How to make 7 figures in anesthesia

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Mr.S said:
I stand corrected. Everyone except me is making 1 million dollars doing anesthesia.' I can name 5 states off the top of my head that have ZERO traditional private practices. Maybe I am looking at the wrong states and have to move to florida or california..
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No, plenty of people are not making a ton. But that doesn't mean nobody is. And reimbursement varies greatly state to state. I know of bordering states that have BCBS rates that are literally double in one state compared to the next one over.
 
I always love the posts on here that talk about making a million a year as if it’s no sweat. Ah, just move or hustle a bit. 🙄

With that said, there are definitely groups out there making well over a million. The ones that are still mom & pop shop anesthesia groups are very few and far between, though. The groups with partners making over a million a piece have by and large turned themselves into AMCs or regional pseudo-AMCs. With the right combo of payer mix and volume a million is possible.

I think what Mr S is getting at is that for the very vast majority of anesthesiologists (>95%), a million or close to it is not going to happen. It’s silly to even suggest it’s as simple as moving to a new town or “knowing a guy.” Again, most people will end up employed by someone and that someone is not paying you a million bucks a year. That’s the reality. 400-600k is attainable for a lot of reasonably skilled anesthesiologists for a good job within 1-2 hours of your desired locale if you hunt a bit.

As an aside, 400-450 seems to be the going rate for a lot of jobs posted on gasworks lately...even crummy sounding AMC jobs. This is a positive because only a few years ago job postings of 300 or even less were common.
 
Mr.S said:
Are you making high six figures in your scenario?


While I agree theoretically that is how you make 7 figures however all of those practices have been acquired and bought by Corporate entities. So they can make the money NOT YOU.
And even before those scenarios were available the groups were so top heavy that a new person in the group would stand no chance.

So where are we?
mid 400s gve or take 75 K (thats where everyone is).

Can you make 600? Maybe, without ANY vacation.
You cant do this job without at least 6-9 weeks away.

That is my assessment.
DO i know it all? Not even close.
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You are correct some have been bought by AMC but many have not. Many groups decided not to be bought out when money was flying around several years ago bc they saw it as a short term gain and once they got a better look behind the curtains of an AMC they quickly realized AMC bring nothing to the table except a sales pitch. Did my group change based on our experience...of course...always evolving.
 
facted said:
Yes, and only one was a job offer. Another was a place I worked at and left (better lifestyle at my current gig) and the third is my current gig.
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Ya, but you’re in NYC. That’s the equivalent of like 180k everywhere else.
 
Twiggidy said:
If you want to make a million dollars become a venture capitalist otherwise anything above 400k is a wonderful salary especially compared to the average US salary.
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yea but why would anyone compare to the average and be satisfied? the avg IQ in the US is 98... and like what i keep telling people, its not about the annual salary so much as the total lifetime income. someone taking 300k loans and then earning 400k at age 30s doesn't really come up that ahead compared to people making less but with minimal loans and earning less. its like if i train until im 65, and then make 2M a year.. i can say i make 2M a year, but it's not that great
 
acidbase1 said:
I know some pain guys do it, are there other avenues to high incomes? Owner of a large group? Etc etc
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7 figure income? I have It. It will cost you. 65-80 hr/wk. 4 weeks vacation. Less than 20% Medicaid/Medicare. And of course a seven figure buy in to have the privilege of making a seven figure income. Comes with the understanding that it won't last for much longer. Make hay while the sun shines...you have the rest of your career as a lowly employee making sub 400k..clearly the fate of many of our peers.
 
drdan4 said:
7 figure income? I have It. It will cost you. 65-80 hr/wk. 4 weeks vacation. Less than 20% Medicaid/Medicare. And of course a seven figure buy in to have the privilege of making a seven figure income. Comes with the understanding that it won't last for much longer. Make hay while the sun shines...you have the rest of your career as a lowly employee making sub 400k..clearly the fate of many of our peers.
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What part of the country are you in?
 
pgg said:
So at this point of the thread, maybe half a dozen people have directly contradicted your assertions. The things you say you don't believe in, exist. The things you say you don't believe happen, are happening.

This is much like most of the threads you post in. You get repeatedly corrected, by many different people, and you just LOL or double down. Is there a point at which you'll simply admit you're wrong, and move on?

Are you simply trolling?
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Why would you call me a troll? Is you intent to offend me and shame me? Does it make you feel more important than you are on a message board where everyone's opinion is taken with a grain of salt.

I think it does not do justice to the people thinking about going into anesthesia to think a 700K- 1M salary is attainable when it simply is not. Do some people make it? Sure. BUt this is exceedingly rare.

Going forward, for the forseeable future (8-14 years) most people will be employed making just above what the employer thinks they can get people to stay. And right now that number hovers around 400 give or take 75k.
 
