Future of Anesthesia (for med school class of 28' and beyond)

[rowsdower88]

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I'm not sure what you mean by "recently", and I can't to speak for aneftp. But work hour restrictions came in 2003, put forth by the ACGME. in 2003, leaders of the ACGME were probably in their 50's. You should thank them in their retirement homes. Prior to that, the first work hour restrictions came in 1987. I'm not sure there are any lurkers on this board that trained before 1987. I can tell you I was an MS-3 in 2003. We weren't picketing for work hours, nor did we celebrate our resident brothers and sisters for fighting the good fight.

The training sucks, but the struggle builds tenacity. Close to 50% of hospitals are actually losing money. Few are "making tons" Either way, we live in a capitalist economy. Hospitals will continue doing what they do until they can no longer recruit medical residents. As long as someone is willing to sign up, there is no incentive for them to change.

But you've got this to look forward to: One day, someone 20 years younger will blame you for the world's problems, too. And you'll get to blame them for all the things that have changed. It's been happening for centuries.

Residents 20 years from now will be able to thank these guys:

Residents Strike, Demonstrate Around Labor Day Weekend

Trainees in Buffalo strike, while those in Philadelphia demonstrate for better pay

www.medpagetoday.com

As far as I know, this strike didn't accomplish it's aims, but progress doesn't happen overnight.

 

[Bertelman]

Lifties in Park City have a better shot at getting what they want.

 

[aneftp]

Residents 20 years from now will be able to thank these guys:

Residents Strike, Demonstrate Around Labor Day Weekend

Trainees in Buffalo strike, while those in Philadelphia demonstrate for better pay

www.medpagetoday.com

As far as I know, this strike didn't accomplish it's aims, but progress doesn't happen overnight.

It could be worst. Srna works for free.

Most places have really cracked down on srna supervision. But with growth of srna programs particularly late 1990s to 2010. Many places loosely supervised srnas.

So much greed especially in Florida with puppy mill srna programs and even the crnas who finished those programs tell
Me it was survival and many poorly trained srnas.

 

[UscGhost]

I'm not sure what you mean by "recently", and I can't to speak for aneftp. But work hour restrictions came in 2003, put forth by the ACGME. in 2003, leaders of the ACGME were probably in their 50's. You should thank them in their retirement homes. Prior to that, the first work hour restrictions came in 1987. I'm not sure there are any lurkers on this board that trained before 1987. I can tell you I was an MS-3 in 2003. We weren't picketing for work hours, nor did we celebrate our resident brothers and sisters for fighting the good fight.

The training sucks, but the struggle builds tenacity. Close to 50% of hospitals are actually losing money. Few are "making tons" Either way, we live in a capitalist economy. Hospitals will continue doing what they do until they can no longer recruit medical residents. As long as someone is willing to sign up, there is no incentive for them to change.

But you've got this to look forward to: One day, someone 20 years younger will blame you for the world's problems, too. And you'll get to blame them for all the things that have changed. It's been happening for centuries.

I agree. Not sure the timeline of everything. Additional restrictions were put in place around 2010-2013 that cause some grumpy older folks to speak out against them.

Incremental gains. Each time, the older docs lament that the newer docs didn't have to go through the same hardships
Instead they should be applauding them.

In terms of hospitals, I believe Medicare pays residencies 150k per position but the avg salary is 61k.

Combine that with the fact that it would easily cost 200-300k per resident, if not more, to replace their labor. An avg residency has 50 anes residents all staffing rooms. How much would replacements cost the hospital?

I agree that residents need hours. But pay them accordingly.

 

[Meyer-Overton]

I went into pain right as the market for general was taking off, and you would have to pay me $2.5 million a year to go back to general anesthesia.

For what reasons do you find pain so much better than OR anesthesia?

 

[mdo1738]

For what reasons do you find pain so much better than OR anesthesia?

I work from 8 am to 4 pm 4 days a week and will make right around 7 figures doing so. I do not work nights, weekends, or holidays. There are zero life-or-death emergencies I have to deal with. I never have to deal with egotistical surgeons. I don’t have to run around from room to room while hoping CRNAs I’m liable for aren’t doing something stupid. I can go to the bathroom whenever I want. Those are all the big reasons that immediately come to mind.

