How is it that Gas Doc's make more than Surgeons

[HEME-ONC]

---

Members don't see this ad.

I am very interested in Gas and I've always thought that Surgeons make more per year than an Anesthesiologist. I am a little ignorant on how surgeons and gas docs bill for there services. anyone out there familiar with this info.

I was also looking at the classifieds for Anesthesiologists in the back of The "Anesthesiology"Journal and there were tons of ads that posted starting salaries at 300k plus full benefits. Those numbers seems incredible!

So basically I am asking where does the money come from and do insurance companies become a pain in the butt like in other specialties?


Thanks

 

[Brass_Monkey]

I am very interested in Gas and I've always thought that Surgeons make more per year than an Anesthesiologist. I am a little ignorant on how surgeons and gas docs bill for there services. anyone out there familiar with this info.

I was also looking at the classifieds for Anesthesiologists in the back of The "Anesthesiology"Journal and there were tons of ads that posted starting salaries at 300k plus full benefits. Those numbers seems incredible!

So basically I am asking where does the money come from and do insurance companies become a pain in the butt like in other specialties?


Thanks

The short answer? Because we deserve to!

 

[2ndyear]

A few reasons.
Think of a week in a general surgeon's life. Here's an example: Mon: office, Tues: cases all day (7:30-3:30), Wed: office then call for group, do a few appys at night. Thurs: cases all day. Fri: half day office.
See, you're only operating 2-3 days per week. You have to spend some time in the office seeing pt's prior to surgery/after surgery. You don't get paid much for the office time. Don't get paid much to round on pt's either. If your cases are mostly hernias, choles, a few thyroids and colon things here and there, you probably won't make much. Now, if you sprinkle in some lap gastric bypasses you start pulling some dough. Become a full-time bariatric surgeon, get a PA to round, pre and post op your pt's, and you're making more than the guy passing your gas for sure.

The anesthesiolgist on the other hand, really has no 'down' time. When you're in the OR, you're billing. And you're going 7:00-4:00 straight. No rounds, no office, etc. Plus you are likely supervising CRNA's a lot of that time as well.

 

[CambieMD]

Little to no overhead.

 

[jwk]

Anesthesia keeps the patient alive in spite of the surgeon's best efforts to do otherwise.

 

[DoctorG]

Anesthesia keeps the patient alive in spite of the surgeon's best efforts to do otherwise.

LOL. Hehe

 

[MS3NavyFS2B]

Anesthesia keeps the patient alive in spite of the surgeon's best efforts to do otherwise.

Why does this one insist on insulting people who devote their lives to medicine and helping people? Surgeons are the hardest working people I know. Their training is unreal. They cure disease. They deserve respect, as do all physicians.

The anesthesiologist keeps the patient alive despite the CRNA's best attempt to do otherwise. Both surgeons and anesthesiologists are board-certified physicians, not ancillary staff or glorified nurses with minimal education.


It's bad form for underlings to speak like this about their bosses.

 

[jwk]

Why does this one insist on insulting people who devote their lives to medicine and helping people? Surgeons are the hardest working people I know. Their training is unreal. They cure disease. They deserve respect, as do all physicians.

The anesthesiologist keeps the patient alive despite the CRNA's best attempt to do otherwise. Both surgeons and anesthesiologists are board-certified physicians, not ancillary staff or glorified nurses with minimal education.


It's bad form for underlings to speak like this about their bosses.

And why does this one refer to others as "this one"?

Take a look at the area you're posting in cowboy. I'm sure the surgeons take plenty of potshots at anesthesia in their sections - if you can't take it, stay in the surgical sections.

My little joke is not new, nor is it original. I heard it 25 years ago when I was in training. But I'll bet there's more than a few anesthesiologists, or CRNA's, or AA's reading this board that would probably agree that it actually rings true once in a while.

