Future of anesthesiology?

[UCImed2000]

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HI everybody thanks for all your help with the info on this board.

I am really interested in anesthesiology, not just cuz the lifestyle and such are so rewarding but i really enjoyed pharm, physio and the OR, but couldn't see myself as a surgeon. I am worried about anesthesiology, because the seemingly cyclical nature of the field, which as an MS3, doesn't not bode well for me (cut it would be 5yrs till I am done and the market could well be saturated by then. Other then the possible/inevitable cuts in anesthesiology re-imbursement, what other changes are in store for field anesthesiology? Has the CNurseAna gotten settled completely yet <is so a link or more info would be much appreciated>?

Also why do I never see any older anesthesiologist? Where are they? Are they phased out because of their age or something? That just made me wonder that maybe anesthesiology is a field that young anesthesiologist are seen as quicker more uptodate then anesthesiologist who have been around for a while? ? ? if so that would really not make the field so stable. Stability is a good thing.



Thanks,
UCImed2000

 

[ortholsu]

i've been reading a lot about the field lately (new found interest), but i haven't seen anything negative about the future in terms of pay or stability. i'd be interested in hearing what the facts are.

khalid

 

[powermd]

What about the danger of American anesthesiologists being replaced by $5/day Indian MDs who run the cases via advanced satellite-controlled anesthesia machines?

 

[VentdependenT]

HHAHAHAHAHHA

I heard that primates were going to start replacing the $5 a day overseas people. Four walnuts a day and a large monkey bar set, and boom, your cases are done for you!

 

[Gas]

The future for anesthesiology looks bright. There is renewed interest in the field and this means more anesthesiologists are going to be in the market for jobs, but the future looks good for other reasons. First off, all these baby-boomers are going to need surgery as they get older, from joint replacements to CABG's to TURP's to TAH's, etc. In fact, the whole health care system is poised to see a sharply increased demand on its services as the percentage of older Americans increases.

Second of all, anesthesiologists themselves are baby-boomers and will retire. I think this may also have to do with not seeing many older anesthesiologists. This may not mean much, but I plan on retiring no later than age 50 or 55 with the way incomes are nowadays. Plus, anesthesiologists are people who inherently like a good lifestyle, so they may not want to work as much when they get older.

There was a study done by the Mayo Clinic on the need for anesthesiologists in the future. I have not seen it myself, so I don't know if it is true, but they supposedly drew the conclusion that the demand for anesthesiology services is increasing faster than the ASA is increasing residency spots. This may change in the future, however.

I have been hearing about this CRNA thing for so long that I think nothing is going to happen. I don't have any facts to back me up, but if something were to have happened, it would have back in the early 1990's when Clinton proposed his universal health care plan and ideas to limit specialists. Also, not to knock CRNA's but this baby-boomer population is spoiled and they feel like they are entitled to the best health care possible (one reason why Medicare is feeling such a financial pinch). With that said, do you think the average American would say "OK" when you tell them that they will be placed under general anesthesia with no MD supervision? As a health care provider, I see CRNA's and I see that they are intelligent, competent, and can handle most cases on their own, but the public image of "nurse" and "doctor" is one that is pretty well-defined.

The counterargument to this is that insurance companies won't give the patient the choice, but again this simply has not happened yet, so don't let it stop you from entering this field.

 

[Tenesma]

1) there are fewer older anesthesiologists because of two factors: high burn-out rate and very high compensation.... most (in private practice) retire in their mid-forties (now i am not basing this on any literature reviews/meta-analyses, but rather after discussions with multiple colleagues)....

2) the CRNA issue will always be there.... over time most states will allow them to provide anesthesia without MD supervision.... due to the continued shortage of anesthesia providers and an ever increasing elderly population, there will continue to be a demand for anesthesia providers... the elderly population will also become more and more complicated and will continue to require our depth of knowledge and our more extensive training. so don't worry about jobs

3) cyclical: every specialty is cyclical - you should choose what gives you the most pleasure.... and yes reimbursements will continue to go down... but that is the case for every specialty except for those that don't have a heavy dependence on medicare/medicaid....

4) the great thing about anesthesia is its portability: you can practice anesthesia in wyoming and then one day decide to move to florida.... you don't have to worry about moving your whole practice, because you are your own practice!

 

[powermd]

Originally posted by powermd
What about the danger of American anesthesiologists being replaced by $5/day Indian MDs who run the cases via advanced satellite-controlled anesthesia machines?

Sorry guys, I think MacGuyver hacked my password and is posting from my account.

 

[Krafty]

One thing about this notion of not being tied down in one place. I went to undergrad in small liberal arts school in PA, once visiting, my fiancee and I decided that maybe after residency we would consider going out and living our first years post residency in a more rural setting. Don't get me wrong, I'm a city slicker, and as much as I hate the overcrowding of NYC, I also like the incredible cultural wealth...ready? Here's my point:

Malpractice Insurance is a drawback of skipping around as an Anesthesiologist. There are different types of coverage that a practitioner could go under. I'm not up on my nomenclature but it's something of continuous versus incident coverage or something like that...meaning-

If you go ahead and change your job, you'll have to be retroactively covered for cases you did before you switched. Your new practice can choose to cover you retroactively (which most don't do now, since they aren't starving for people anymore) or you pick up your "slack". I think it's like the 5-10 years post last insurance policy at a previous place that you need to be covered for.

You could also go uncovered, but then your court/attorney fees are out of pocket should you unfortunately get sued.

Something to keep in mind. I'll try to look up those insurance details. Sorry about the long post.

 

[juddson]

I'm not sure how long the "tail" coverage should go back for, but given that most states have a 2 or 3 year statute of limitations on medical injury tort filings, I can't see why the tail insurance should need to extent more than 3 years or so.

Further, this is somewhat of a nuanced issue. Many insurance policies cover expenses incurred for incidences that take place during the coverage period. Hence, even if you cancel your policy in early 2004, and are sued for something in 2005 for something you did (or failed to do) in 2003, I think the policy you had in 2003 should cover you even without "tail" coverage.

I'll have to check my books, but ordinarily I thought that this is how it worked.

Judd

Judd