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Are you seeing hiring freezes in Anesthesia departments. My institution, a large one, is now on a hiring freeze.
The job market for anesthesiologists is abyssmal. New grads will find this out soon, unfortunately.
Are you seeing hiring freezes in Anesthesia departments. My institution, a large one, is now on a hiring freeze.
We haven't been on an official "freeze", but we haven't hired anybody in 2 years. Our surgical volume which had increased 3-5% per year for more than 10 straight years flattened out in the recession and is only just now resuming that prior growth rate. Haven't had anybody retire because the older docs are still trying to recoup their stock market losses from 2009 and are working longer than they anticipated. Also a lot of trepidation as to what Obama-care will mean to revenue in the future and many don't want to commit to paying new docs when revenue might drop significantly.
I'd imagine lots of other groups are similar. Just waiting to see how it all shakes out. I suspect in 3-4 years there will be a rather large need for hires as the pent up demand will need to be met.
I shall save this post and bring it up in 2016 to show you just how horribly wrong you were.
I shall save this post and bring it up in 2016 to show you just how horribly wrong you were.
AGREE.
I will believe that there is hope for the job market if and only if there is a massive drop in the number of medical students who match into anesthesia.
Please do. There are a LOT of anesthesiologists nearing age 65 and the utilization of our services both in and out of ORs continues to grow. I'd bet that it 2016, there will be something like 10% more anesthetics given in the US than there were in 2012.
Any bet against a need for future hiring can only be right if anesthesiologists aren't in the equation. And we are still working in opt out states and there are many states that aren't anywhere near opting out of anything.
Why? The need for our services goes up every year as the US population expands, yet the number of residency spots has remained constant for some time.
http://www.grogono.com/nrmp/2001/Recruitment01.pdf
Go to page 8 figure 1.
The good job market circa 1999-2009 is a direct result of the drop off in med students entering the match in the mid-late 90s.
The training programs hired like mad during this time in order to do the work of residents who just stopped showing up. This mopped up the excess anesthesiologists looking for jobs. Suddenly there were jobs, but more importantly the pipeline was empty. Hence the decade long bull market for anesthesiologists.
Now we have fewer alternatives for med students. Excess positions in the match are now much less.
Throw in a sh*tty stock market and real estate market, bounce back kids, and I believe the old guys will be hanging around longer than anyone thinks.
Add CRNAs graduating huge numbers and their legislative victories and hospitals pushing ever harder to increase supervisory ratios. Add MD only groups going the way of the dinosaur.
That is why I am pessimistic.
http://www.grogono.com/nrmp/2001/Recruitment01.pdf
Go to page 8 figure 1.
The good job market circa 1999-2009 is a direct result of the drop off in med students entering the match in the mid-late 90s.
I disagree that surgical procedures will increase with an aging population. While nobody knows for sure what's coming, here is what some of the "higher ups" in the ASA and AMA have told me...
Rationing is coming. But unlike Europe, the US government does not want to be seen as the rationer. Instead, they will "force" surgeons to ration care. How will they do that?
They are already planting the seeds. And there are 2 ways to do it. We can use knee replacement surgery as an example.
1. Bundled payments. Medicare only pays one global fee for a knee replacement. If the patient suffers a complication and needs additional resources (wound infection, PE, MI, CVA, CHF, etc) the hospital and treating physicians will have to "eat it". Eventually the hospital and treating physicians will tell the surgeons we are not going to tolerate this unless the surgeons want to give up their portion of the global fee. So surgeons will be forced to operate only on the healthiest patients to avoid complications. Over age 70 nope. BMI > 30 nope. Smoker nope. HgbA1C > 7 nope. EF <50% nope. Uncontrolled HTN nope. Pretty soon there's not a lot of patients left to operate on.
2. Quality Initiative. Medicare will start "grading" physicians on their quality outcomes. If you don't meet the benchmarks, you don't get paid. For surgeons that means your post-op complications have to be below a certain level in order to get fully reimbursed. So how do surgeons decrease their complication rate? Operate on healthier patients. Again, only "healthy" patients will get their surgery. And we all know how many "healthy" patients are out there 😉
Then comes full circle true fee-for-service care for people who pay out of pocket or carry private insurance, kind of like how the Surgery Center of OK does it.
I only partially agree with you. Private insurance will follow Medicare's guidelines. Guaranteed. So private insurers will also use bundled payments and quality initiatives.
Self pay might be the only way to get around it and be able to operate on the sicker patients. The obvious problem with that is how many people can afford to self-pay for a surgery in this economy?