And neither you, nor anyone else on this board is my boss, and I am certainly not your underling. And if a surgeon screws something up in my room on my patient, trust me, I won't wait for an anesthesiologist to come in the room so they can make it a doc-to-doc chat. I'm perfectly capable of having that discussion. All of us are there for the patient's benefit. Egos can be checked at the door.

 

[MS3NavyFS2B]

And why does this one refer to others as "this one"?

Take a look at the area you're posting in cowboy. I'm sure the surgeons take plenty of potshots at anesthesia in their sections - if you can't take it, stay in the surgical sections.

My little joke is not new, nor is it original. I heard it 25 years ago when I was in training. But I'll bet there's more than a few anesthesiologists, or CRNA's, or AA's reading this board that would probably agree that it actually rings true once in a while.

And neither you, nor anyone else on this board is my boss, and I am certainly not your underling. And if a surgeon screws something up in my room on my patient, trust me, I won't wait for anesthesiologist to come in the room so they can make it a doc-to-doc chat. All of us are there for the patient's benefit. Egos can be checked at the door.

After at least a quarter-century as an assistant of some sort, it might be thought that this one would have some insight...or at least maturity. Taking so-called "potshots" at hard-working, respectable physicians is unsophisticated at best.

Maybe you should check what area you are taking the liberty of posting in granny. This is a graduate medical forum for med students, residents, and attendings. Ancillary staff have various forums in other sections.

The anesthesiologist is the consultant who the surgeon asks for expert knowledge in caring for his patient during surgery. Ask the surgeon who he wants caring for his patient. If you don't call your attending when the patient becomes unstable, then you surely aren't acting in the patient's best interest. It's dangerous for this type of malpractice to even exist. Direct doc-to-doc communication is the best way to ensure a successful outcome (see the FL study, which basically showed the when MDAs were directly involved in pt care, the outcomes where better). Salaries for MDAs are ever increasing (starting at >$300,000 in many areas), suggesting that hospitals would rather pay for quality care upfront, rather than pay for the sequelea of inferior care (in the form of lawsuits from non-physicians not calling their attending, for example).

This one has the typical mindset of an overzealous nurse, thinking she can doctor. OR nurses and ancillary staff often have this type of demenor, since the surgeon and anesthesiologist make difficult issues seem simple (via their extensive training). OR nurses, who I've come to despise, forget that medical students become residents who become attendings. It is these people who take the potshots...but never at the attending, only the med students. We remember. I actually had one say she would slap my hand...well, I haven't seen her in quite a while after I spoke with the Dean of the med school. When I have med students (student physicians), I'll demand they get the same respect that actual physicians get from staff.

Anyway, it's dangerous to dumb-down medicine.

Maybe you should check your ego at the door...at least it won't be checked into my practice!

 

[Willamette]

🙄 Maybe we should make an Anesthesiologists VS. Anesthetists sticky? 🙄


Willamette

 

[ncstudentdoc]

good grief.

 

[Lonestar]

Mama sez life is like a box of chocolates! Ya nevah know what ya gonna get. 😉

 

[gasgodess]

Take it outside please. No one wants to hear this crap AGAIN!! I FOR ONE AND SICK OF THE WHINING BY ANESTHESTISTS AND SICK OF THE POT SHOTS TAKEN BY THOSE WHO AREN'T ANESTHESTISTS.....GET OVER IT ALREADY. Additionally, I think all who post to MS3's responses are childish. He's an @ss. Many of us can see that WHY CAN'T YOU? If you do a good job than great, you don't need to prove it to us just your patient and if you have been in this profession for many years then you shouldn't have to prove it to anyone other than your patient especially not a med student.

GROW THE f$%^ UP PEOPLE

 

[JP2005]

thas hot

 

[tkim]

both of you need to quit it.

 

[MechE]

Can't we all just get along?