That old saying “those who say it cannot be done should not interrupt those who are doing it” applies nicely here.
Here’s a hint: nobody is going to hand you a 600k plus anesthesia job on a silver platter. Stop complaining on SDN, be open to relocation, make connections at meetings or whenever you go for anesthesia related stuff, and work hard.
If you’re so personality disordered that you basically call everyone a liar who doesn’t subscribe to your narrow world view, then all of the above probably won’t help you anyway because the good groups will sniff that out about you immediately and you won’t even get an interview.
 
drdan4 said:
7 figure income? I have It. It will cost you. 65-80 hr/wk. 4 weeks vacation. Less than 20% Medicaid/Medicare. And of course a seven figure buy in to have the privilege of making a seven figure income. Comes with the understanding that it won't last for much longer. Make hay while the sun shines...you have the rest of your career as a lowly employee making sub 400k..clearly the fate of many of our peers.
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If this doesn’t scream first world problems then I don’t know what does...
 
Man o War said:
That old saying “those who say it cannot be done should not interrupt those who are doing it” applies nicely here.
Here’s a hint: nobody is going to hand you a 600k plus anesthesia job on a silver platter. Stop complaining on SDN, be open to relocation, make connections at meetings or whenever you go for anesthesia related stuff, and work hard.
If you’re so personality disordered that you basically call everyone a liar who doesn’t subscribe to your narrow world view, then all of the above probably won’t help you anyway because the good groups will sniff that out about you immediately and you won’t even get an interview.
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Totally has a personality disorder. Reminds me of my ex.
 
dannyboy1 said:

If this doesn’t scream first world problems then I don’t know what does...
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Hey if you're okay with giving up half of your salary for harder work and longer hours with decreased autonomy, shoot me a pm
 
chocomorsel said:
Totally has a personality disorder. Reminds me of my ex.
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I don’t think Mr. S has a personality disorder at all. I think everyone is being hard on him. SDN is not representative of the real world of anesthesia. For some reason the entire 0.1% of anesthesiologists making a million bucks a year are on here. I can get into reasons, but that is beyond the scope of this thread. The loudest voices are the ones who don’t mind a little “humble bragging.” The guy who is the sucker making 300k for 80 hour weeks with 4 weeks vacation is not going to admit to such. The humble-braggers on here represent such a minuscule piece of the anesthesia market that it’s not difficult to think of them as being in a different reality than the one Mr S exists in. He exists in the real world of AMCs, hospital employment, and used-car salesman private practices that suck the life force out of the anesthesia market.
 
GravelRider said:
I don’t think Mr. S has a personality disorder at all. I think everyone is being hard on him. SDN is not representative of the real world of anesthesia. For some reason the entire 0.1% of anesthesiologists making a million bucks a year are on here. I can get into reasons, but that is beyond the scope of this thread. The loudest voices are the ones who don’t mind a little “humble bragging.” The guy who is the sucker making 300k for 80 hour weeks with 4 weeks vacation is not going to admit to such. The humble-braggers on here represent such a minuscule piece of the anesthesia market that it’s not difficult to think of them as being in a different reality than the one Mr S exists in. He exists in the real world of AMCs, hospital employment, and used-car salesman private practices that suck the life force out of the anesthesia market.
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You should have seen what he PMd me. Something isn’t right with him.

The fact that he keeps arguing about crap over and over is ridiculous.

I have previously stated on multiple occasions that I never made that much money in anesthesia and the fact that I stated what I made weekly but did not do it full time, but if I had.... and he wants my paystub? WTF? Why do I need to prove anything to him? And it’s just not me. He’s doing it to everyone.

The man/woman is crazy.
 
Mr.S said:
Why would you call me a troll? Is you intent to offend me and shame me? Does it make you feel more important than you are on a message board where everyone's opinion is taken with a grain of salt.
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I'll be honest, I can't figure you out. I don't know why you're here. People can have very different personas on the internet vs in real life, and I suspect if we were sitting in chairs at a table, we'd probably get along fine. You wouldn't say ridiculous things like your multiple refusals to believe what other posters have told you, and I'd have no reason to think you're crazy. But you sure act crazy here.

Mr.S said:
I think it does not do justice to the people thinking about going into anesthesia to think a 700K- 1M salary is attainable when it simply is not. Do some people make it? Sure. BUt this is exceedingly rare.
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I think it's uncommon, but I know it's not rare. I also know that the lifestyle for these positions is often brutal - long hours, high supervision ratios.

