Interest in Anesthesiology and What the Future Holds (cRNAs, salaries, practice)

[nimbus]

There's a lot of BS on these boards. Plenty of truth, sure, but also a lot of BS.

I'll try to ignore the noise and get back to the OP's original question. I can only offer my own experience.

I'd say it is a terrible time to be thinking of becoming a physician anesthesiologist, at least one who wants to do his/her own cases. On the other hand, the future of CRNAs has never been brighter.

I would not advise my own children to go to medical school. I would advise them to go to PA or nursing school. You are already in medical school, so that advice does not apply. Once you've made the mistake of going to medical school, the best possible outcome might yet to be an anesthesiologist. If you like to be yelled at by surgeons (and surgical PAs), nurses, non-clinical nurses, hospital administrators, and (more and more) your AMC overlords, while taking more liability for lower reimbursement...then, yes, I think anesthesia might be for you.

Be sure to budget your time for a fellowship if you want to work in any halfway desirable city.

And I'll offer my own experience.....

I wish my daughter wanted to go to medical school but she wants to go an even harder route. I'll take my life over that of a PA or nurse any day....seriously. I'm 21 years in and still loving it.

Nobody yells at us and we don't have AMC overlords. We're in a "halfway desirable city" and most of our needs and new hires are generalists.

---

Members don't see this ad.

 

[sevoflurane]

To be fair, a lot of PAs do not have peachy lives. Their road to get there is easy cheese compared to the doc route.
The ability to get significant time off is easier to find when you take the high road and become an anesthesiologist.
At least that's my perception. I don't know any PAs that work three 12's and then get to have a 4 day weekend- although I'm sure there are some.

 

[NightNight]

There's a lot of BS on these boards. Plenty of truth, sure, but also a lot of BS.

I'll try to ignore the noise and get back to the OP's original question. I can only offer my own experience.

I'd say it is a terrible time to be thinking of becoming a physician anesthesiologist, at least one who wants to do his/her own cases. On the other hand, the future of CRNAs has never been brighter.

I would not advise my own children to go to medical school. I would advise them to go to PA or nursing school. You are already in medical school, so that advice does not apply. Once you've made the mistake of going to medical school, the best possible outcome might yet to be an anesthesiologist. If you like to be yelled at by surgeons (and surgical PAs), nurses, non-clinical nurses, hospital administrators, and (more and more) your AMC overlords, while taking more liability for lower reimbursement...then, yes, I think anesthesia might be for you.

Be sure to budget your time for a fellowship if you want to work in any halfway desirable city.

"physician anesthesiologist"

This is redundant.

Murse?


Sent from my iPhone using SDN mobile

 

[zero0]

I thought you were a CRNA until you wrote this.

Don't be silly. Why would a CRNA comment in the anesthesiology forum on SDN?

 

[aneftp]

I think we need to look at the big picture. The vast majority of crnas while they think they want to be "independent". Ok give them that.

But most do not want to be the "alpha" dog.

What do I mean by this? This means while most can perform "independently" in 90-95% of cases. The simply fact is many of them still want "backup" help if needed. Not that they "need it". But they still like backup help. Get my drift?

When crap hits the fan, many would like another set of hands.

That's where I agree with blade who has mentioned in the past we may see 1:6, 1:8 room coverage as a modified proposal and the anesthesiologist may seem to be more of a fireman who's called if needed and preop and pacu scut monkey.

 

[sevoflurane]

I think we need to look at the big picture. The vast majority of crnas while they think they want to be "independent". Ok give them that.

But most do not want to be the "alpha" dog.

What do I mean by this? This means while most can perform "independently" in 90-95% of cases. The simply fact is many of them still want "backup" help if needed. Not that they "need it". But they still like backup help. Get my drift?

When crap hits the fan, many would like another set of hands.