 

[gasgodess]

A few reasons.
Think of a week in a general surgeon's life. Here's an example: Mon: office, Tues: cases all day (7:30-3:30), Wed: office then call for group, do a few appys at night. Thurs: cases all day. Fri: half day office.
See, you're only operating 2-3 days per week. You have to spend some time in the office seeing pt's prior to surgery/after surgery. You don't get paid much for the office time. Don't get paid much to round on pt's either. If your cases are mostly hernias, choles, a few thyroids and colon things here and there, you probably won't make much. Now, if you sprinkle in some lap gastric bypasses you start pulling some dough. Become a full-time bariatric surgeon, get a PA to round, pre and post op your pt's, and you're making more than the guy passing your gas for sure.

The anesthesiolgist on the other hand, really has no 'down' time. When you're in the OR, you're billing. And you're going 7:00-4:00 straight. No rounds, no office, etc. Plus you are likely supervising CRNA's a lot of that time as well.

Would you say that a surgeon's billing situation is similar to a pain doc in anesthesia, since they do have overheard, "rounds", etc.? They still tend to make out better right? yes or no? I'm very curious since I may want to pursue a career in pain.

 

[toughlife]

After at least a quarter-century as an assistant of some sort, it might be thought that this one would have some insight...or at least maturity. Taking so-called "potshots" at hard-working, respectable physicians is unsophisticated at best.

Maybe you should check what area you are taking the liberty of posting in granny. This is a graduate medical forum for med students, residents, and attendings. Ancillary staff have various forums in other sections.

The anesthesiologist is the consultant who the surgeon asks for expert knowledge in caring for his patient during surgery. Ask the surgeon who he wants caring for his patient. If you don't call your attending when the patient becomes unstable, then you surely aren't acting in the patient's best interest. It's dangerous for this type of malpractice to even exist. Direct doc-to-doc communication is the best way to ensure a successful outcome (see the FL study, which basically showed the when MDAs were directly involved in pt care, the outcomes where better). Salaries for MDAs are ever increasing (starting at >$300,000 in many areas), suggesting that hospitals would rather pay for quality care upfront, rather than pay for the sequelea of inferior care (in the form of lawsuits from non-physicians not calling their attending, for example).

This one has the typical mindset of an overzealous nurse, thinking she can doctor. OR nurses and ancillary staff often have this type of demenor, since the surgeon and anesthesiologist make difficult issues seem simple (via their extensive training). OR nurses, who I've come to despise, forget that medical students become residents who become attendings. It is these people who take the potshots...but never at the attending, only the med students. We remember. I actually had one say she would slap my hand...well, I haven't seen her in quite a while after I spoke with the Dean of the med school. When I have med students (student physicians), I'll demand they get the same respect that actual physicians get from staff.

Anyway, it's dangerous to dumb-down medicine.

Maybe you should check your ego at the door...at least it won't be checked into my practice!

MS3NavyFS2B you are the man! Why can't all anesthesia boys have cojones like you to tell these midlevels how it is!

 

[dry dre]

This one has the typical mindset of an overzealous nurse, thinking she can doctor.

You don't mean to imply that ~9 years of training provides more knowledge and insight than ~2 years, do you? Man, what is this world coming to?

 

[CambieMD]

Take it outside please. No one wants to hear this crap AGAIN!! I FOR ONE AND SICK OF THE WHINING BY ANESTHESTISTS AND SICK OF THE POT SHOTS TAKEN BY THOSE WHO AREN'T ANESTHESTISTS.....GET OVER IT ALREADY. Additionally, I think all who post to MS3's responses are childish. He's an @ss. Many of us can see that WHY CAN'T YOU? If you do a good job than great, you don't need to prove it to us just your patient and if you have been in this profession for many years then you shouldn't have to prove it to anyone other than your patient especially not a med student.



GROW THE f$%^ UP PEOPLE

Thank you.

CambieMD

 

[SteadyEddy]

Dude...why argue with this cat...he's not even a real doctor! Med students don't argue with nurses. Picture this guy meeting the parents...so what do you do...I'm a male nurse (snickers eminate from all attending the dinner).

