Future anesthesia job market ?

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Do you recommend going into Anesthesia (projected residency graduation in 2019)

  • Yes

    Votes: 93 38.8%

  • No

    Votes: 59 24.6%

  • not sure, too hard to predict

    Votes: 90 37.5%
  • Total voters
    240
Stank811 said:
I have to remember to revisit this thread in 36-48months....I bet AMC wont even be a large part of the discussions anymore. All this talk about young physicians not willing to take the risk to start their own groups to undercut the AMCs or any other group is silly...I am confident young physicians are willing to take the risk...just not enough pressure currently in the market to make the risk worth it...at least in my neck of the woods.
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Quoting so that I can come back in 3 years.
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How about merging with all of the existing groups in your area and forming a large anesthesiology group that way? Of course it's ugly and complicated, but if everyone had a noncompete it would be very difficult to replace one or more groups. Additionally that many physicians would have the capital to potentially beat back an AMC incursion.
 
There are groups like that in San Diego and the Portland area. I agree they would be difficult to overthow, but everyone has their price. The recent AMC takeovers in Texas and Florida weren't exactly small tight knit groups.
 
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chmd said:
How about merging with all of the existing groups in your area and forming a large anesthesiology group that way? Of course it's ugly and complicated, but if everyone had a noncompete it would be very difficult to replace one or more groups. Additionally that many physicians would have the capital to potentially beat back an AMC incursion.
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This is happening in many states... but these mega groups are at the end of the day not that different from AMCs for the new guys who would like to work in their territories.
 
I am so not believing that answer. Does anybody and I mean anybody remember the bit#ching about senior partners? Anyone?
 
I always assumed I'd just be an employee. At least taxes will be simpler and you're more likely to be employed by a nonprofit (=loan forgiveness after 10 yrs)... right?
 
MaximusD said:
I always assumed I'd just be an employee. At least taxes will be simpler and you're more likely to be employed by a nonprofit (=loan forgiveness after 10 yrs)... right?
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Taxes easier sure. But I doubt loan forgiveness will be an option much longer.
 
I have a brother who is debating between anesthesia and ortho, with significant research in both. With his scores he could probably get into a top anesthesia program (BWH, Columbia et al), but likely a middle but solid tier ortho program (Wisconsin, UMass et al). Given impending changes, what would you guys in the anesthesia side recommend? Would he be crazy to choose anesthesia at this point? My feeling is that incomes for all specialists are going to go down, but does the CRNA backdoor with anesthesia and ease of practice management company takeovers make it more susceptible? Is it a different story if you trained at a top anesthesia program? or just makes it a little bit easier to find your first job? He's not too interested in a longterm academic career either.

Short version: if you know you could go to either a top anesthesia program or a solid but not top ortho program and you'll become an attending around 2020, which would you pick?
 
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The lowest ranking ortho program would be smarter than an elite anesthesia program.
 
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I don't think orthopedics and anesthesiology attract the same individuals. It strikes me as odd to choose between the two for anything other than attraction to $$
 
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MaximusD said:
I don't think orthopedics and anesthesiology attract the same individuals. It strikes me as odd to choose between the two for anything other than attraction to $$
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+1.

Ortho is surgical carpentry, while anesthesia is internal medicine/intensive care in the OR.
 
MaximusD said:
I always assumed I'd just be an employee. At least taxes will be simpler and you're more likely to be employed by a nonprofit (=loan forgiveness after 10 yrs)... right?
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Sure. You can even get your limbs amputated, so you can qualify for Social Security and Medicare right now. Why wait till 65?

"At least taxes will be simpler"... :bang:
 
Ortho....no question. You can make anything interesting if you put your heart into it. And Ortho is easily interesting.....and satisfying.....and rewarding.

Don't get me wrong, I love anesthesia in general and my job in particular. But if my child goes into medicine and asks me the same question.....there is no doubt what my answer would be.

At the end of the day, training at a "top" program is meaningless if you're not enjoying your life or taking home half the $$.
 
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MaximusD said:
LOL lay it on a little thicker... I'm not catching your point!
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My point is that AMCs amputate both your earnings and your professional standing.
 
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Thanks for the replies. Sounds pretty unanimous. Anesthesia always seemed like a good and relatively cushy gig with some happy personalities. Would things get better for the field eventually? Say when the Boomers retire or when Obamacare/IPAB makes all the specialties roughly equal in compensation? Or are CRNAs and AMCs checkmate?

