CRNA vs. MD Anesthesiologist Income in 2015

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
BLADEMDA

BLADEMDA

Full Member
Lifetime Donor
Verified Member
15+ Year Member
Platinum Member
Joined
Apr 22, 2007
Messages
22,307
Reaction score
8,945
Moderators,

If possible let this thread run for a while on the main forum provided people STICK to the topic on this thread. We have dozens of open threads on the midlevel forum for debating this topic. This thread is for speculation about CRNA and/or MD Anesthesiology income in the year 2015.

Please avoid debate so we can get opinions as to what providers are thinking about the future.
Members don't see this ad.
 
By 2015 the DNAP CRNA should be in place for some schools. I suspect the Obama Health Care plan will be in full swing as well.

My conjecture is that MD Anesthesiology income is reduced 25-30% from today's levels. CRNA income should hold at today's levels but I am not sure if cost of living is keeping up with the dollar now known as hard toilet paper.

Anyone else care to speculate?
 
The closer the crna income gets to the MD income the less attractive they become.
 
Members don't see this ad :)
I agree that MD salary reduction is inevitable, though not necessarily at the direct hands of CRNAs (read: Gov't continue reduction in Medicare reimbursement). I also agree that if the salary gap between MD and Nurse shrinks (either due to DNP CRNA or other factors), their appeal would probably diminish. A couple of questions:

1. Does anyone suspect that malpractice for CRNAs will increase given their quest for more autonomy (autonomy in large metropolis, not rural setting)? If so, not sure how they would be a cost-saving option.

2. Would there be a benefit if the field of anesthesiology became subspecialized in the sense of having board certification in CT, neuro, OB (in other words board cert similar to CCS and pain)? While this may be an inconveinence (sp?) to some, I would think we would have further justification in having MDs in charge. In other words, hospitals would be hard pressed to have CRNA in a CT case over a Board Cert MD in CT (Much in the same way a NP who works with a Cardiologist is in no position to replace the Board Cert specialist).

My biggest concern is not that CRNAs think they are analgous to MDs, but that there are MDs who agree with this statement as well :eek:
 
  • Like
Reactions: 1 user
IMED4Life said:
I agree that MD salary reduction is inevitable, though not necessarily at the direct hands of CRNAs (read: Gov't continue reduction in Medicare reimbursement). I also agree that if the salary gap between MD and Nurse shrinks (either due to DNP CRNA or other factors), their appeal would probably diminish. A couple of questions:

1. Does anyone suspect that malpractice for CRNAs will increase given their quest for more autonomy (autonomy in large metropolis, not rural setting)? If so, not sure how they would be a cost-saving option.

2. Would there be a benefit if the field of anesthesiology became subspecialized in the sense of having board certification in CT, neuro, OB (in other words board cert similar to CCS and pain)? While this may be an inconveinence (sp?) to some, I would think we would have further justification in having MDs in charge. In other words, hospitals would be hard pressed to have CRNA in a CT case over a Board Cert MD in CT (Much in the same way a NP who works with a Cardiologist is in no position to replace the Board Cert specialist).

My biggest concern is not that CRNAs think they are analgous to MDs, but that there are MDs who agree with this statement as well :eek:
Click to expand...


1) Someone will pay the malpractice if the crna is independent. The settlements won't decrease. Just who pays is yet to be determined exactly. But if the crna's get stuck with the payout then their premiums must go up.

2) But this is the reason I responded to your post. Do you really think we can subspecialize ourselves into control? I just don't see any advantage to having MD's with separate cert's. Now there would need to be an anesthesiologist for every type of subspecialty at each facility in essence. Anesthesia is not so difficult from case to case typically or else nurses wouldn't be doing it. Limiting ourselves with subspecialties would also risk pricing ourselves out of the market.

I understand your last comment about the crna's believing they are equal but the vast majority of physicians out there that do cases other than boob-jobs, colonoscopies, hernias know that there is a difference. We may be equal when it comes to the easy ASA 1-3's (we know there's a difference here as well) but its the difficult cases and the knowledge that we bring to the table that sets us apart.
 