 

[Bryan O’Blivion]

The most well researched projection of the anesthesia market that I’ve been an observer to indicated that there would be a shortage of anesthesia services from 2019-2029, which seems to thus far correlate with the changing job market. I would expect this to correct in about that timeframe, honestly. Lots of nurses are seeing CRNAs make money and are getting the requisite months of ICU experience to apply to nurse anesthetist school, which is going to produce a crop in 5 years. Same with medical students going through residency.

I can’t speak to the cardiology market, the friends and associates that I’ve had who have been in cards have always been in demand, which has been a two edged sword. They’ve always been well compensated, but working constantly. Nothing is perfect.

Anesthesia has been great for me, but I wouldn’t recommend it for everyone.

 

[Coffee PRN]

The most well researched projection of the anesthesia market that I’ve been an observer to indicated that there would be a shortage of anesthesia services from 2019-2029, which seems to thus far correlate with the changing job market. I would expect this to correct in about that timeframe, honestly. Lots of nurses are seeing CRNAs make money and are getting the requisite months of ICU experience to apply to nurse anesthetist school, which is going to produce a crop in 5 years. Same with medical students going through residency.

I can’t speak to the cardiology market, the friends and associates that I’ve had who have been in cards have always been in demand, which has been a two edged sword. They’ve always been well compensated, but working constantly. Nothing is perfect.

Anesthesia has been great for me, but I wouldn’t recommend it for everyone.

I’ve heard that the nadir is projected to be in 5 years.

 

[Account1]

I'm not sure what you mean by "recently", and I can't to speak for aneftp. But work hour restrictions came in 2003, put forth by the ACGME. in 2003, leaders of the ACGME were probably in their 50's. You should thank them in their retirement homes. Prior to that, the first work hour restrictions came in 1987. I'm not sure there are any lurkers on this board that trained before 1987. I can tell you I was an MS-3 in 2003. We weren't picketing for work hours, nor did we celebrate our resident brothers and sisters for fighting the good fight.

The training sucks, but the struggle builds tenacity. Close to 50% of hospitals are actually losing money. Few are "making tons" Either way, we live in a capitalist economy. Hospitals will continue doing what they do until they can no longer recruit medical residents. As long as someone is willing to sign up, there is no incentive for them to change.

But you've got this to look forward to: One day, someone 20 years younger will blame you for the world's problems, too. And you'll get to blame them for all the things that have changed. It's been happening for centuries.

Thank the ACGME? Lol

Hour reductions would’ve come regardless of what a bunch of political chumps were trying to change.

Residencies would’ve had insanely bad PR if they went status quo. Can you imagine if every resident had a TikTok or instagram to reveal the truth to the public about who’s taking care of them after a 100 hour work week?

The patients would riot, lawsuits from expectant mother residents would close billion dollar hospitals, and the first time a resident on the way home after a 40 hour shift has their dash cam record their face going through the windshield, even a team of hospital lawyers will open the money firehose to never have that lawsuit again.

The internet would’ve made every change that’s happened inevitable. So no, I don’t need to thank “the ACGME” for anything except their protecting our certifications for their own monetary benefit.

 

[Bertelman]

Thank the ACGME? Lol

Hour reductions would’ve come regardless of what a bunch of political chumps were trying to change.

Residencies would’ve had insanely bad PR if they went status quo. Can you imagine if every resident had a TikTok or instagram to reveal the truth to the public about who’s taking care of them after a 100 hour work week?

The patients would riot, lawsuits from expectant mother residents would close billion dollar hospitals, and the first time a resident on the way home after a 40 hour shift has their dash cam record their face going through the windshield, even a team of hospital lawyers will open the money firehose to never have that lawsuit again.

The internet would’ve made every change that’s happened inevitable. So no, I don’t need to thank “the ACGME” for anything except their protecting our certifications for their own monetary benefit.

The power of Insta/TikTok/Twitter came 20 years after work hour restrictions. It was 4 years after those changes that iPhones were released. You don't have to thank anyone, but personally, I'm happy it happened when it did.

I also think you may be overestimating society's empathy for physician training hours. We are clearly coming at this from different generations, but I'm not counting on social media to save me from abuse at any point in my lifetime. Physicians aren't generally classified as a persecuted population.