MaximusD said:
I don't think orthopedics and anesthesiology attract the same individuals. It strikes me as odd to choose between the two for anything other than attraction to $$
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I think he's interested in pain management, procedural type of things. Ortho is more of a recent discovery. He likes fields that improve a pt's quality of life.
 
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Then he should go into palliative care. Oh, wait, that's more like quality of (slow) death. :)

Seriously, many surgical interventions visibly improve a patient's quality of life, so that does not explain ortho.

For the nth time, anesthesia is not a "cushy gig". It's a pretty stressful service industry.
 
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Wow, I don't understand how can he make public statements like this and get away with it. UC Davis anesthesia leadership need to grow some balls.
 
As I said before, the physicians lost the battle in this country when they allowed the boards of nursing (and other healthcare professions) to be independent of medical board supervision and veto. This on top of letting nurses and others run hospitals without physician supervision.

The inmates are running the asylum. Everywhere you look, it's mostly disguised class warfare against physicians.
 
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digitox said:
Wow, I don't understand how can he make public statements like this and get away with it. UC Davis anesthesia leadership need to grow some balls.
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UC Davis anesthesia leadership is probably supervised by some nurses from UC Davis hospital management. ;)
 
aside from salaries tanking, how do you think the actual practice will change? if anesthesiologist is responsible for 4-8 nurse anesthetists, do you think the job itself will be more or less stressful? will there be more or less time to read books on the job?
 
naus said:
Thanks for the replies. Sounds pretty unanimous. Anesthesia always seemed like a good and relatively cushy gig with some happy personalities. Would things get better for the field eventually? Say when the Boomers retire or when Obamacare/IPAB makes all the specialties roughly equal in compensation? Or are CRNAs and AMCs checkmate?


I think he's interested in pain management, procedural type of things. Ortho is more of a recent discovery. He likes fields that improve a pt's quality of life.
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No... It will not get better... It's basically over for this specialty
 
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Planktonmd said:
No... It will not get better... It's basically over for this specialty
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As someone not in Anesthesiology, I am absolutely shocked that Anesthesiology is allowing this to be done to you guys. A very difficult specialty to practice, and you guys are being treated like herd cattle. Your leadership needs a leader like Dr. Karen Sibert, not the ones you currently have.
 
The most negative, pessimistic remarks can be found on the anesthesia forum. I truly believe there are some clinically depressed people that regularly post on this forum. I also believe that these same people would complain about their career choice if they had chosen to be an orthopedic surgeon, dermatologist etc.. We all understand that anesthesiology is changing rapidly, but that doesn't equate to the death of the specialty. There are plenty of young, intellegint physicians in this specialty that are proud and passionate about thier career choice. We will continue to advance the specialty, and show the value we bring to health care. This may involve " reinventing" ourselves, but isn't that exciting? The future of this field is what we make of it. So quit crying and get to work!
 
InvisibleSphere said:
The most negative, pessimistic remarks can be found on the anesthesia forum. I truly believe there are some clinically depressed people that regularly post on this forum. I also believe that these same people would complain about their career choice if they had chosen to be an orthopedic surgeon, dermatologist etc.. We all understand that anesthesiology is changing rapidly, but that doesn't equate to the death of the specialty. There are plenty of young, intellegint physicians in this specialty that are proud and passionate about thier career choice. We will continue to advance the specialty, and show the value we bring to health care. This may involve " reinventing" ourselves, but isn't that exciting? The future of this field is what we make of it. So quit crying and get to work!
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LMAO. Sorry, but the stark optimism in this post compared to the other posts in this thread is interesting.
 
BLADEMDA said:
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All I ask is that you listen to this guy for 3 minutes. Fast forward to the 30 minute mark and listen/watch for 3 minutes. I watched the entire "lecture" and I came away with the conclusion CRNA=MDA. I doubt any PA or ARNP could claim "equal to Ortho" in any lecture.
 
Ortho will retain its earning potential far longer than we will in anesthesiology.

Sent from my SM-N900P using Tapatalk
 
FFP said:
Then he should go into palliative care. Oh, wait, that's more like quality of (slow) death. :)

Seriously, many surgical interventions visibly improve a patient's quality of life, so that does not explain ortho.

For the nth time, anesthesia is not a "cushy gig". It's a pretty stressful service industry.
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Isn't it cushiER relative to ortho?

and they earn more but on average they work more.
 