  • Like
Reactions: 1 users
Noyac said:
1) Someone will pay the malpractice if the crna is independent. The settlements won't decrease. Just who pays is yet to be determined exactly. But if the crna's get stuck with the payout then their premiums must go up.

2) But this is the reason I responded to your post. Do you really think we can subspecialize ourselves into control? I just don't see any advantage to having MD's with separate cert's. Now there would need to be an anesthesiologist for every type of subspecialty at each facility in essence. Anesthesia is not so difficult from case to case typically or else nurses wouldn't be doing it. Limiting ourselves with subspecialties would also risk pricing ourselves out of the market.

I understand your last comment about the crna's believing they are equal but the vast majority of physicians out there that do cases other than boob-jobs, colonoscopies, hernias know that there is a difference. We may be equal when it comes to the easy ASA 1-3's (we know there's a difference here as well) but its the difficult cases and the knowledge that we bring to the table that sets us apart.[/QUOTE]


And this is why I feel the field is not in as dire straights as some might suggest. With an increasingly OLD and SICK population combined with new technologies in surgery as well as surgeons and anesthesiologists pushing the envelope, I feel quite confident about the future of the field and the demand for skilled providers that can impact and mitigate the inherent risks of the above.

That being said, I think we all agree that we need to pay closer attention and fund the ASA-PACs going forward. The best defense in a good offense, for sure.
Click to expand...
 
If MD salaries go down, then I predict that CRNA salaries will also decrease by about the same percentage. CRNA schools are much less selective and may eventually saturate their respective market, kinda like law schools have done with lawyers, driving down average wages.

I am intrigued by the idea (from the other thread) that the MacSleepy machine will replace CRNAs rather than MDs. Instead of the MD supervising several rooms with CRNAs in them, they are supervising several MacSleepys. Getting rid of CRNAs may well save the hospitals more money than getting rid of MDs. This will lead to an increase supply of CRNAs and a decreased demand for their services, driving down their wages.

The only way I see CRNA wages actually increasing is if they take on increased hourly duties, though I see lucrative overtime pay becoming a thing of the past. 36 hours a week and anything beyond is paid at 1.5X your normal salary? Hospitals won't be able to run like that. They will likely increase duty hours and drop overtime pay.
 
Last edited:
Impromptu said:
If MD salaries go down, then I predict that CRNA salaries will also decrease by about the same percentage. CRNA schools are much less selective and may eventually saturate their respective market, kinda like law schools have done with lawyers, driving down average wages.

I am intrigued by the idea (from the other thread) that the MacSleepy machine will replace CRNAs rather than MDs. Instead of the MD supervising several rooms with CRNAs in them, they are supervising several MacSleepys. Getting rid of CRNAs may well save the hospitals more money than getting rid of MDs. This will lead to an increase supply of CRNAs and a decreased demand for their services, driving down their wages.

The only way I see CRNA wages actually increasing is if they take on increased hourly duties, though I see lucrative overtime pay becoming a thing of the past. 36 hours a week and anything beyond is paid at 1.5X your normal salary? Hospitals won't be able to run like that. They will likely increase duty hours and drop overtime pay.
Click to expand...


Current/future CRNAs are the GM workers of the past. In their prime, they got fat, happy and made great salaries with not so much education. This was possible due to the UAW aggressive lobby, their union dues and political clout. They demanded higher salaries, more benefits, etc. GM realized these union workers were just asking for too much.

All this lasted until the mexicans and chinese came along and took their jobs away. Now their former company is bankrupt and their great jobs gone forever. Easy come, easy go.
 
ProRealDoc said:
Current/future CRNAs are the GM workers of the past. In their prime, they got fat, happy and made great salaries with not so much education. This was possible due to the UAW aggressive lobby, their union dues and political clout. They demanded higher salaries, more benefits, etc. GM realized these union workers were just asking for too much.