After at least a quarter-century as an assistant of some sort, it might be thought that this one would have some insight...or at least maturity. Taking so-called "potshots" at hard-working, respectable physicians is unsophisticated at best.

Maybe you should check what area you are taking the liberty of posting in granny. This is a graduate medical forum for med students, residents, and attendings. Ancillary staff have various forums in other sections.

The anesthesiologist is the consultant who the surgeon asks for expert knowledge in caring for his patient during surgery. Ask the surgeon who he wants caring for his patient. If you don't call your attending when the patient becomes unstable, then you surely aren't acting in the patient's best interest. It's dangerous for this type of malpractice to even exist. Direct doc-to-doc communication is the best way to ensure a successful outcome (see the FL study, which basically showed the when MDAs were directly involved in pt care, the outcomes where better). Salaries for MDAs are ever increasing (starting at >$300,000 in many areas), suggesting that hospitals would rather pay for quality care upfront, rather than pay for the sequelea of inferior care (in the form of lawsuits from non-physicians not calling their attending, for example).

This one has the typical mindset of an overzealous nurse, thinking she can doctor. OR nurses and ancillary staff often have this type of demenor, since the surgeon and anesthesiologist make difficult issues seem simple (via their extensive training). OR nurses, who I've come to despise, forget that medical students become residents who become attendings. It is these people who take the potshots...but never at the attending, only the med students. We remember. I actually had one say she would slap my hand...well, I haven't seen her in quite a while after I spoke with the Dean of the med school. When I have med students (student physicians), I'll demand they get the same respect that actual physicians get from staff.

Anyway, it's dangerous to dumb-down medicine.

Maybe you should check your ego at the door...at least it won't be checked into my practice!

 

[rn29306]

1. The "one" you refer to is not a nurse or CRNA.
2. Nor is he a "she" as referred to in other postings.
3. 25 years of experience in delivering anesthesia- you would think that perhaps a med student would listen to someone with this much knowledge and experience, but that is a lesson you will learn at some point, either now or later. Quit beating your chests proclaiming "I am God" and realize there are things to learn from others.

 

[lama]

Like the OP, I have many questions about anesthesia salaries. It seems to me that anesthesia is almost too good to be true. And when something is too good to be true,....

So anesthesiologist make 250-350k and their malpractice and overhead are at the rock bottom. Doesn't it seem almost automatic that when doctors are doing well, in any field, medicare/hmo's come through and reduce reimbursements? Why hasn't this happened in anesthesia? Anesthesia is safer today than ever before so malpractice is minimal, there are more anesthesiologists in the market (more supply, less demand) and they have 60 hour work weeks (not exactly tops in the hours worked/week). I just can't believe that medicare/insurance co. haven't caught on yet and reduced compensation. If anesthesia is flying under the radar, how long before they find us out and salaries change?

 

[Skip Intro]

If anesthesia is flying under the radar, how long before they find us out and salaries change?

It's not flying under the radar. By definition, anesthesiology is a "high risk" specialty (i.e., "hours of boredom, moments of terror..."). Medicare won't screw around with reimbursements.

What you have to worry more about is people like Victor Ortiz who are suing state governments to get more independent practice rights. If successful, they will negotiate lower reimbursements with the primary provider, and this may effect the overall reimbursement that private practice groups are willing to share on patient-funded direct fee-for-service procedures (such as elective ambulatory procedures, etc.).

-Skip

 

[toughlife]

It's not flying under the radar. By definition, anesthesiology is a "high risk" specialty (i.e., "hours of boredom, moments of terror..."). Medicare won't screw around with reimbursements.

What you have to worry more about is people like Victor Ortiz who are suing state governments to get more independent practice rights. If successful, they will negotiate lower reimbursements with the primary provider, and this may effect the overall reimbursement that private practice groups are willing to share on patient-funded direct fee-for-service procedures (such as elective ambulatory procedures, etc.).

