Best States for Anesthesiology?

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JLarry8900

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As someone interested in the field, what states are best for practicing Anesthesiology? Texas? Cali? Wisconsin? Indiana? Just looking for some advice on the matter. Thanks!
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JLarry8900 said:
As someone interested in the field, what states are best for practicing Anesthesiology? Texas? Cali? Wisconsin? Indiana? Just looking for some advice on the matter. Thanks!
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States are too big to lump together. As a general rule, places where few people want to live have better jobs. Some of those may be in any state. A lot of California sucks. I've never been to Indiana but I'm sure there are areas where lots of people want to live. An so forth.
 
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Not to be too militaristic, but when are we going to go on the attack and take back some territory?
 
nolagas said:
States are too big to lump together. As a general rule, places where few people want to live have better jobs. Some of those may be in any state. A lot of California sucks. I've never been to Indiana but I'm sure there are areas where lots of people want to live. An so forth.
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In general, a very valid response. It's all supply and demand. If you want to live in a place where everyone else wants to live the the market will be tight and the pay will be moderate to lower based on the cost of living in that area (examples: California metro cities, Florida, New York (NYC), DC, probably even Austin/Dallas, and Seattle). To contrast if he head to the central valley of California, where no one really wants to live (you don't move to California to live in Bakersfield) then there will be very good salaries for a decent amount of work. Likewise, states that aren't desirable to most people (parts of the South, Midwest, very cold rural northeast and northwest) may have more job opportunities with decent pay and decent cost of living.

To add to the confusion, some states that are very affordable to live (midwest) may not have jobs BECAUSE it's so affordable and people don't retire from their nice jobs with good pay, so they may be hard states to break into the market. In general, if you think there's somewhere you REALLY want to live, try to do your residency/fellowship in that area so you'll have connections.
 
Wrt California, anesthesia compensation is determined primarily by payor mix. Some of the most desireable areas to live also have the best payor mix. So good jobs are available in nice areas, they are just more competitive to get, (eg Newport Beach, Marin). The best jobs in California are not necessarily in bfe Central Valley towns.
 
Best states for what? $? Fair judicial system? Lifestyle? Gotta narrow it down bud.... I'm in Indiana now. $ is good, no one seems to sue here even when they should. I don't work too many hours.... But when it's crazy it's crazy. I've worked 30 hours straight before... And I went home at noon today bc the cases were done. But there's nothing to do here with the free time lol. Also there's zero backup, the patients are really sick and equipment suboptimal, other doctors care like cards n hospitalist is often a total joke .... When the **** really hits the fan I'm holding it by myself....
 
amyl said:
Best states for what? $? Fair judicial system? Lifestyle? Gotta narrow it down bud.... I'm in Indiana now. $ is good, no one seems to sue here even when they should. I don't work too many hours.... But when it's crazy it's crazy. I've worked 30 hours straight before... And I went home at noon today bc the cases were done. But there's nothing to do here with the free time lol. Also there's zero backup, the patients are really sick and equipment suboptimal, other doctors care like cards n hospitalist is often a total joke .... When the **** really hits the fan I'm holding it by myself....
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I guess just a mixture of malpractice, $, job opportunities. I realize that every state has rural areas where you can make more, but I was under the impression that some states had stronger markets for anesthesiologists than others.
 
Here in Wisconsin the practice climate is good. Reimbursements are not bad but there are very few private practice groups left. Most have either been bought out or are hospital employed. The largest hospital system, Aurora Healthcare has employed all the anesthesiologists at all their hospitals except at their mothership St Lukes and that's going down in due course. Aurora is still all MD, though. Marshfield Clinic is all ACT hospital employees 400k. Rural areas are all Crna. Madison is all ACT hospital employees 400k.
 
Wiscoblue said:
Here in Wisconsin the practice climate is good. Reimbursements are not bad but there are very few private practice groups left. Most have either been bought out or are hospital employed. The largest hospital system, Aurora Healthcare has employed all the anesthesiologists at all their hospitals except at their mothership St Lukes and that's going down in due course. Aurora is still all MD, though. Marshfield Clinic is all ACT hospital employees 400k. Rural areas are all Crna. Madison is all ACT hospital employees 400k.
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Thanks. Do you know what an Anesthesiologist could expect in Milwaukee? And is the 400K number you have for starting, or is that with years of experience? Also, can an Anesthesiologist get a position in a rural area, or is that exclusively CRNA? Thanks.
 
It's tough to break into rural hospitals. They employ the CRNAs and make money off them.

I think 400k plus benefits is the going rate for a new hire in Milwaukee. Not sure if experience matters.
 
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I've worked in both Texas and Indiana, in addition to others. And in both those states, my malpractice premiums were pretty low. I think they have caps on damages, and I think Indiana has some sort of physician review process for malpractice suits. Texas also has no state income tax, another thing to consider.

Generally rural areas will have better paying jobs. You can earn lots of money in big cities if you are in the right group - good payor mix, busy OB, etc. But you will find those groups are very difficult to get into without connections.
 
Wiscoblue said:
It's tough to break into rural hospitals. They employ the CRNAs and make money off them.

I think 400k plus benefits is the going rate for a new hire in Milwaukee. Not sure if experience matters.
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I want to practice back in my home state of Indiana, but 400K plus benefits sounds great for a city like Milwaukee. Might not be too bad to be on the lake.
 
Wiscoblue said:
Here in Wisconsin the practice climate is good. Reimbursements are not bad but there are very few private practice groups left. Most have either been bought out or are hospital employed. The largest hospital system, Aurora Healthcare has employed all the anesthesiologists at all their hospitals except at their mothership St Lukes and that's going down in due course. Aurora is still all MD, though. Marshfield Clinic is all ACT hospital employees 400k. Rural areas are all Crna. Madison is all ACT hospital employees 400k.
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I thought Meriter was a private, MD only group in Madison. It has historically been desirable to area grads.