All this lasted until the mexicans and chinese came along and took their jobs away. Now their former company is bankrupt and their great jobs gone forever. Easy come, easy go.
Click to expand...

now let's not sleep on them. they are the only nurse subspecialty reimbursed 100% medicare that a physician gets, as someone pointed out in another forum. if they can get this far, they can get farther. so donate to ASAPAC and make sure your voice is heard. the older MDA's close to retirement, at least in my city, aren't too worried b/c their retirement is set. but you shouldn't rest..

'i never sleep, cuz sleep is the cousin of death.' - nas
 
sweetalkr said:
now let's not sleep on them. they are the only nurse subspecialty reimbursed 100% medicare that a physician gets, as someone pointed out in another forum. if they can get this far, they can get farther. so donate to ASAPAC and make sure your voice is heard. the older MDA's close to retirement, at least in my city, aren't too worried b/c their retirement is set. but you shouldn't rest..

'i never sleep, cuz sleep is the cousin of death.' - nas
Click to expand...

:laugh: I don't think we ever have to worry about PRD sleeping on the CRNA issue. You make a good point, though.
 
Members don't see this ad :)
ProRealDoc said:
All this lasted until the mexicans and chinese came along and took their jobs away. Now their former company is bankrupt and their great jobs gone forever. Easy come, easy go.
Click to expand...

So...anesthesiologists are the Mexicans and Chinese in your analogy? :p
 
  • Like
Reactions: 1 user
Oh, and anesthesiologists currently have a median income of $358,000, up a decent amount from an average of $292,000 in 2009. Doom and gloom, doooooom and gloooooom!
 
  • Like
Reactions: 1 users
Median income is down for some. More employed doctors. AMCs have a much larger market share. I'd say income is down for many but not all. Job market sucks. Oversupply of providers. Private groups have sold or are selling out at a record pace.

Overall, I'd say things do not look go going forward. Ignore the advice at your own peril
 
  • Like
Reactions: 1 user
BLADEMDA said:
Median income is down for some. More employed doctors. AMCs have a much larger market share. I'd say income is down for many but not all. Job market sucks. Oversupply of providers. Private groups have sold or are selling out at a record pace.

Overall, I'd say things do not look go going forward. Ignore the advice at your own peril
Click to expand...
I'm doubting anesthesiologists will ever hit PCP levels of pay, even in a worst case scenario. A pay reduction isn't good news, but it likely isn't going to be field-destroying levels of pay reduction. Let's see how things look in another five years.
 
Mad Jack said:
I'm doubting anesthesiologists will ever hit PCP levels of pay, even in a worst case scenario. A pay reduction isn't good news, but it likely isn't going to be field-destroying levels of pay reduction. Let's see how things look in another five years.
Click to expand...

In 5 years the median pay will be lower, much fewer true private practice jobs and more supervision of crnas (3-5 crnas per MD). AANA will use the ACA to keep chipping away at independent practice. A good analogy is a prisoner trying to dig his way out using a spoon. Progress is measured in decades not days.
 
We have a DNP crna. She makes the same as the others, doesn't call herself doctor, and is a lovely person i enjoy working with.
 
  • Like
Reactions: 1 users
For individuals who enjoy thinking about physiology, an Anesthesiology residency + fellowship (5 yrs) still offers a much better combination of lifestyle (no patients), employee compensation, and ease of finding a job than General Cardiology (6 yrs) in 2015. This has been corroborated anecdotally as well as by investigation of SDN forums. Everything is relative.

The rise of AMCs and managed care provides new graduates with the new opportunity to attain executive physician positions. PSH training integrated within residency will help facilitate this goal.
 
  • Like
Reactions: 1 user
Carbocation1 said:
For individuals who enjoy thinking about physiology, an Anesthesiology residency + fellowship (5 yrs) still offers a much better combination of lifestyle (no patients), employee compensation, and ease of finding a job than General Cardiology (6 yrs) in 2015. This has been corroborated anecdotally as well as by investigation of SDN forums. Everything is relative.

The rise of AMCs and managed care provides new graduates with the new opportunity to attain executive physician positions. PSH training integrated within residency will help facilitate this goal.
Click to expand...