-Skip

Is Victor Ortiz cuban? If so, I am gonna find out where he lives and send his ass back to Cuba and let Castro take care of him.

 

[SteadyEddy]

1. Even worse...this whack isn't even a nurse
2. Who cares
3. I'm definitely not God and nor do I claim to be. What does irk me is when non-physicians take hacks at my mentors. Spend some time in Med school, compete against the best in the country, and then take some call as a resident...then maybe I'll respect your current lowly opinion.

1. The "one" you refer to is not a nurse or CRNA.
2. Nor is he a "she" as referred to in other postings.
3. 25 years of experience in delivering anesthesia- you would think that perhaps a med student would listen to someone with this much knowledge and experience, but that is a lesson you will learn at some point, either now or later. Quit beating your chests proclaiming "I am God" and realize there are things to learn from others.

 

[rn29306]

What I find MOST amusing is that there are several who are self-proclaimed anesthesia encyclopedias, but don't even know which books he/she can get so you can READ about anesthesia. The fact that I have them all in my library and i'm just a lowly system-cheating, law-loophole-finding CRNA student is another agruement within itself. Granted you were learning how to do a rectal (and still do as a bunch of MS) while I was titrating levophed and vasopressin in the units, it makes me glad I picked my route and you picked yours, just don't be jealous. Give me a break, all anyone says on here is how anesthesia isn't that hard to crack into, so tell someone who will actually believe you about the "best in the country" BS.

 

[hans19]

Quit beating your chests proclaiming "I am God" and realize there are things to learn from others.

But we ARE gods.

 

[VentdependenT]

There is an IGNORE function located in a bar at the top of the page. This thread provides a great impetus to use it.

 

[toughlife]

What I find MOST amusing is that there are several who are self-proclaimed anesthesia encyclopedias, but don't even know which books he/she can get so you can READ about anesthesia. The fact that I have them all in my library and i'm just a lowly system-cheating, law-loophole-finding CRNA student is another agruement within itself. Granted you were learning how to do a rectal (and still do as a bunch of MS) while I was titrating levophed and vasopressin in the units, it makes me glad I picked my route and you picked yours, just don't be jealous. Give me a break, all anyone says on here is how anesthesia isn't that hard to crack into, so tell someone who will actually believe you about the "best in the country" BS.

Having books in your library does not an expert make you. I wonder whether you even understand what is written on those books being just a nurse.
People like yourself must have a fetish with those med students, residents and gas attendings as you like to roam around in this forum. Just go and hang out with those who will understand your plight (e.g., the allied health forum).
Please remember your place in the totem pole and don't forget that in the eyes of med students, residents and physicians you will always be inferior. That's the reality of your life and it will be with you until your last days on this earth.

 

[rhinosp_33]

Please remember your place in the totem pole and don't forget that in the eyes of med students, residents and physicians you will always be inferior. That's the reality of your life and it will be with you until your last days on this earth.

ha damn!

let me just ask these crnas one question... has a surgeon or even the primary care doctor ever called you and asked for your opinion on whether a patient should undergo/delay surgery or whether any other workup be necessary before surgery? if not, why?


i agree , theres no reason insurance/medicare are going to cut reimburshments just because 'anesthesias has been flying under the radar'. and the only situation that i would see malpratice going up would possibily be in the arena of ambulatory surgery. really, the salaries will be dependent on 2 factors : 1.) supply/demand obviously... right now, its leaning on the demand side so salaries are up. but that demand was placed by the lack of anesthesiologist coming out during the early 90s. so in X years, the supply should balance out the demand and at that point, salaries (esp entering) will go down. 2.) the point mentioned by SkipIntro regarding lowerlevels who will negotiate for lower price.

