett, or Bellingham), Tennessee, Alaska, and South Dakota. One commonality between all these states is the lack of a state income tax, which can range up to 10% and equate to taking a $30000 cut out of your income annually (think of it as a lease on 3 Range Rovers). These states also have low malpractice costs (Florida would also be nice if it wasn't for their high malpractice costs). Alaska and South Dakota also seem attractive because of a lack of a sales tax and their innate beauty, while Tennessee property taxes seem low. It's all about keeping your money away from Uncle Sam.

I wasn't impressed with compensation in WA back when I was looking at gigs there (including Bellingham). TN is becoming more and more AMC. I'd focus on AK and SD but you should really look into WY and ND as well.

 

[deleted162650]

Keep in mind that State income taxes are deductible on your federal returns (unless you get AMT bitch slapped).

 

[tartesos]

I wasn't impressed with compensation in WA back when I was looking at gigs there (including Bellingham). TN is becoming more and more AMC. I'd focus on AK and SD but you should really look into WY and ND as well.

Tn is beautiful.


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[deleted162650]

Tn is beautiful.


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Never said it wasn't (well, eastern TN is pretty, western TN is pretty hideous). From a practice perspective though, I would prefer to focus my search on areas that haven't yet contracted the AMC virus.

 

[deleted171991]

Vouch for Tn


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So does the KKK.

 

[deleted171991]

Mom is in a wealthy chicago burb (pp) and they are offering 2 year partnership track to >400. Can't find anyone young because all of the millenials want to live/work in the city. So no the Chicago area does not suck.

Plus the millennials have heard the horror stories about bad partnership tracks and poor community hospitals.

 

[NotFrankUnderwood]

Plus the millennials have heard the horror stories about partnership tracks and community hospitals. (Even if they don't screw you, you will practice 20th century low-cost anesthesia.)

I don't know enough about anesthesiology to contend "20th century low cost anesthesia" (I'm assuming you mean crna supervision which she definitely does) but ok... So if you don't go to a community hospital you go to an academic center where you're definitely not going to make pp money. What then do you propose? She's been there for over a decade but from what I can tell her life, except for call 1x per week is pretty fantastic.

 

[deleted171991]

I don't know enough about anesthesiology to contend "20th century low cost anesthesia" (I'm assuming you mean crna supervision which she definitely does) but ok... So if you don't go to a community hospital you go to an academic center where you're definitely not going to make pp money. What then do you propose? She's been there for over a decade but from what I can tell her life, except for call 1x per week is pretty fantastic.

She's lucky. Things were much different 10+ years ago, and one doesn't get these deals easily anymore.

I didn't mean the ACT model. What I meant is that there are poor community hospitals which lack common resources usually found in academia, so some millennials may not feel comfortable reinventing the wheel just to maybe make $100K more. Money isn't everything. For example, there are people who just hate paper charting, or not having help to change circuits. suction, set up fluids etc., or having just the most basic drugs (e.g. no sugammadex), or having to push stretchers as an attending physician, and so on.

I personally would rather take a $100K paycut if it makes my work much more enjoyable.

 

[anbuitachi]

Can make 400k in academic institutions in NYC. Cover multiple rooms , take a lot of calls and work 80 hr weeks

 

[turnupthegas]

Can anyone comment on the SoCal (LA/OC/SD) market? Ideally something coastal. I'm looking to head back west in a bit. From what I heard, UC's tend to pay alright and still offer pensions. I've heard salaries have fallen in SoCal Kaiser's but haven't heard exact numbers.

 

[GravelRider]

Can make 400k in academic institutions in NYC. Cover multiple rooms , take a lot of calls and work 80 hr weeks

400k? Think a lot lower in NYC. I know of one major academic institution in NYC that starts you at low 200s base. You have to take a lot of extra call to break 300.

 

[turnupthegas]

Mt. Sinai attendings make over 400k in NYC but they are working for it. NYU, Cornell, and Columbia pay pennies. Beth Israel used to do alright, but now they are closing down the hospital. Better luck outside of Manhattan. Can still get 300+.

 

[deleted171991]

400k? Think a lot lower in NYC. I know of one major academic institution in NYC that starts you at low 200s base. You have to take a lot of extra call to break 300.

Yep. I know of that one, too. And let's not forget the stupendous cost of living in NYC, including a crazy local income tax.

 

[tartesos]

So does the KKK.

That's a little more to the south than here
Im brown Hispanic and no issues yet.
Lots of tolerance at least on the big 4 cities( Memphis, Nashville, Chattanooga, +/- Knoxville)and around them.
And I have a lifetime ccw permit, just in case.



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[anbuitachi]

Mt. Sinai attendings make over 400k in NYC but they are working for it. NYU, Cornell, and Columbia pay pennies. Beth Israel used to do alright, but now they are closing down the hospital. Better luck outside of Manhattan. Can still get 300+.

Jebus. How hard are these attendings working in NYU/cornell/columbia. How do they even have enough attending anesthesiologists. who would work there...