Way to spin it. You may indeed be "executive material" for an AMC
 
  • Like
Reactions: 1 users
Carbocation1 said:
For individuals who enjoy thinking about physiology, an Anesthesiology residency + fellowship (5 yrs) still offers a much better combination of lifestyle (no patients), employee compensation, and ease of finding a job than General Cardiology (6 yrs) in 2015. This has been corroborated anecdotally as well as by investigation of SDN forums. Everything is relative.

The rise of AMCs and managed care provides new graduates with the new opportunity to attain executive physician positions. PSH training integrated within residency will help facilitate this goal.
Click to expand...


http://www.haverfordhealthcare.com/...ology-Practice-Acquisitions-January-20151.pdf
 
If you can't beat 'em, join 'em. Adapt or die.
 
  • Like
Reactions: 1 user
nolagas said:
We have a DNP crna. She makes the same as the others, doesn't call herself doctor, and is a lovely person i enjoy working with.
Click to expand...

I worked with a DNAP CRNA who used to sneak off and do cases by herself without telling me. Then she'd expect me to come sign the charts. She wore the imprimatur of "chief anesthetist" at the hospital and thought this meant that she was an anesthesiologist. She didn't know her limitations.

Ah, anecdotes. Anecdotes.
 
Mad Jack said:
I'm doubting anesthesiologists will ever hit PCP levels of pay, even in a worst case scenario. A pay reduction isn't good news, but it likely isn't going to be field-destroying levels of pay reduction. Let's see how things look in another five years.
Click to expand...
Why? I don't see how this is some absolute truth. I already see PCP incomes going up over the years, not to mention the job market is wide open. Everything changes.
 
bronx43 said:
Why? I don't see how this is some absolute truth. I already see PCP incomes going up over the years, not to mention the job market is wide open. Everything changes.
Click to expand...
I would agree with Mad Jack. The bread & butter of what an anesthesiologist does on a daily basis is inherently more risky/stressful than what a PCP does and deserves higher compensation.
 
Carbocation1 said:
I would agree with Mad Jack. The bread & butter of what an anesthesiologist does on a daily basis is inherently more risky/stressful than what a PCP does and deserves higher compensation.
Click to expand...

What you "deserve" and what the government (Medicare/Medicaid) decides to reimburse you are not related in anyway, shape or form. No one cares what you think you deserve. Fairness only exists in fairy tales. #1 lession of adulthood --> Life isn't fair.

Not trying to be a jerk just painfully honest.
 
Last edited:
  • Like
Reactions: 7 users
BuzzPhreed said:
I worked with a DNAP CRNA who used to sneak off and do cases by herself without telling me. Then she'd expect me to come sign the charts. She wore the imprimatur of "chief anesthetist" at the hospital and thought this meant that she was an anesthesiologist. She didn't know her limitations.

Ah, anecdotes. Anecdotes.
Click to expand...

She should have been fired. That would nip that **** in the bud.
 
  • Like
Reactions: 1 users
If compensation for Anesthesiology dropped to Family Practice levels, many senior Anesthesiologists with FU accounts in place will immediately retire, thereby increasing the demand for Anesthesiologists exponentially, similar to levels after the crisis a couple decades ago. Supply and demand will then trigger an increase in Anesthesiology compensation.
 
http://www.anesthesiallc.com/public...ctice-information-from-medscape-s-2015-survey

05-11-2015eAlertChart1BlueChart.jpg


"most recent MGMA Physician Compensation and Production Survey: 2014 Report Based on 2013 Data, which reported a national mean total compensation level of $439,509 (and a standard deviation of $121,743). Then again, Doximity, a LinkedIn style social network for physicians featured in The Atlantic online (January 27, 2015) claimed to include data from more than 18,000 physicians with an average anesthesiologist salary of $357,116."
 
Carbocation1 said:
I would agree with Mad Jack. The bread & butter of what an anesthesiologist does on a daily basis is inherently more risky/stressful than what a PCP does and deserves higher compensation.
Click to expand...
Lol, what's risk got to do with it? This is like people making up s*** to try and justify their salary, even though the reasons are entirely decoupled from reality. Who's got more risk in their daily activities? A dermatologist making 700k or a an EM doc making 270k? How about a gastroenterologist who does screening colonoscopies all day making 600k or a surgical oncologist who does Whipples and makes 300k?
 