 

[jwk]

ha damn!

let me just ask these crnas one question... has a surgeon or even the primary care doctor ever called you and asked for your opinion on whether a patient should undergo/delay surgery or whether any other workup be necessary before surgery? if not, why?

Yes.

 

[mwbeah]

ha damn!

let me just ask these crnas one question... has a surgeon or even the primary care doctor ever called you and asked for your opinion on whether a patient should undergo/delay surgery or whether any other workup be necessary before surgery? if not, why?

When you are the only anesthesia provider in house (or a FOB in Iraq) that answer is yes.

Like I have said before, in the real world, MDAs, CRNAs, and AAs all (for the most part) work well together and respect each other. Remember there are not enough anesthesia providers to go around. Do you think there are MDAs at every facility in the US.............

Let's not start this "MDA versus......" again because the bottom line is that we all are needed to provide safe anesthesia to patients. This argument is pointless as there will always be MDAs around for the MEDCEN populations providing quality care just as there will be CRNAs providing quality care for the underserved areas. So let's all learn from each other, respect each other, and in doing so keep the standards of patient safety we all adhere to.

Hope everyone has a great day,
Mike

 

[GMO2003]

When you are the only anesthesia provider in house (or a FOB in Iraq) that answer is yes.

Like I have said before, in the real world, MDAs, CRNAs, and AAs all (for the most part) work well together and respect each other. Remember there are not enough anesthesia providers to go around. Do you think there are MDAs at every facility in the US.............

Let's not start this "MDA versus......" again because the bottom line is that we all are needed to provide safe anesthesia to patients. This argument is pointless as there will always be MDAs around for the MEDCEN populations providing quality care just as there will be CRNAs providing quality care for the underserved areas. So let's all learn from each other, respect each other, and in doing so keep the standards of patient safety we all adhere to.

Hope everyone has a great day,
Mike

I am all for equality and respect to others..however, no your role and don't overstep your boundaries...and let's just say if I ever need surgery..even minor surgery...please make sure an MDA is at the head of my table 😀

 

[jwk]

I am all for equality and respect to others..however, no your role and don't overstep your boundaries...and let's just say if I ever need surgery..even minor surgery...please make sure an MDA is at the head of my table 😀

You mean "know" your role... 😉

And more likely than not, in many hospitals that have lots of anesthesiologists, you're still going to have a CRNA or AA at the head of the table. Anesthesia Care Team, remember? You want an anesthesiologist to personally administer your anesthetic and be in the room with you 100% of the time with no CRNA or AA? Fine, we can do that. Just make sure you make arrangements several days ahead of time. As a surprise request on the morning of surgery, you'll be hard pressed to get an MD. They will already be committed elsewhere.

 

[hoyden]

Somewhere deep inside, I wonder, if I'll have time and patience to read all the fighting threads ... later? Maybe I will, because of pure amusement it provides.
JWK, it looks like you have a mischievous sense of humor 😉

 

[jwk]

JWK, it looks like you have a mischievous sense of humor 😉

Hey, I'm having a ball! 😀

 

[DocM]

Anesthesia keeps the patient alive in spite of the surgeon's best efforts to do otherwise.

LOL!!!!!!!!!!!!!!!

 

[MAC10]

You mean "know" your role... 😉

"And more likely than not, in many hospitals that have lots of anesthesiologists, you're still going to have a CRNA or AA at the head of the table."

AHHHHHHH

"You want an anesthesiologist to personally administer your anesthetic and be in the room with you 100% of the time with no CRNA or AA? "

If it were me.......YEAH

 

[jwk]

"You want an anesthesiologist to personally administer your anesthetic and be in the room with you 100% of the time with no CRNA or AA? "

If it were me.......YEAH

That wasn't exactly the point I was making if you re-read the post. If you want an MD at my facility, fine. You can have one - IF you ask prior to the day of surgery.

 

[Brass_Monkey]

You can have one - IF you ask prior to the day of surgery.

I'll ask 🙂