 

[UscGhost]

Thank the ACGME? Lol

Hour reductions would’ve come regardless of what a bunch of political chumps were trying to change.

Residencies would’ve had insanely bad PR if they went status quo. Can you imagine if every resident had a TikTok or instagram to reveal the truth to the public about who’s taking care of them after a 100 hour work week?

The patients would riot, lawsuits from expectant mother residents would close billion dollar hospitals, and the first time a resident on the way home after a 40 hour shift has their dash cam record their face going through the windshield, even a team of hospital lawyers will open the money firehose to never have that lawsuit again.

The internet would’ve made every change that’s happened inevitable. So no, I don’t need to thank “the ACGME” for anything except their protecting our certifications for their own monetary benefit.

Maybe. But they came 20 years as before tik tok.

And and additional changes DUE to tiktok will further any potential improvements

 

[Account1]

Maybe. But they came 20 years as before tik tok.

And and additional changes DUE to tiktok will further any potential improvements

Lawsuits would’ve been the primary driver. That was coming with or without social media.

Why do you think all these programs
cover transportation fares for residents coming off of night shifts? The world didn’t become nice on its own, lawyers realized how vulnerable the endowments were. That stuff did not exist in 2000

 

[aneftp]

Lawsuits would’ve been the primary driver. That was coming with or without social media.

Why do you think all these programs
cover transportation fares for residents coming off of night shifts? The world didn’t become nice on its own, lawyers realized how vulnerable the endowments were. That stuff did not exist in 2000

Took a very long time from the Libby Zion death case to implement the 80 hr work rules

Libby Zion Law - Wikipedia

en.m.wikipedia.org

 

[UscGhost]

Lawsuits would’ve been the primary driver. That was coming with or without social media.

Why do you think all these programs
cover transportation fares for residents coming off of night shifts? The world didn’t become nice on its own, lawyers realized how vulnerable the endowments were. That stuff did not exist in 2000

I am not aware of any lawsuits that drove the change in hours when I was there.

It was ACGME and resident driven.

Lawsuits are less likely because Attendings take the responsibility regardless of how many hours a resident has worked.

Lawsuits would probably be inevitable....but would require a catastrophic event in order to spur change alone. Unless it's a monopoly/unionization lawsuit

 

[Account1]

I am not aware of any lawsuits that drove the change in hours when I was there.

It was ACGME and resident driven.

Lawsuits are less likely because Attendings take the responsibility regardless of how many hours a resident has worked.

Lawsuits would probably be inevitable....but would require a catastrophic event in order to spur change alone. Unless it's a monopoly/unionization lawsuit

Lawsuits by residents against programs.

Imagine how easy a wrongful death would be without a program providing rides home to a resident working 40 hours straight. Think that persons family might find a lawyer willing to take that case?

You can’t even fire problem residents without wrongful termination or discrimination suits now.

Residents would have found their footing regardless of work hour restrictions. Same as college football players have now. Inevitable.

Would be easy to sue for ill health conditions due to excessive work hours. HR complaints, hostile work environments. All inevitable as conditions stayed bad for residents relative to the rest of society

 

[UscGhost]

Lawsuits by residents against programs.

Imagine how easy a wrongful death would be without a program providing rides home to a resident working 40 hours straight. Think that persons family might find a lawyer willing to take that case?

You can’t even fire problem residents without wrongful termination or discrimination suits now.

Residents would have found their footing regardless of work hour restrictions. Same as college football players have now. Inevitable.

Would be easy to sue for ill health conditions due to excessive work hours. HR complaints, hostile work environments. All inevitable as conditions stayed bad for residents relative to the rest of society

All things I would be a general proponent of.

Most big companies, hospitals won't change unless they are forced to (lawsuits like you said, or ACGME mandate, or unionization)

I don't like the lawsuits filed by problem residents (usually when the residency tries to get rid of them for legit reasons). But hard to avoid

 

[Doc mu]

The most well researched projection of the anesthesia market that I’ve been an observer to indicated that there would be a shortage of anesthesia services from 2019-2029, which seems to thus far correlate with the changing job market. I would expect this to correct in about that timeframe, honestly. Lots of nurses are seeing CRNAs make money and are getting the requisite months of ICU experience to apply to nurse anesthetist school, which is going to produce a crop in 5 years. Same with medical students going through residency.

