Future??

[Houseness]

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Hey All-

I have been reading you guys forever now it seems. Even before the FAQ came out. It's so great to see the 7 or so regulars constantly keep this board fresh! I'm an MS1 and I am really considering Anesthesia. It seems to have everything I want (at my current immature stage yet). Basically, I want something where patient contact is short, but meaningful, the results of my actions are immediate and satisfying. I hate anatomy right now (I'm passing though), but I love biochemistry and physiology, and I anticipate enjoying pharmacology.

There was an article (summary of a task force report actually) in the recent ASA Newsletter that was called "Future Paradigms of Anesthesia Practice". Gist is, Anesthesia will be extremely important in the future, but changes must be made now to meet trends. That is, the future of hospitals is to become more intensive in terms of care and increase in number of inpatient beds, as the increase in outpatient services will allow only the most ill patients to remain in the hospital. With the technical aspects of Anesthesia becoming increasingly advanced and user friendly, technicians will be able to do most of the work.

The recommendation of the taskforce was to have Anesthesia truly reclaim what it once had: Critical Care and Pain Management. Those are things that other specialties (namely, hospitalists, medicine and Cardiopulmonary, PM&R) are stepping in and really doing good work. Anesthesia has "the potential to be the hospitalists of the future" in all aspects of care including perioperative.

What do you guys currently practicing think of this? I ask you think in terms of someone like me who is considerin Anesthesia as a specialty based solely on personality reasons I stated in the first paragraph. I know the future changes might not affect you so much, but how should someone like me interpret all of this?

In order to hedge any combative posts, I just want to say that my dad is an Anesthesiologist and loves what he does. I have had considerable exposure to the specialty in terms of lifestyle, workload, etc. I was in middle school when he was doing his residency and I remember what he went through from the family perspective. But for some reason, his outlook on the future is more grim and whenever I express interest in Anesthesia, he appreciates it, but doesn't totally encourage it either (it may be because he thinks I only want to go into it because of him and doesn't want to influence me). But I feel like I have my own legitimate reasons for having interest in it. More than what I said above, I like the management of care aspect, the diverse procedures, the knowledge of the entire body (physiologically), and the teamwork involved.

 

[VolatileAgent]

man we really need to get the search function fixed.

 

[Houseness]

Totally...I actually only found intermittent discussions of this topic. Like specific issues (CRNA vs. MD). So there wasn't one thread where something like this was posted. Sorry if it is a repeat. Maybe y'all can link me appropriately?

 

[jetproppilot]

Hey All-

I have been reading you guys forever now it seems. Even before the FAQ came out. It's so great to see the 7 or so regulars constantly keep this board fresh! I'm an MS1 and I am really considering Anesthesia. It seems to have everything I want (at my current immature stage yet). Basically, I want something where patient contact is short, but meaningful, the results of my actions are immediate and satisfying. I hate anatomy right now (I'm passing though), but I love biochemistry and physiology, and I anticipate enjoying pharmacology.

There was an article (summary of a task force report actually) in the recent ASA Newsletter that was called "Future Paradigms of Anesthesia Practice". Gist is, Anesthesia will be extremely important in the future, but changes must be made now to meet trends. That is, the future of hospitals is to become more intensive in terms of care and increase in number of inpatient beds, as the increase in outpatient services will allow only the most ill patients to remain in the hospital. With the technical aspects of Anesthesia becoming increasingly advanced and user friendly, technicians will be able to do most of the work.

The recommendation of the taskforce was to have Anesthesia truly reclaim what it once had: Critical Care and Pain Management. Those are things that other specialties (namely, hospitalists, medicine and Cardiopulmonary, PM&R) are stepping in and really doing good work. Anesthesia has "the potential to be the hospitalists of the future" in all aspects of care including perioperative.

What do you guys currently practicing think of this? I ask you think in terms of someone like me who is considerin Anesthesia as a specialty based solely on personality reasons I stated in the first paragraph. I know the future changes might not affect you so much, but how should someone like me interpret all of this?

In order to hedge any combative posts, I just want to say that my dad is an Anesthesiologist and loves what he does. I have had considerable exposure to the specialty in terms of lifestyle, workload, etc. I was in middle school when he was doing his residency and I remember what he went through from the family perspective. But for some reason, his outlook on the future is more grim and whenever I express interest in Anesthesia, he appreciates it, but doesn't totally encourage it either (it may be because he thinks I only want to go into it because of him and doesn't want to influence me). But I feel like I have my own legitimate reasons for having interest in it. More than what I said above, I like the management of care aspect, the diverse procedures, the knowledge of the entire body (physiologically), and the teamwork involved.

Those are very legitimate issues, Houseness.

I can tell you from my perspective that I enjoy the scope of my practice, which does not include critical care or pain management. Not sure I'd enjoy it as much if those two subspecialties were incorporated.

 

[militarymd]

Here are the things that you need to be aware of for the future of anesthesia.