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soccerboy2288 said:
Isn't it cushiER relative to ortho?

and they earn more but on average they work more.
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I work more than 90% of Orthopedic Surgeons but earn less than most of them. They are highly compensated for their work and are viewed as valuable by the hospital. I, on the other hand, am seem as a necessary expense performing a simple function.

Don't be fooled into thinking "hours worked" is the only metric by which you judge a specialty.
 
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BLADEMDA said:
I work more than 90% of Orthopedic Surgeons but earn less than most of them. They are highly compensated for their work and are viewed as valuable by the hospital. I, on the other hand, am seem as a necessary expense performing a simple function.

Don't be fooled into thinking "hours worked" is the only metric by which you judge a specialty.
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Hey BLADEMDA, what would you say to a third year med student who is planning to do anesthesia as a means of working as an ICU doc via fellowship? Don't you think training in anesthesia is excellent for working in the ICU down the road?

Also, as a general note to those who are already in the field of anesthesia and like to be debbie downers and discourage good students from going into ansesthesia - please note that all residency spots WILL be filled. Discouraging the good students from going into anesthesia means the future of the specialty will be filled with even more lazy, bottom-of-the-barrel students. Wouldn't it be wiser to get the smart students to go into anesthesia so there will actually be some leadership in the field?
 
BLADEMDA said:
Fast forward to the 30 minute mark and listen/watch for 3 minutes.
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I did this. And I got to the point where he said "anesthesia school is pretty much identical to an anesthesiology residency" and I had to shut it off.

How the **** would he be able to even remotely make such an idiotic statement without having gone through an anesthesiology residency? If I'd been there, I would have said, "Whoa, whoa, whoa, whoa. Back up a second, sparky." And done what's known in the military as an on-the-spot correction. There's not enough of that in our business.

It's easy to make such bold statements when no one is there to challenge you. Repeat lie often enough and no one questions it anymore... and starts to believe it.
 
ASA (sic) President Jane C.K. Fitch, MD, said she knows personally how these 2 training paths compare. She became an anesthesiologist in 1992 after spending 1.5 years as a CRNA. Having been trained in both areas, she said there is greater depth and breadth possible during the longer training period experienced by physicians.

"The biggest difference is that we see patients preoperatively and can diagnose and treat their medical conditions and get them prepared for anesthesia," Dr. Fitch said. "The majority of problems relate to underlying medical illnesses. You need to know the medical illnesses, as well as the treatments, so that you can make the safest choice of anesthetics, especially in drug-shortage situations where you may be using second- or third-choice drugs."
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http://www.medscape.com/viewarticle/761405

I've seen this firsthand. If I'd left certain CRNAs to their own devices in certain situations, God only knows what might have happened. We're not talking every case. But we're talking enough cases in a week to make a difference.
 
InvisibleSphere said:
The most negative, pessimistic remarks can be found on the anesthesia forum. I truly believe there are some clinically depressed people that regularly post on this forum. I also believe that these same people would complain about their career choice if they had chosen to be an orthopedic surgeon, dermatologist etc.. We all understand that anesthesiology is changing rapidly, but that doesn't equate to the death of the specialty. There are plenty of young, intellegint physicians in this specialty that are proud and passionate about thier career choice. We will continue to advance the specialty, and show the value we bring to health care. This may involve " reinventing" ourselves, but isn't that exciting? The future of this field is what we make of it. So quit crying and get to work!
Click to expand...

My story is that I took a job in a more desirable location. Within a very short time frame, I was shocked at what I saw. Reinventing ourselves should not mean letting the nursing profession chip away at our role as the leader in the field, at least not without a corequisite reduction in our responsibility. That's the issue. Nurses want more and more responsibility and decision making without the increased fiduciary and medicolegal responsibility to the patient. It's a "have your cake and eat it too" phenomenon. And they've been chipping away at this for decades and are slowly but surely winning.

And it's not just here that people are worried. Here is but a small sampling of a litany of information on teh interwebs related to the challenges about this and a variety of other issues related to our field:

https://www.locumtenens.com/press-r...-shows-pessimism-on-universal-healthcare.aspx

http://www.nytimes.com/2012/05/02/u...minister-anesthesia-moves-to-courts.html?_r=0

http://www.kevinmd.com/blog/2011/11...-nurse-anesthetist-threat-patient-safety.html

http://www.coana.org/About Us/aboutusnapractice.php

http://online.wsj.com/news/articles/SB10001424052702303983904579093252573814132

http://members.csahq.org/blog/2014/...ncome-view-asa-practice-management-conference

http://www.foxnews.com/opinion/2013/11/09/real-cost-obamacare-loss-good-doctors/

Take off the rose colored glasses, don't be a Pollyanna, get educated, and get motivated to protect our specialty. That's the only way we're going to remain in charge. That's not only best for our bank accounts, it's also best for our patients.
 