I can’t speak to the cardiology market, the friends and associates that I’ve had who have been in cards have always been in demand, which has been a two edged sword. They’ve always been well compensated, but working constantly. Nothing is perfect.

Anesthesia has been great for me, but I wouldn’t recommend it for everyone.

source?

 

[aneftp]

I think we are approaching 1990/91 applicant status where those who came out in 1994/1995 had very good jobs left.

So those coming at in 2029/30 may likely encounter drastically different job market than it’s been the past 3 years. It’s still very hard to predict with how healthcare is going. We all know demand is still there for surgery especially off site.

But a major thing is happening in Florida where Envison is leaving a big area where they employ like 60-75 anesthesiologists (they have very few locums MD 1099) and 200 crnas (plus 1099 crna locums) (or something like that). And the hospital taking over is likely retaining 90% of the w2 MD staff. Most of the w2 AA and Crnas are staying as well.

So people are not bolting away.

 

[2019medstudent]

I think we are approaching 1990/91 applicant status where those who came out in 1994/1995 had very good jobs left.

So those coming at in 2029/30 may likely encounter drastically different job market than it’s been the past 3 years. It’s still very hard to predict with how healthcare is going. We all know demand is still there for surgery especially off site.

But a major thing is happening in Florida where Envison is leaving a big area where they employ like 60-75 anesthesiologists (they have very few locums MD 1099) and 200 crnas (plus 1099 crna locums) (or something like that). And the hospital taking over is likely retaining 90% of the w2 MD staff. Most of the w2 AA and Crnas are staying as well.

So people are not bolting away.

In the last couple years since the market has been good, when groups dissolve, don’t most people still stay on since they don’t want to move?

 

[NPJR]

2032 is 7 years away.

Life is not gonna get better or easier for physicians in anesthesia. There will be significant downward pressure on income and increased production pressure. We will be almost exclusively employed by the health systems and when that happens they will want to maximize utilization. (ie. your life is gonna suck). The bureaucracy in healthcare is growing to insane levels and becoming impenetrable. These trends are not the friend of someone in a patient facing specialty especially one who relies on this bureacracy(anesthesia) as a means to an end.

 

[NPJR]

In the last couple years since the market has been good, when groups dissolve, don’t most people still stay on since they don’t want to move?

People are creatures of habit. If you are going to the same place for 14 years, do you want to suddenly find somewhere else to go? especially if you have a house that has 14 years of stuff in it, and 3 children in the local school system. It isnt that easy to move and this is what your employer exploits.

 

[GassYous]

People are creatures of habit. If you are going to the same place for 14 years, do you want to suddenly find somewhere else to go? especially if you have a house that has 14 years of stuff in it, and 3 children in the local school system. It isnt that easy to move and this is what your employer exploits.

That's why I have a big emergency fund in cash. I would have done a lot better if I put it in the market but the peace of mind is incalculable.

 

[NPJR]

That's why I have a big emergency fund in cash. I would have done a lot better if I put it in the market but the peace of mind is incalculable.

Put that emergency fund in VOO

 

[ambiturner]

I think we are approaching 1990/91 applicant status where those who came out in 1994/1995 had very good jobs left.

So those coming at in 2029/30 may likely encounter drastically different job market than it’s been the past 3 years. It’s still very hard to predict with how healthcare is going. We all know demand is still there for surgery especially off site.

But a major thing is happening in Florida where Envison is leaving a big area where they employ like 60-75 anesthesiologists (they have very few locums MD 1099) and 200 crnas (plus 1099 crna locums) (or something like that). And the hospital taking over is likely retaining 90% of the w2 MD staff. Most of the w2 AA and Crnas are staying as well.

So people are not bolting away.

I agree, 2 recent trends that suggest the market may turn in the next 1-2 years is 1) the last big health system to blow up in Michigan had hordes of people interested in locums work and cancelled many of them, which means health systems may begin to pick and choose lower rates for locums, and 2) the recent health system blow-ups haven’t seen a huge exodus and retained a decent percentage of their staff - indeed there’s not too many places left to go that aren’t some variation of hospital/academic/AMC employment in my area. This suggests that income increases will start to level off for a bit after the craziness of the past few years.