Carbocation1 said:
If compensation for Anesthesiology dropped to Family Practice levels, many senior Anesthesiologists with FU accounts in place will immediately retire, thereby increasing the demand for Anesthesiologists exponentially, similar to levels after the crisis a couple decades ago. Supply and demand will then trigger an increase in Anesthesiology compensation.
Click to expand...
It likely won't change over night. It's unlikely that these older anesthesiologists will wake up one day with their compensation slashed by 40%. It may very well be a steady erosion of their purchasing power through inflation and stagnant or even falling salaries. The impetus to get up and quit in this situation is minimal, in fact, I would argue that no one in their right mind would quit when they see inflation and increasing uncertainty in the markets and their assets. There may very well be a big correction coming in the equity markets, which will incinerate a large portion of these "FU accounts."
 
BuzzPhreed said:
I worked with a DNAP CRNA who used to sneak off and do cases by herself without telling me. Then she'd expect me to come sign the charts. She wore the imprimatur of "chief anesthetist" at the hospital and thought this meant that she was an anesthesiologist. She didn't know her limitations.

Ah, anecdotes. Anecdotes.
Click to expand...

In this situation, if you were to say "I can't sign that, I wasn't present for those cases", is she 100% responsible for anything that happens to those patients?
 
Carbocation1 said:
If compensation for Anesthesiology dropped to Family Practice levels, many senior Anesthesiologists with FU accounts in place will immediately retire, thereby increasing the demand for Anesthesiologists exponentially, similar to levels after the crisis a couple decades ago. Supply and demand will then trigger an increase in Anesthesiology compensation.
Click to expand...
Did a unicorn whisper this in your ear while you were sliding down a rainbow and landing in a pot of gold?
 
  • Like
Reactions: 1 users
Carbocation1 said:
If compensation for Anesthesiology dropped to Family Practice levels, many senior Anesthesiologists with FU accounts in place will immediately retire, thereby increasing the demand for Anesthesiologists exponentially, similar to levels after the crisis a couple decades ago. Supply and demand will then trigger an increase in Anesthesiology compensation.
Click to expand...

i remember people saying something like this about path
such wishful thinking
 
If compensation dropped to FP levels it wouldn't be for the people with FU accounts. The recent grad drop in income will be greater to help maintain senior docs' incomes.
 
Last edited by a moderator:
  • Like
Reactions: 1 user
NOsaintsfan said:
What you "deserve" and what the government (Medicare/Medicaid) decides to reimburse you are not related in anyway, shape or form. No one cares what you think you deserve. Fairness only exists in fairy tales. #1 lession of adulthood --> Life isn't fair.

Not trying to be a jerk just painfully honest.
Click to expand...
The government funding things is precisely why PCPs will always be paid less. There's simply more of them, and we can't afford to give them all neurosurgeon levels of pay.
 
Whats up with all these med students trying to tell the attending anesthesiologists how things work?


Mad Jack said:
Oh, and anesthesiologists currently have a median income of $358,000, up a decent amount from an average of $292,000 in 2009. Doom and gloom, doooooom and gloooooom!
Click to expand...

Mad Jack said:
I'm doubting anesthesiologists will ever hit PCP levels of pay, even in a worst case scenario. A pay reduction isn't good news, but it likely isn't going to be field-destroying levels of pay reduction. Let's see how things look in another five years.
Click to expand...

Carbocation1 said:
For individuals who enjoy thinking about physiology, an Anesthesiology residency + fellowship (5 yrs) still offers a much better combination of lifestyle (no patients), employee compensation, and ease of finding a job than General Cardiology (6 yrs) in 2015. This has been corroborated anecdotally as well as by investigation of SDN forums. Everything is relative.

The rise of AMCs and managed care provides new graduates with the new opportunity to attain executive physician positions. PSH training integrated within residency will help facilitate this goal.
Click to expand...
 