UW and St Mary's are the other area groups and are academic and ACT employed, respectively.
 
You are correct that they are all MD. My impression has been that they are not good to their junior associates. I could be wrong. We hired a guy from their group a few years ago. Madison is a great place to live and the academics and athletics are exceptional. Maybe that's what makes them so attractive when there's not much to choose from.
 
JLarry8900 said:
I want to practice back in my home state of Indiana, but 400K plus benefits sounds great for a city like Milwaukee. Might not be too bad to be on the lake.
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400 plus benefits seems pretty standard in Indiana..... High 400s happens too
 
550K (first year out)-750K (best year). 10-13 weeks. If you took less, you made more. Indiana is a gold mine in certain regions. That being said, it also is a very depressive state and I worked harder than most when I was on. I am so glad I left as I find value in other aspects of life. I'll never go back.
I prefer my new backyard much better (at a reduced income). A good job is not defined by a number.

Iphone photo... so not the best quality... but you get the picture.

IMG_2031_zpsuzjwuiys.jpg
 
May I ask what state is that?

P.S. Never mind. I have found where the picture was taken.
 
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sevoflurane said:
550K (first year out)-750K (best year). 10-13 weeks. If you took less, you made more. Indiana is a gold mine in certain regions. That being said, it also is a very depressive state and I worked harder than most when I was on. I am so glad I left as I find value in other aspects of life. I'll never go back.
I prefer my new backyard much better (at a reduced income). A good job is not defined by a number.

Iphone photo... so not the best quality... but you get the picture.

IMG_2031_zpsuzjwuiys.jpg
Click to expand...



That is a beautiful view!
It seems from here you made the right choice!
 
Well, I'm from Indiana, so I would be going back for family. Plus, honestly, med school has been so tough and filled with such prestige hungry gunners that I miss being back around more like minded folks like me. As a result, I've probably developed rose colored glasses for the state. A piece of me, though, would love to live on the lake, so Milwaukee is intriguing. Chicago would be nice too, but the state seems terrible for medicine, and I doubt they could match 400K like in Wisconsin and Indiana.
 
Litigation is bad in Illinois. The state is broke and Medicaid is behind on payments. Chicago does have a couple of good groups and reimbursements are excellent along the north shore and northwestern suburbs. Tough to get a job with them.
 
Wiscoblue said:
Litigation is bad in Illinois. The state is broke and Medicaid is behind on payments. Chicago does have a couple of good groups and reimbursements are excellent along the north shore and northwestern suburbs. Tough to get a job with them.
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How tough is it to get a good paying job in Milwaukee?
 
Pretty much stay away from any state that is bordered by something with the word "Ocean" in it. I kid (or do it?)
 
The name of this thread is "Best States for Anesthesiology".
The answer to this question is completely dependent on the person asking the question.
 
Twiggidy said:
Pretty much stay away from any state that is bordered by something with the word "Ocean" in it. I kid (or do it?)
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Not entirely sure about that... If you've made a plan and executed it and want to live by the ocean as a 50 y/o part timer... I wouldn't necessarily stay away.

You need to have a plan.

maxwell-rasche-1.jpg


Diffrent strokes for diffrent folks. :cigar:
 
sevoflurane said:
Not entirely sure about that... If you've made a plan and executed it and want to live by the ocean as a 50 y/o part timer... I wouldn't necessarily stay away.

You need to have a plan.

maxwell-rasche-1.jpg


Diffrent strokes for diffrent folks. :cigar:
Click to expand...

you_got_me_breaking_bad.gif
 
Wiscoblue said:
Here in Wisconsin the practice climate is good. Reimbursements are not bad but there are very few private practice groups left. Most have either been bought out or are hospital employed. The largest hospital system, Aurora Healthcare has employed all the anesthesiologists at all their hospitals except at their mothership St Lukes and that's going down in due course. Aurora is still all MD, though. Marshfield Clinic is all ACT hospital employees 400k. Rural areas are all Crna. Madison is all ACT hospital employees 400k.
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Madison fell? I thought there was a private group at Meriter?
 
Liked Saint Lukes. Nice facilities and good heart hospital as I recall. This was 10+ years ago though.
 
In general I think you'll find as much or more variaion within any given state as you will between states. And what Sevo says is s true. The best state/city/etc. to practice in is gonna be highly dependent on the individual.

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. In that case, I would start by getting a list of all the states with meaningful med mal tort reform, and then cross referencing that list with a list of which states have the lowest tax burden (keep in mind that involves a lot more than just state income tax). General cost of living is the next variable I would factor in.

Other things to keep in mind:
1) CRNA's tend to have less of a foothold as you move west.
2) AMC's tend be less prevalent as you move west (at least for now).
 
imfrankie said:
Madison fell? I thought there was a private group at Meriter?
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No, Meriter is still MD only, and PP. though the hospital was recently purchased by a large multi specialty group out of Iowa. Otherwise St. Mary's is straight supervision and UW is academic.
 
SaltyDog said:
In general I think you'll find as much or more variaion within any given state as you will between states. And what Sevo says is s true. The best state/city/etc. to practice in is gonna be highly dependent on the individual.

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. In that case, I would start by getting a list of all the states with meaningful med mal tort reform, and then cross referencing that list with a list of which states have the lowest tax burden (keep in mind that involves a lot more than just state income tax). General cost of living is the next variable I would factor in.

.
Click to expand...

:laugh:🤣
 
How accurate is gaswork? Obviously, I don't know as well as anyone else in this thread, but I rarely see anything in Wisconsin for above 300K, including Milwaukee.
 
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