Yes, there was a drop off in the late 90s in terms of # of residents being trained. In the last decade, however, it's been flat. And it is almost impossible to increase it in our current system.
So while the good job market earlier was definitely related to the previous downturn in resident numbers, that does not project to a bad market in the future. As I said, the US population keeps getting bigger and we keep having more people in their 60s and 70s and 80s living here. They need surgeries. Baby boomers are getting to the age when you expect a sharp upturn in their need for CABGs and TKAs. That means the number of surgeries performed in our country should rise even faster than the overall population growth. Then add in ever increasing numbers of cases outside the OR that we get dragged in to and there is no end in sight to the demand for our services.
Physicians can hold off on retiring to some extent, but not forever.
Increasing demand and fixed supply of personnel means the job market will have to improve.
Private insurance only follows that until they can't attract customers. If people want the quality of health care they are used to, they will have to pay for it. Considering that insurance companies are doing just fine financially I suspect people will continue to pay for it.
Numbers have been flat the last few years, but what I believe is a high level. Certainly more than replacement of those leaving the field.
I assume an educated person like yourself has been reading the news lately. Major health insurance companies have been enacting double digit rate hikes despite the overall costs of healthcare leveling out. And the states have no power to stop it. There is no reason this won't continue.
The result? Individuals cannot afford to buy private health insurance so they are going on Medicaid or going without any coverage. Companies are no longer offering health insurance to their employees. The ones that still offer coverage are increasing employee premiums to reflect the increases in premiums leveed by the insurance companies.
At some point, virtually no one will have private health insurance. This will cause quite a stir from the American public. What will be the result? Universal Healthcare i.e. Medicare for all! Again, the US government gets what it wants (universal healthcare) without looking like the bad guy. They blame the insurance companies and look like heroes for saving everyone with a national health system.
The government isn't as stupid as they appear folks.
I assume an educated person like yourself has been reading the news lately. Major health insurance companies have been enacting double digit rate hikes despite the overall costs of healthcare leveling out. And the states have no power to stop it. There is no reason this won't continue.
The result? Individuals cannot afford to buy private health insurance so they are going on Medicaid or going without any coverage. Companies are no longer offering health insurance to their employees. The ones that still offer coverage are increasing employee premiums to reflect the increases in premiums leveed by the insurance companies.
At some point, virtually no one will have private health insurance. This will cause quite a stir from the American public. What will be the result? Universal Healthcare i.e. Medicare for all! Again, the US government gets what it wants (universal healthcare) without looking like the bad guy. They blame the insurance companies and look like heroes for saving everyone with a national health system.
The government isn't as stupid as they appear folks.
I am aware of all of that. I am also aware that in places like the UK with nationalized health care that private hospitals still exist. That overwhelming majority of voters have no desire for national healthcare. People with insurance like their insurance and plan to keep it.
Do you work where I do? This perfectly describes my patient population.Hmm. My medicaid patients seem happier than pigs in shyt. They don't take care of themselves, are able to afford iPhones, use their food stamps to eat McDonalds 5 times a day, and can visit the ER as much as their little hearts desire. If they need pain meds they get it, if they need a hot meal they get it, if they need a TV and more blankets they get it, and if they need surgery they get it.
The job market for anesthesiologists is abyssmal. New grads will find this out soon, unfortunately.
AGREE.
I will believe that there is hope for the job market if and only if there is a massive drop in the number of medical students who match into anesthesia.
I assume an educated person like yourself has been reading the news lately. Major health insurance companies have been enacting double digit rate hikes despite the overall costs of healthcare leveling out. And the states have no power to stop it. There is no reason this won't continue.
The result? Individuals cannot afford to buy private health insurance so they are going on Medicaid or going without any coverage. Companies are no longer offering health insurance to their employees. The ones that still offer coverage are increasing employee premiums to reflect the increases in premiums leveed by the insurance companies.
At some point, virtually no one will have private health insurance. This will cause quite a stir from the American public. What will be the result? Universal Healthcare i.e. Medicare for all! Again, the US government gets what it wants (universal healthcare) without looking like the bad guy. They blame the insurance companies and look like heroes for saving everyone with a national health system.
The government isn't as stupid as they appear folks.
This doesn't make any sense. The number of Medical Students keeps increasing each year while the Residency spots stay relatively fixed. This means every Anesthesiology slot is more competitive with each graduating class.
Supply vs Demand applies more than ever and the demand for a Residency position (any position) has never been greater in my lifetime.
I believe what, something like 1100-1200 people graduate an anesthesia residency every year in this country? Assume an overly generous average of a 30 year full time career per graduate and you are holding flat at 33000-36000 anesthesiologists in the country at any time, excluding foreign trained docs working here. But a 30 year full time career is way overgenerous as a median. Plenty of docs end up working part time or even leaving fulltime medicine for family responsibilities.