  • Like
Reactions: 3 users
olivarynucleus said:
Whats up with all these med students trying to tell the attending anesthesiologists how things work?
Click to expand...
I'm stating facts in regard to income. As to my speculation about future income, as this very thread demonstrated, even attending anesthesiologists have zero clue where salaries will be for sure in five years.
 
Mad Jack said:
I'm stating facts in regard to income. As to my speculation about future income, as this very thread demonstrated, even attending anesthesiologists have zero clue where salaries will be for sure in five years.
Click to expand...

The fact that we now mostly get salaries where we used to collect our billing is a big change, is terrible, and could lead to declines in income even if billing is unchanged.
 
Carbocation1 said:
If compensation for Anesthesiology dropped to Family Practice levels, many senior Anesthesiologists with FU accounts in place will immediately retire,
Click to expand...

This is the opposite of what actually happens when a person's income decreases. It doesn't matter what field, in or out of medicine. When people suffer pay cuts, if they have the option of working more hours, they will do so in order to maintain their accustomed level of income. They don't quit and take their income to $0.
 
  • Like
Reactions: 1 users
Mad Jack said:
I'm stating facts in regard to income. As to my speculation about future income, as this very thread demonstrated, even attending anesthesiologists have zero clue where salaries will be for sure in five years.
Click to expand...
Mad Jack said:
I'm stating facts in regard to income. As to my speculation about future income, as this very thread demonstrated, even attending anesthesiologists have zero clue where salaries will be for sure in five years.
Click to expand...


The exact timing of when a bubble will burst is difficult. But, the evidence clearly shows that hundreds of groups have sold out or folded since 2009. This means income went down in those hospitals for many anesthesiologists.

The "N" in these surveys is low and I think you need to compare the survey number with the actual number of Anesthesiologists in the work place. Do you think that surveying 4 percent of Anesthesiologists in an non random manner predicts salary? The trend is downward and has been that way the past few years. That said, about 1/4 of PP attendings are earning record income while the bottom 1/4 scrounges for low paid work. There is a glut in the market place which forces salaries downward. This fact is best shown in the trending of academic salaries. If things are so rosy out there why does academic pay keep declining in your chart? Is it because there is a glut of labor for the Chairs to squeeze extra hard?
 
BLADEMDA said:
The exact timing of when a bubble will burst is difficult. But, the evidence clearly shows that hundreds of groups have sold out or folded since 2009. This means income went down in those hospitals for many anesthesiologists.

The "N" in these surveys is low and I think you need to compare the survey number with the actual number of Anesthesiologists in the work place. Do you think that surveying 4 percent of Anesthesiologists in an non random manner predicts salary? The trend is downward and has been that way the past few years. That said, about 1/4 of PP attendings are earning record income while the bottom 1/4 scrounges for low paid work. There is a glut in the market place which forces salaries downward. This fact is best shown in the trending of academic salaries. If things are so rosy out there why does academic pay keep declining in your chart? Is it because there is a glut of labor for the Chairs to squeeze extra hard?
Click to expand...
I think it is less a glut of labor and more a desire for meaningful employment outside of an AMC. In any case, I think anesthesia has a future for those that have decent business or management skills, or those that have a fellowship that makes them hard for a CRNA to replace. I agree with you that it woll get rough for the bottom of the barrel anesthesiologists out there, new grads with no fellowship that want to work their own cases.
 
You must log in or register to reply here.
Next unread thread

Similar threads

C
Post op note, MD vs CRNA
Replies
24
Views
2K
chessknt
chessknt
A
24 hour “shifts” crna vs MD
Replies
16
Views
3K
aneftp
A
Dr. Anonymouss
  • Locked
Difference between anesthesiologist and CRNA
Replies
2
Views
1K
Arch Guillotti
Arch Guillotti
D
Anesthesiologist shortage
2 3
Replies
138
Views
10K
Dantrolene FC
D
Bobcat18
RHOBH “Nurse Anesthesiologist”
Replies
11
Views
2K
Bobcat18
Bobcat18
Top