Mr.S said:
Going forward, for the forseeable future (8-14 years) most people will be employed making just above what the employer thinks they can get people to stay. And right now that number hovers around 400 give or take 75k.
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See, now this is a reasonable, rational comment. I think you're probably correct, and employment for $3-500K will be about average. But this isn't what you've been saying in this thread. You've had a string of near-histrionic denials and challenges to the experiences of half a dozen people.

I'm trying to walk a fine line, between being a moderator who tries to stay very hands-off, and a member who has become progressively more and more annoyed at your antics the last couple months.

Maybe you could, you know, chill out a little, and maybe show others here the basic courtesy of not calling them liars, telling them their practices don't exist, and that they're wrong about everything?

There are other longtime posters here with similarly negative views about the state and feared fate of our specialty, and while I don't always agree completely with them, they somehow manage to make their arguments without attacking other people.

As for me, I'll try to be civil and not jump on you, but man, you make it hard.
 
chocomorsel said:
You should have seen what he PMd me. Something isn’t right with him.

The fact that he keeps arguing about crap over and over is ridiculous.

I have previously stated on multiple occasions that I never made that much money in anesthesia and the fact that I stated what I made weekly but did not do it full time, but if I had.... and he wants my paystub? WTF? Why do I need to prove anything to him? And it’s just not me. He’s doing it to everyone.

The man/woman is crazy.
Click to expand...

Well asking a stranger for a paystub is weird. I obviously don’t know anything about PMs. What I do know is a year or two in the wrong job can make anyone angry and cynical about the state of the field. There are an awful lot of those “wrong jobs” out there. There are nuggets of truth to what Mr S says. His regional reality could very well be a desert of crummy jobs. It’s not always easy to pick up and move a life elsewhere. Put the most skilled, personable, hard worker in one of those lousy jobs for a year and take away his ability to leave and you have the exact recipe for the jaded cynicism (burnout) that we see growing in all of medicine. Take his experience as a cautionary tale to highlight the importance of always being willing and able the leave a job and/or region.
 
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I apologize for diverting the conversation, but when y’all are saying “do residency where you want to practice because of connections”, does this include fellowships? I don’t necessarily want to work where I do residency, but they offer great fellowships at places I would like to practice.
 
GravelRider said:
I don’t think Mr. S has a personality disorder at all. I think everyone is being hard on him. SDN is not representative of the real world of anesthesia. For some reason the entire 0.1% of anesthesiologists making a million bucks a year are on here. I can get into reasons, but that is beyond the scope of this thread. The loudest voices are the ones who don’t mind a little “humble bragging.” The guy who is the sucker making 300k for 80 hour weeks with 4 weeks vacation is not going to admit to such. The humble-braggers on here represent such a minuscule piece of the anesthesia market that it’s not difficult to think of them as being in a different reality than the one Mr S exists in. He exists in the real world of AMCs, hospital employment, and used-car salesman private practices that suck the life force out of the anesthesia market.
Click to expand...


I think the median total comp for a full time anesthesiologist in this country is somewhere around 450-475K. I know people with random decent AMC jobs in suburbia of major cities making $450K a year in salary plus benefits. I'd bet at least 30-40% are making >$500K total comp. And the averages are dragged down greatly by people working in academic departments that don't pay squat.
 
TRED1400 said:
I apologize for diverting the conversation, but when y’all are saying “do residency where you want to practice because of connections”, does this include fellowships? I don’t necessarily want to work where I do residency, but they offer great fellowships at places I would like to practice.
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Yes. Train where you want to work. If you dislike the market around your residency program, and plan on doing a fellowship anyway, then consider the program's location and alumni network when composing your rank list.
 
Locums are making this at our place a week for 7-5pm, and more If they stay past 5pm (even 1min past).
 
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TRED1400 said:
I apologize for diverting the conversation, but when y’all are saying “do residency where you want to practice because of connections”, does this include fellowships? I don’t necessarily want to work where I do residency, but they offer great fellowships at places I would like to practice.
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Ya that works. You just want to be able to get to know people and make connections so that when the good groups are looking for someone and they ask their friends, your name gets brought up.

I will say this though (speaking just for my group), it means more to us where you did your residency. We would prefer to take someone from a known residency program who did their fellowship elsewhere, than someone who did their fellowship at a known program but residency somewhere we are unfamiliar with.
 
Mman said:
I think the median total comp for a full time anesthesiologist in this country is somewhere around 450-475K. I know people with random decent AMC jobs in suburbia of major cities making $450K a year in salary plus benefits. I'd bet at least 30-40% are making >$500K total comp. And the averages are dragged down greatly by people working in academic departments that don't pay squat.
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I agree with that statement. The thread was about making a million (or pretty darn close to it), though. That’s either a unicorn practice, practice with hands in something else, or a practice only hiring employees with no new partners (regional pseudo-AMC).
 