I don't think that's enough to meet the long term need.
Hi all. Long time lurker on this site, always love to read the lively discussions. As a CA-1, this issue is causing me significant stress already.
So where does this leave us residents? Are the majority of 1,300 new grads every year going to have a very difficult time finding employment of any kind? Does Obamacare spell the end for the anesthesiologist as we know it? This is really freaking scary, and it makes it hard to get through the grind of a 70 hour work week knowing that there may not be a ligth at the end of the tunnel after all.
CA-3's graduating from my program still seem to be finding jobs (for now), but it seems like it's been somewhat tough.
Work Hard. Excel at what you do. Network for a job. Consider a Fellowship to improve your odds of finding a good job.
Things are tough out there but a quality, Fellowship trained Anesthesiologist can still find a good job.
Agree with above. Also be flexible geographically. If you want to live in urban pardise or resort area you will pay up for it big time in your compensation.
Wrong. Dead Wrong. The Hospitals want efficient care. This means cheaper, easier to replace midlevels doing the stool sitting with less supervisers. Your method of ASA Medical Direction won't last much longer as ObamaCare doesn't reimburse enough to pay the bills.
I hope the AAs can get the same supervision rules as the CRNAs in a few years or I fear many will lose their jobs. Great markets like Atlanta will be the last to fall under ObamaCare but they will fall nonetheless.
Right now there are hundreds of new CRNA graduates looking for work in my state. Next year hundreds more will graduate again without any hope for a $120K job (which used to pay over $130K) in my State. The CRNA mills are pumping out new graduates at record levels saturating the market with cheap labor. I hear stories of $110K (W-2) jobs being posted then immediately filled by a new CRNA graduate. If things continue CRNA pay will fall back at least 1 or 2 decades in terms of pay scale. If flooding the market is part of some long term political action plan by the AANA they better hope their membership can survive it.
The job market for anesthesiologists is abyssmal. New grads will find this out soon, unfortunately.
Thank your generation for completly selling out to CRNA's.
Agree with above. Also be flexible geographically. If you want to live in urban pardise or resort area you will pay up for it big time in your compensation.
The job market for anesthesiologists is abyssmal. New grads will find this out soon, unfortunately.
you are too much the optimist. it's worse than that.
Wrong. Dead Wrong. The Hospitals want efficient care. This means cheaper, easier to replace midlevels doing the stool sitting with less supervisers. Your method of ASA Medical Direction won't last much longer as ObamaCare doesn't reimburse enough to pay the bills.
I hope the AAs can get the same supervision rules as the CRNAs in a few years or I fear many will lose their jobs. Great markets like Atlanta will be the last to fall under ObamaCare but they will fall nonetheless.
Right now there are hundreds of new CRNA graduates looking for work in my state. Next year hundreds more will graduate again without any hope for a $120K job (which used to pay over $130K) in my State. The CRNA mills are pumping out new graduates at record levels saturating the market with cheap labor. I hear stories of $110K (W-2) jobs being posted then immediately filled by a new CRNA graduate. If things continue CRNA pay will fall back at least 1 or 2 decades in terms of pay scale. If flooding the market is part of some long term political action plan by the AANA they better hope their membership can survive it.
Geography is a huge consideration. Florida is overrun by CRNA schools, yet other states still go wanting for anesthetists of either type as well as anesthesiologists. Those who are bound and determined they MUST work in the big cities are likely to be mighty disappointed in many cases. Those willing to be flexible will find reward. And - those who are willing to actually get out and REALLY look for a job will find them, unlike the spouse who posted here recently, whose resident spouse was wanting her husband to do the job hunting because she was too busy.
Best REAL advice I've heard in a while.
Be flexible in location. Once you get out of the hole and build up some reserves, go to where you want to play and have fun... or stay and retire earlier than the guy in LA, Boston, Chicago, etc...
While you are paying down debt and getting that reserve, time will be on your side and you can calculate your next move under no pressure with as much time as you want- if that is indeed what you want to do. Some places that are a little off the grid offer a lot more than people may think, and often times, people dont move for a variety of reasons.
Please do. There are a LOT of anesthesiologists nearing age 65 and the utilization of our services both in and out of ORs continues to grow. I'd bet that it 2016, there will be something like 10% more anesthetics given in the US than there were in 2012.
Any bet against a need for future hiring can only be right if anesthesiologists aren't in the equation. And we are still working in opt out states and there are many states that aren't anywhere near opting out of anything.