Future of Anesthesiology

[Dr. Anonymouss]

As a third year wanting to pursue anesthesiology I would love to hear from those who are experienced, have been in the field, and are seeing the changes happen everyday around them. What do you personally see as the future of anesthesiology? Some questions that come to mind, but please answer freely.

1.) Do you believe all of anesthesia will move towards private equity owned groups or will physician owned private practice groups remain?
2.) Do you see the 3:1/4:1 care team model taking over and becoming the gold standard?
3.). Anything related to the CRNA versus anesthesiologist work dilemma.

---

Members don't see this ad.

 

[DocMcCoy]

Going into fifth year in practice.

1.) I'm hospital employed and my WAG is that most will be employed in the future. Not enough to squeeze anymore for PE, too hard for private groups to make it with the way reimbursement is set up.

2.) Unpopular opinion, and though I wish it wasn't the case, reading the writing on the wall, huge push from midlevels in all fields + huge shortage of physicians = full independence likely in our lifetimes. They will be sitting cases as your "equal", or at best one firefighter anesthesiologist working in a collaborative model over an army of CRNAs. For every decent study that shows why this is a bad idea, they have 10 sh*tty "non inferiority" studies that (wrongly) support independence. That, and with bullsh*t online 12 month doctorates, everybody is going to be a "doctor" anyway.

3.) They (CRNAs) are militant and organized. Slow equalization of pay as their salaries creep up and ours creep down. The only chance to make extra will be in taking call and working weekends because they likely won't. We will become less like physicians and more like clock punchers.

I pray I'm wrong and I still like my job. Probably just a little jaded because I've seen how far my group has fallen in four short years.

 

[dabears505]

There is no future

 

[T-burglar]

status quo until the entire healthcare system collapses

 

[secretasianman]

To the OP this picture is not just anesthesia but all of medicine. When you go see a pcp or a specialist chances are you might be seeing an online mill np/pa fresh out of bullsht school printing fresh “board certified” certificates. True expertise is devalued and when the entire nursing complex is militant and corrupt, it’s only a question of when they take everything over. The real question of our lifetime is whether advocating for our own care will be even possible.

Going into fifth year in practice.

1.) I'm hospital employed and my WAG is that most will be employed in the future. Not enough to squeeze anymore for PE, too hard for private groups to make it with the way reimbursement is set up.

2.) Unpopular opinion, and though I wish it wasn't the case, reading the writing on the wall, huge push from midlevels in all fields + huge shortage of physicians = full independence likely in our lifetimes. They will be sitting cases as your "equal", or at best one firefighter anesthesiologist working in a collaborative model over an army of CRNAs. For every decent study that shows why this is a bad idea, they have 10 sh*tty "non inferiority" studies that (wrongly) support independence. That, and with bullsh*t online 12 month doctorates, everybody is going to be a "doctor" anyway.

3.) They (CRNAs) are militant and organized. Slow equalization of pay as their salaries creep up and ours creep down. The only chance to make extra will be in taking call and working weekends because they likely won't. We will become less like physicians and more like clock punchers.

I pray I'm wrong and I still like my job. Probably just a little jaded because I've seen how far my group has fallen in four short years.

 

[Gern Blansten]

Encroachment in all fields of medicine. Our specialty has been at the tip of the spear but now all are seeing it. Name a specialty and I’ll tell you who is vying to do their job with far less training. In other words, gaining through legislation what we gained through education.

If it makes you feel any better, when I was in med school, I was told our specialty was dead. That was ~25 years ago. We may be dying, but the rate is slow and almost all specialties are in the same boat.

 

[BLADEMDA]

As a third year wanting to pursue anesthesiology I would love to hear from those who are experienced, have been in the field, and are seeing the changes happen everyday around them. What do you personally see as the future of anesthesiology? Some questions that come to mind, but please answer freely.

1.) Do you believe all of anesthesia will move towards private equity owned groups or will physician owned private practice groups remain?
2.) Do you see the 3:1/4:1 care team model taking over and becoming the gold standard?
3.). Anything related to the CRNA versus anesthesiologist work dilemma.