That's where I agree with blade who has mentioned in the past we may see 1:6, 1:8 room coverage as a modified proposal and the anesthesiologist may seem to be more of a fireman who's called if needed and preop and pacu scut monkey.

Conceding to this is conceding to their agenda.

 

[aneftp]

Conceding to this is conceding to their agenda.

Yes. I get that.

But this is where the asa/ABA board of directors and their lobbyist and the AMCs cozy relationships factor into play. AMCs will push the agenda. And since many past and president ASA board members are part of AMCs. They will rubber stamp the loose supervision ratios.

 

[NightNight]

What do I mean by this? This means while most can perform "independently" in 90-95% of cases.

This is categorically false.


Sent from my iPhone using SDN mobile

 

[Mman]

This is categorically false.


Sent from my iPhone using SDN mobile

depends what he means with the " " around the word independently. Anesthesia is safe. Most anesthetics in this country are very low risk of anything bad happening. If you can handle a normal airway, it's unlikely anything terrible is going to happen most of the time.

If you left a CRNA to be totally independent and do their own thing, the mortality rate in the OR would not be 10%, or in other words the patient would be alive >90% of the time. Heck, it'd be way more than 90% of the time.

That isn't saying CRNA's should have independent practice. They shouldn't. But you have to understand what the actual odds of bad things happening are to understand where WE (anesthesiologists) make a difference and how big that difference is.

 

[pgg]

What do I mean by this? This means while most can perform "independently" in 90-95% of cases.

This is categorically false.

It all depends on where you set the bar for acceptable performance. Most CRNAs can get through most cases without killing anybody. To deny this is to put on the same blinders they wear. But easily 90-95% of cases done nationwide are elective B&B cases in people who are admittedly hard to kill. The vast, vast majority of "independent" CRNAs aren't doing cases that involve more complex technical skills or genuinely sick patients.

The problem is that while we know that there's more to delivering an anesthetic than merely avoiding sentinel events, the public doesn't know that. The nurse propaganda machine is powerful and effective, and has been carefully cultivating a public perception of warm & fuzzy hero-worship affection for nurses.

Questioning the motives, training, capability, or skills of a nurse is like questioning the same things in a fireman, or a nun volunteering in an orphanage in sub-Saharan Africa.

Nurse worship is the Orwellian groupthink of modern healthcare. They're doubleplus good.

Society has set the bar for acceptable anesthetic care at a level that most CRNAs can attain for most cases. The best we can do at this point is try to keep them away from the cases that need us the most.

 

[Mman]

It all depends on where you set the bar for acceptable performance. Most CRNAs can get through most cases without killing anybody. To deny this is to put on the same blinders they wear. But easily 90-95% of cases done nationwide are elective B&B cases in people who are admittedly hard to kill. The vast, vast majority of "independent" CRNAs aren't doing cases that involve more complex technical skills or genuinely sick patients.

The problem is that while we know that there's more to delivering an anesthetic than merely avoiding sentinel events, the public doesn't know that. The nurse propaganda machine is powerful and effective, and has been carefully cultivating a public perception of warm & fuzzy hero-worship affection for nurses.

Questioning the motives, training, capability, or skills of a nurse is like questioning the same things in a fireman, or a nun volunteering in an orphanage in sub-Saharan Africa.

Nurse worship is the Orwellian groupthink of modern healthcare. They're doubleplus good.

Society has set the bar for acceptable anesthetic care at a level that most CRNAs can attain for most cases. The best we can do at this point is try to keep them away from the cases that need us the most.

It is politically incorrect to say anything less the glowing about any form of nurse. It is also politically acceptable to speak poorly of doctors for various reasons.

 

[GravelRider]

Nurse worship is the Orwellian groupthink of modern healthcare. They're doubleplus good.

Healthcare has become a dystopia. The use of the word "provider" is like the newspeak of Orwell's future. The Joint Commission, the clipboard nurses, and other such groups are the directors of the the doublethink that keeps us in our place...the Thought Police.