The one thing still very much in our favor is the crnas absolutely refusing to settle for old-style daytime employment jobs which creates a natural floor for our income at their locums rate.

 

[Dawkter]

I work from 8 am to 4 pm 4 days a week and will make right around 7 figures doing so. I do not work nights, weekends, or holidays. There are zero life-or-death emergencies I have to deal with. I never have to deal with egotistical surgeons. I don’t have to run around from room to room while hoping CRNAs I’m liable for aren’t doing something stupid. I can go to the bathroom whenever I want. Those are all the big reasons that immediately come to mind.

As someone who practices anesthesia and pain, you are ignoring the clinic notes, peer to peers, prior authorizations, difficult patients, and emergency phone calls when a patient has a complication from one of your procedures. There are pros and cons to both fields.

 

[mdo1738]

As someone who practices anesthesia and pain, you are ignoring the clinic notes, peer to peers, prior authorizations, difficult patients, and emergency phone calls when a patient has a complication from one of your procedures. There are pros and cons to both fields.

Clinic notes are almost always done before I leave the room. P2P are rare (I haven’t done one in like 2 or 3 months, been long enough I can’t remember for sure; I won the battle within 5 minutes). My MA does my prior auths. Patients certainly can be difficult but I am adept at handling that at this point. I’m going on my 3rd year and have had one after-hours phone call. There are certainly cons to pain, I am not denying that. But many of the commonly cited cons are not that bad. The most accurate cons are the difficult patients and one you didn’t mention, which is that even on vacation you generally will need to bring your computer, as it’s highly likely you’ll need to do about 15 minutes a day of placing orders (med refill, etc) or other administrative stuff. Not much but enough to be annoying.

 

[NPJR]

I agree, 2 recent trends that suggest the market may turn in the next 1-2 years is 1) the last big health system to blow up in Michigan had hordes of people interested in locums work and cancelled many of them, which means health systems may begin to pick and choose lower rates for locums, and 2) the recent health system blow-ups haven’t seen a huge exodus and retained a decent percentage of their staff - indeed there’s not too many places left to go that aren’t some variation of hospital/academic/AMC employment in my area. This suggests that income increases will start to level off for a bit after the craziness of the past few years.

The one thing still very much in our favor is the crnas absolutely refusing to settle for old-style daytime employment jobs which creates a natural floor for our income at their locums rate.

This may be region specific. While west Mi may have hordes of applicants, other areas would not. I know Massachusetts hisorically has been a road less travelled though that may be because the license is such a pain in the ass to get.

 

[aneftp]

This may be region specific. While west Mi may have hordes of applicants, other areas would not. I know Massachusetts hisorically has been a road less travelled though that may be because the license is such a pain in the ass to get.

People definitely chase. Even low rates. Down in south Florida. Boca raton area place had 150 applicants within 1 hr when the locums opportunity opened on a Thursday morning. Crazy demand I couldn’t get them higher than $375/hr (which is decent rate for south Florida) cause I wanted $425/hr. By Friday they said they were confident they can get lower at $325/hr or $350/hr. Because the south Florida based docs don’t want to fly out of the area.

 

[Drwine]

Depends on how you look at it. Circa 1990, I went to one of the half a dozen residencies that were on everyone's short list for "best in the country" There was usually one MD-PhD in each class and lots of name brand college and med school credentials in the residency trainee groups. Conversely there were also lots of unfilled slots in anesthesia across the country in the less competitive programs. I suspect that there are just many killer CVs in the A-list super competitive residency programs of today and very few unfilled slots today.
Ranking a few Anesthesia programs was not uncommon as a backup for would be ophthalmology, dermatology, surgery wannabes. Not sure how great these docs turned out to be at anesthesia. Things went to **** for a few matches in the mid 90s. Fast.

I don't know if anybody can even apply to more than one specialty during one year today.

I started medical school with the intention of going into ophthalmology, and I had no exposure to anesthesiology before medical school lectures and rotations. I had never considered anesthesiology before doing a rotation and liked it enough to consider it as an alternative. I didn't match into ophthalmology and ended up in anesthesiology. Looking back over the last 40 years, I have no regrets about ending up with my second-choice specialty and think I am a much better anesthesiologist than I would have been as an ophthalmologist. Obviously, more nights and weekends in anesthesiology, but I would never have been able to go on 3-week ski trips or other extended vacations I have taken if I had the overhead of an office.