This thread is fun :corny:🙂

Otoh math is quite simple; i don't know much about how billing goes in the US but 12.000 units @ 40$/unit is very easy and gets you close to 500k (without overhead i know).
15000 @60... and that's not even supervising...:cigar::pompous::=|:-):
 
chocomorsel said:
Totally has a personality disorder. Reminds me of my ex.
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You are just mad probably because Ii called you out about that 560K 46 weeks locums comment comment. Plus that private message I sent you was advice in changing a curse word that you posted. Was it that bad? saved you an infraction from the mods. I should have reported you but I didn't because I felt sorry for you and I thought you might appreciate it. BUt you didnt!
 
Mr.S said:
You are just mad probably because Ii called you out about that 560K 46 weeks locums comment comment. Plus that private message I sent you was advice in changing a curse word that you posted. Was it that bad? saved you an infraction from the mods. I pshould have reported you but I didn't because I felt sorry for you and I thought you might appreciate it. BUt you didnt!
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You are totally crazy. In the personality disordered, no meds or therapy can help you kind of way.
You didn’t ask. And you called out no one. Clearly your reading comprehension skills need help and your personality disorder keeps getting in the way cuz you think you know it all.
Everyone sees how crazy you are and have only been on this board less than what, a year?
 
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GravelRider said:
Well asking a stranger for a paystub is weird. I obviously don’t know anything about PMs. What I do know is a year or two in the wrong job can make anyone angry and cynical about the state of the field. There are an awful lot of those “wrong jobs” out there. There are nuggets of truth to what Mr S says. His regional reality could very well be a desert of crummy jobs. It’s not always easy to pick up and move a life elsewhere. Put the most skilled, personable, hard worker in one of those lousy jobs for a year and take away his ability to leave and you have the exact recipe for the jaded cynicism (burnout) that we see growing in all of medicine. Take his experience as a cautionary tale to highlight the importance of always being willing and able the leave a job and/or region.
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Aint that the truth....
 
It's out there. At least it was.
Now... everything has a price, but the DINK lifestyle does has it's ups and will definitely get you 7 figures and financial independence at a much much earlier time in your career. If you are in a "anesthesia in need BFE location"... you can def. bring in upwards of 1.5 as a DINK. It's a good way to get up on life and then later, if you want, have kids (or move to dream location at a lower salary).
 
sevoflurane said:
It's out there. At least it was.
Now... everything has a price, but the DINK lifestyle does has it's ups and will definitely get you 7 figures and financial independence at a much much earlier time in your career. If you are in a "anesthesia in need BFE location"... you can def. bring in upwards of 1.5 as a DINK. It's a good way to get up on life and then later, if you want, have kids (or move to dream location at a lower salary).
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You’re glossing over the best part : No Kids!!
 
SaltyDog said:
You’re glossing over the best part : No Kids!!
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Yeah. Maybe. Not sure who is going to take care of me when I'm 98 y/o = age at which my gramps passed after formal neck fx. My uncle was taking care of him until the end. Although... having kids is no guarantee of a caretaker when your sphincters no longer work.

I try not to think about that... :nailbiting::nailbiting::nailbiting:
 
Probably end up in some old folks home with a 6'5" scary Helga nurse taking care of me.

+pity++pity+
 
sevoflurane said:
Yeah. Maybe. Not sure who is going to take care of me when I'm 98 y/o = age at which my gramps passed after formal neck fx. My uncle was taking care of him until the end. Although... having kids is no guarantee of a caretaker when your sphincters no longer work.

I try not to think about that... :nailbiting::nailbiting::nailbiting:
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Just go out in a horrific heli-boarding accident before you get to that point.
 
chocomorsel said:
You are totally crazy. In the personality disordered, no meds or therapy can help you kind of way.
You didn’t ask. And you called out no one. Clearly your reading comprehension skills need help and your personality disorder keeps getting in the way cuz you think you know it all.
Everyone sees how crazy you are and have only been on this board less than what, a year?
Click to expand...


chocomorsel said:
You are totally crazy. In the personality disordered, no meds or therapy can help you kind of way.
You didn’t ask. And you called out no one. Clearly your reading comprehension skills need help and your personality disorder keeps getting in the way cuz you think you know it all.
Everyone sees how crazy you are and have only been on this board less than what, a year?
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Everyone knows the deal about you! I wont say anything further.
Let this end or we will be both banned which is what i tried to explain to you privately and you did not listen.
 
Mr.S said:
Everyone knows the deal about you! I wont say anything further.
Let this end or we will be both banned which is what i tried to explain to you privately and you did not listen.
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Really? What does everyone know about me?
That I am an outspoken, opinionated black woman? WTF else is new? Please, tell me something that I don’t already know. Please do.... I am waiting. Go ahead.
 
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