1. Private Equity is losing market share slowly to Hospitals. I think the big ones will survive for 5-10 more years. Small and Medium sized private groups are likely in trouble due to the No Surprise Act. If you want a true PP job avoid long tracks. I think all these types of jobs will exist in 5 years.

2. The ACT isn't going anywhere. CRNAs are more expensive than ever before so if anything you may see a bit more MD only anesthesia. But, I expect no significant change to the current staffing model overall nationally.

3. There is no dilemma. Anesthesiologists are becoming more like "hourly" employees in many locations. They get paid based on the hours worked. Still, most employed anesthesiologists are salaried W-2 employees. I see more contracts specifying the hours per week with extra pay for additional time.

This field is in high demand and I see that continuing for the near future (3 years). My crystal ball gets fuzzy after 3 years but I have never wanted for work in my career and the only period of time finding a job was difficult/hard was the mid 1990's (I was already employed). But, even then there was work for all providers.

 

[Dr. Anonymouss]

Thanks for everyones replies. I know it's impossible to know the future, but you are all the closest to seeing how it might play out. I guess what worries me the most is going into anesthesiology and then finding that the job market/salary isn't strong and all the time I spent throughout school will be wasted. We are seeing that midlevels are making great strides in getting autonomy and pay increases, but the ultimate decider of this will be patients. If patients feel comfortable being treated by midlevels rather than physicians then our field is truly doomed, but if they believe in the rigor of our training and that we are the utmost qualified then I still see hope.

 

[vector2]

Thanks for everyones replies. I know it's impossible to know the future, but you are all the closest to seeing how it might play out. I guess what worries me the most is going into anesthesiology and then finding that the job market/salary isn't strong and all the time I spent throughout school will be wasted. We are seeing that midlevels are making great strides in getting autonomy and pay increases, but the ultimate decider of this will be patients. If patients feel comfortable being treated by midlevels rather than physicians then our field is truly doomed, but if they believe in the rigor of our training and that we are the utmost qualified then I still see hope.

My 2 cents:

1. Pick a field where you bring in patients and those patients belong to you.

2. Pick a field where midlevels can't even pretend to do your job let alone actually do your job.

The most future-proof jobs qualify for both 1 and 2, but try to get at least one of those.

 

[Dr. Anonymouss]

My 2 cents:

1. Pick a field where you bring in patients and those patients belong to you.

2. Pick a field where midlevels can't even pretend to do your job let alone actually do your job.

The most future-proof jobs qualify for both 1 and 2, but try to get at least one of those.

What do you have in mind? So far the only specialty that has interested me is anesthesiology. I truly am fascinated by it and think it fits my personality the best. It's just the future outlook on the field which worries me.

 

[Dr. Anonymouss]

Are there any fields within anesthesiology that you all see are safer than others i.e. cardiac, peds, pain?

 

[ambiturner]

What do you have in mind? So far the only specialty that has interested me is anesthesiology. I truly am fascinated by it and think it fits my personality the best. It's just the future outlook on the field which worries me.

Surgical fields are the obvious choice, or any other procedural field that has procedures complicated enough that they take years to learn (cardiology, interventional stroke, Mohs, etc). These are competitive and often involve poor lifestyles.

If you want a non-procedural field pick something where knowledge is valued and a lot of innovation is occurring. When I was an intern 10 years ago one of my seniors went into rheum saying it had a lot of potential, when at the time it was boring and low paying. Now they’re doing procedures and have lots of fancy new drugs, so he was right. Heme onc and neuro are other good examples.

For me I like anesthesia and enjoy the work, even with the stagnant pay. But like others in this thread I have seen very little positive in this field other than a temporarily booming job market. Adjusted for inflation, my highest earning year is still my second year in practice over 5 years ago. But would that be different in other fields? Based on friends it doesn’t seem like it, many make more than me but I have yet to hear any with a solidly increasing trajectory based on clinical revenue alone.