 

[pgg]

2032 is 7 years away.

Life is not gonna get better or easier for physicians in anesthesia. There will be significant downward pressure on income and increased production pressure. We will be almost exclusively employed by the health systems and when that happens they will want to maximize utilization. (ie. your life is gonna suck). The bureaucracy in healthcare is growing to insane levels and becoming impenetrable. These trends are not the friend of someone in a patient facing specialty especially one who relies on this bureacracy(anesthesia) as a means to an end.

This sad state of affairs is just medicine as a whole.

However.

Anesthesiology as a lucrative specialty will live or die based on how society (government) chooses to value and reimburse procedures. There's no indication that we're going to quit spending a disproportionate percentage of healthcare dollars on surgery. New, expensive devices and techniques drive healthcare investment and spending - and almost all of that stuff is related to procedures. The population is getting older, fatter, sicker. Those old and fat people are the most reliable voters in the country. We'll cut more useful things before we cut their access to surgery and implants and device-facilitated procedures.

In times of financial pressure, hospital-employed physicians' salaries will remain propped up in the areas that keep hospitals solvent. There is no reason to think that won't be OR and non-OR procedures. We are a necessary cost to keep the meat moving on the conveyor belt. There aren't enough of us, and there aren't going to be enough of us.

No one can outmaneuver supply and demand.

 

[Account1]

This sad state of affairs is just medicine as a whole.

However.

Anesthesiology as a lucrative specialty will live or die based on how society (government) chooses to value and reimburse procedures. There's no indication that we're going to quit spending a disproportionate percentage of healthcare dollars on surgery. New, expensive devices and techniques drive healthcare investment and spending - and almost all of that stuff is related to procedures. The population is getting older, fatter, sicker. Those old and fat people are the most reliable voters in the country. We'll cut more useful things before we cut their access to surgery and implants and device-facilitated procedures.

In times of financial pressure, hospital-employed physicians' salaries will remain propped up in the areas that keep hospitals solvent. There is no reason to think that won't be OR and non-OR procedures. We are a necessary cost to keep the meat moving on the conveyor belt. There aren't enough of us, and there aren't going to be enough of us.

No one can outmaneuver supply and demand.

Economics: Supply and Demand

 

[pgg]

People are creatures of habit. If you are going to the same place for 14 years, do you want to suddenly find somewhere else to go? especially if you have a house that has 14 years of stuff in it, and 3 children in the local school system. It isnt that easy to move and this is what your employer exploits.

The new generation of anesthesiologists is much different. 10+ years ago it was absolutely unheard of for a new grad to do full-time locums right out of the gate.

The concept of loyalty to an employer is dead. There are precious few private groups left, where partnership means something and has significant value. Nearly all new grads are taking jobs as employees, either in academics, for hospital systems, or AMCs.

Young people and young professionals especially are having fewer children.

The market is more transparent than it has ever been. Gone are the days when there was significant opacity to what others were earning and how many hours others were working, elsewhere.


Sure, there's always some inertia and reluctance to pick up and move. Moving sucks. But more recent graduates are more mobile, less loyal, and less tethered than physicians have ever been. A family's anchor used to be the physician who was a partner in a group - now it's a lot more likely to be the physician's spouse.

Kids? Kids move when their parents tell them they're moving. They make new friends. They're fine. In general, parents' reluctance to move their kids is weird, unhealthy, and counterproductive.

 

[Account1]

The new generation of anesthesiologists is much different. 10+ years ago it was absolutely unheard of for a new grad to do full-time locums right out of the gate.

The concept of loyalty to an employer is dead. There are precious few private groups left, where partnership means something and has significant value. Nearly all new grads are taking jobs as employees, either in academics, for hospital systems, or AMCs.

Young people and young professionals especially are having fewer children.

The market is more transparent than it has ever been. Gone are the days when there was significant opacity to what others were earning and how many hours others were working, elsewhere.


Sure, there's always some inertia and reluctance to pick up and move. Moving sucks. But more recent graduates are more mobile, less loyal, and less tethered than physicians have ever been. A family's anchor used to be the physician who was a partner in a group - now it's a lot more likely to be the physician's spouse.