At the ASA, there is talk of spending LESS time in the OR, and MORE time outside of the OR to do things like critical care medicine/pain/etc......things that physicians (perioperative,hospitalist, etc.) do.

I chose anesthesia with the intent of doing critical care medicine. I thought that the practice of anesthesia in the US was similary to the UK, and I was wrong.

The reimbursement issues in the US has made the practice of anything other than OR anesthesia impractical.

However, with the aging population (read medicare////no pay insurance), the shift will be towards more cases....less pay....an environment where it will force the "business" of anesthesia to more CRNA supervision....to allow the anesthesiologist to perform for "doctor" stuff.....ICU/pain management,,,etc.

If nothing else, the next 20 years will be interesting.

 

[adleyinga]

Here are the things that you need to be aware of for the future of anesthesia.

At the ASA, there is talk of spending LESS time in the OR, and MORE time outside of the OR to do things like critical care medicine/pain/etc......things that physicians (perioperative,hospitalist, etc.) do.

I chose anesthesia with the intent of doing critical care medicine. I thought that the practice of anesthesia in the US was similary to the UK, and I was wrong.

The reimbursement issues in the US has made the practice of anything other than OR anesthesia impractical.

However, with the aging population (read medicare////no pay insurance), the shift will be towards more cases....less pay....an environment where it will force the "business" of anesthesia to more CRNA supervision....to allow the anesthesiologist to perform for "doctor" stuff.....ICU/pain management,,,etc.

If nothing else, the next 20 years will be interesting.

Wow- i completely agree with above. ABA is considering increasing the ICU requirements to 6 months of ICU during four years. So when looking for residency check out the ICU situation.

This brings up a bigger issue
Will Medicine be socialized before you guys even get out of residency and if not- how soon after.

 

[davvid2700]

Wow- i completely agree with above. ABA is considering increasing the ICU requirements to 6 months of ICU during four years. So when looking for residency check out the ICU situation.

This brings up a bigger issue
Will Medicine be socialized before you guys even get out of residency and if not- how soon after.

6 months of ICU.. Thats absurd.. IF one wants to do critical care medicine just do a fellowship...

 

[chicamedica]

we should all just move to the UK. . .



j/k 😀

I'm gonna stay optimistic. I think things are going to be fine one way or another. I do hope that pain med isn't going to be incorporated into general anesthesia practice, b/c i do NOT want to do pain. CCM is fine, I'm actually considering the fellowship. However, i'm sure not all anesthesia applicants are interested in CCM either. I just think these subspecialties shouldn't get incorporated.

p.s. I dont think medicine is going to get socialized in the US. Ever. It's miserably functioning in Canada already.

 

[davvid2700]

Here are the things that you need to be aware of for the future of anesthesia.

At the ASA, there is talk of spending LESS time in the OR, and MORE time outside of the OR to do things like critical care medicine/pain/etc......things that physicians (perioperative,hospitalist, etc.) do.

I chose anesthesia with the intent of doing critical care medicine. I thought that the practice of anesthesia in the US was similary to the UK, and I was wrong.

The reimbursement issues in the US has made the practice of anything other than OR anesthesia impractical.

However, with the aging population (read medicare////no pay insurance), the shift will be towards more cases....less pay....an environment where it will force the "business" of anesthesia to more CRNA supervision....to allow the anesthesiologist to perform for "doctor" stuff.....ICU/pain management,,,etc.

If nothing else, the next 20 years will be interesting.

Being in the OR "IS" what physicians DO

 

[Houseness]

What does all this say about future compensation then?

 

[jetproppilot]

p.s. I dont think medicine is going to get socialized in the US. Ever. It's miserably functioning in Canada already.

I absolutely agree with you, Chica.

 

[militarymd]

Being in the OR "IS" what physicians DO

I'm simply repeating some of what the "big wigs" in anesthesia are stating at the ASA/ABA.....I'm the messenger here.

When I attend in the ICU, I don't take care of just one patient....I have ICU nurses do a lot of the stuff that I want done.

Do you think that this is any different in the OR?

 

[Noyac]

6 months of ICU.. Thats absurd.. IF one wants to do critical care medicine just do a fellowship...

Well you may want to avoid New Mexico. I did 5 months ICU (NICU, PICU, MICU, SICU, and Trauma/burn) in my intern year and 4 months the next 3 years. Add it up, thats 9 months. I enjoyed every minute of it,too. It can only make you a better anesthesiologist.

How about you Zippy? Did you get the same amount?

 

[zippy2u]

did the minimum of 2 months ---Zip

 

[davvid2700]

I'm simply repeating some of what the "big wigs" in anesthesia are stating at the ASA/ABA.....I'm the messenger here.

When I attend in the ICU, I don't take care of just one patient....I have ICU nurses do a lot of the stuff that I want done.

Do you think that this is any different in the OR?

Yes, it is different.. because being in the OR is a physicians job