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BuzzPhreed said:
How the **** would he be able to even remotely make such an idiotic statement without having gone through an anesthesiology residency? If I'd been there, I would have said, "Whoa, whoa, whoa, whoa. Back up a second, sparky." And done what's known in the military as an on-the-spot correction. There's not enough of that in our business.

It's easy to make such bold statements when no one is there to challenge you. Repeat lie often enough and no one questions it anymore... and starts to believe it.
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He should know better to make such a statement without having to go through an anesthesiology residency. By that logic, how can you critique the rigor of CRNA training without going through it yourself?
 
CityLights said:
By that logic, how can you critique the rigor of CRNA training without going through it yourself?
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Does being forced to supervise SRNAs and directly witness how they're trained count (in two separate programs)? No call. 7:00 am to 3:30 pm. No pre-op evaluations. No informed consent processing. No rounding on pain patients. No pre-operative clinic where medical decisions, such as whether or not a patient needs further cardiac testing, are made. Less numbers of blocks required. Less number of epidurals. Often in community programs with minimal exposure to complex patients. No oral board examination. Want me to go on?

I've seen SRNA training firsthand. It's monkey-see, monkey-do and garbage-in, garbage out for the most part. I've seen bad and sloppy technique passed-off by other CRNAs "training" them, some of whom are barely out of training themselves.

Now, couple that with the fact that SRNAs get literally half the supervised training in terms of actual time in "training" that a physician anesthesiologist does before being turned loose on the public.

I think I'm well qualified to critique the "rigor" of CRNA training thank-you-very-much.
 
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Listen, if everyone wants to simply be a pre-op scut monkey doing all the grunt work and turning over all of the technical aspects of care to some 25-year-old fresh-out-of-CRNA-school nurse, then just roll over and play dead until you're replaced. I'm not going to be one of those guys.
 
Wow that guy in the video is an absolute joke.

"Every day I'm talking to someone about anesthesia"

And his comments about sRNa training being equivalent to an ACGME residency is reprehensible.

Like many others on here, I couldn't stand it any longer and had to turn it off. Pathetic.
 
BLADEMDA said:
All I ask is that you listen to this guy for 3 minutes. Fast forward to the 30 minute mark and listen/watch for 3 minutes. I watched the entire "lecture" and I came away with the conclusion CRNA=MDA. I doubt any PA or ARNP could claim "equal to Ortho" in any lecture.
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Well Oregon passed a mid level equality bill last year.

So PA/NPs will now get paid for same billing codes by insurance as MDs. Same goes for regular Vaginal delivery by mid wives.
 
DoctorDude said:
Hey BLADEMDA, what would you say to a third year med student who is planning to do anesthesia as a means of working as an ICU doc via fellowship? Don't you think training in anesthesia is excellent for working in the ICU down the road?

Also, as a general note to those who are already in the field of anesthesia and like to be debbie downers and discourage good students from going into ansesthesia - please note that all residency spots WILL be filled. Discouraging the good students from going into anesthesia means the future of the specialty will be filled with even more lazy, bottom-of-the-barrel students. Wouldn't it be wiser to get the smart students to go into anesthesia so there will actually be some leadership in the field?
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I post the truth as I see it. I'm not going to sugar coat the specialty so some gullible, ignorant but intelligent MS-3 signs up. Instead, I prefer the honest approach so the MS-3 knows what he/she is in for.

As for anesthesia getting you prepared to do ICU via a Fellowship I totally agree.
 
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TheKidCanRun said:
Wow that guy in the video is an absolute joke.

"Every day I'm talking to someone about anesthesia"

And his comments about sRNa training being equivalent to an ACGME residency is reprehensible.

Like many others on here, I couldn't stand it any longer and had to turn it off. Pathetic.
Click to expand...


You can't turn off the AANA party line. Instead, you should hear the propaganda first hand as more DNAPs begin to proclaim equivalency in speeches/lectures throughout the USA.
 
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