Kids? Kids move when their parents tell them they're moving. They make new friends. They're fine. In general, parents' reluctance to move their kids is weird, unhealthy, and counterproductive.

Yes the super streamlined employment market and communication has made things a bit weird. You’re lucky if a group is the same from one year to the next if it’s more than 10 people. Pretty darn rare now

 

[AdmiralChz]

Kids? Kids move when their parents tell them they're moving. They make new friends. They're fine. In general, parents' reluctance to move their kids is weird, unhealthy, and counterproductive

That’s the military in you talkin’!

 

[Gern Blansten]

Economics: Supply and Demand

I was going to see a community theater thing about 25 years ago ( well past Father Guido Sarducci’s peak) and he walked in and sat in the audience, in his stage costume. It was a small community and no one else knew who he was. They all thought he was just a clergy guy who came to see community theater. I was the only one, seemingly in the entire theater, who knew who he was and got shushed by my own family for pointing him out. He just sat there, watched the show and not a single person approached him. Then, he quietly left. He is a comedy treasure.

 

[NPJR]

The new generation of anesthesiologists is much different. 10+ years ago it was absolutely unheard of for a new grad to do full-time locums right out of the gate.

The concept of loyalty to an employer is dead. There are precious few private groups left, where partnership means something and has significant value. Nearly all new grads are taking jobs as employees, either in academics, for hospital systems, or AMCs.

Young people and young professionals especially are having fewer children.

The market is more transparent than it has ever been. Gone are the days when there was significant opacity to what others were earning and how many hours others were working, elsewhere.


Sure, there's always some inertia and reluctance to pick up and move. Moving sucks. But more recent graduates are more mobile, less loyal, and less tethered than physicians have ever been. A family's anchor used to be the physician who was a partner in a group - now it's a lot more likely to be the physician's spouse.

Kids? Kids move when their parents tell them they're moving. They make new friends. They're fine. In general, parents' reluctance to move their kids is weird, unhealthy, and counterproductive.

Try telling your 2 daughters in 7th and 9th grade they're moving and have to leave their friends and boyfriends behind because you can't get along with the chief of anesthesia over money. Talk about trauma.

 

[pgg]

Try telling your 2 daughters in 7th and 9th grade they're moving and have to leave their friends and boyfriends behind because you can't get along with the chief of anesthesia over money. Talk about trauma.

Try talking to any military family that moves every 2-3 years.

It's fine.

Your tweenage girls will be fine. They'll be better for it.

I mean, god forbid a middle school romance ends. Talk about trauma.

 

[WhatJobDoIPick]

It'll be doing better than Emergency Medicine that's for sure.

Dunno why med students are still applying to this dead field.

 

[NPJR]

It'll be doing better than Emergency Medicine that's for sure.

Dunno why med students are still applying to this dead field.

9 shifts/days for 500k. That is probably why. Im guessin.

 

[WhatJobDoIPick]

9 shifts/days for 500k. That is probably why. Im guessin.

This is an outlier rate.

Assuming 12 hour shifts, that would be $385/hr which is rare unless locums or a partner in a private group.

 

[aneftp]

This is an outlier rate.

Assuming 12 hour shifts, that would be $385/hr which is rare unless locums or a partner in a private group.

9 shifts/days for 500k. That is probably why. Im guessin.

My buddy does 14-18 hrs a week total (3 days a week) with a crna for 500k outpatient gig at insurance owned surgery center these days plus 10 weeks off plus free healthcare since he’s employed by the insurance company. Total scam lol. I seriously thought they would close the surgery center down within the last year but he’s still riding it for over 6 years. Either he’s on the golf course by 12pm or working second job at 3pm for extra 1099 cash.

 

[finalpsychyear]

Things will mean revert in anesthesia like all other fields. The last several have been insanely good. Couple that with the market soaring and if u have been investing 5+ years heavily you likely have set urself up for life given the income paired with market returns esp if u milked it doing 1099. Also add in ai and robotics plus continued mid levels and im glad im closer to the end of my career as a whole.

I hope the gravy train goes another 5 years stocks and high salaries combo but we r due for market crashes so its unlikley ull get this kind of market even if ur salary stays similar. Trust me i want this market till 2030 but not holding my breath