Is the future looking brighter?

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I’m really sick of the doom and gloom scenarios. My father is a physician, and I can remember his friend telling me around 1993 that anesthesiology was a “dying field”. I was in grade school at the time.

Well guess what, it’s 25 years later and anesthesiology is still one of the highest paying fields of medicine. I live in a beach town, and if anything we have a SHORTAGE of both anesthesiologists AND CRNAs. This is true in large portions of the country as baby boomers retire. Both MDs and CRNAs continue to command exceptionally high salaries.

The negative outlook is a classic case of “grass is always greener” combined with response bias.

I would be willing to bet anyone on this board $10,000 that in 15 years, the median anesthesiologist salary will be HIGHER than it is today, even adjusting for inflation.

To give you some perspective if you’re a medical student still choosing, I make 33-45% more than my brother who is a very well compensated ophthalmologist.

So all these people can speak of doom and gloom, but it’s reminiscent of the Middle Ages, when scores of false prophets claim the end times were near, only for life to go on.

It’s like that old Seinfeld routine about them constantly making new cars but not making new parking spaces. The US population is expanding at a good clip, but residency class sizes are flat. The population is also aging (making them more surgery prone). Surgery is also the cash cow of all hospitals. Without it, many would go under. Guess what, MDs will always be needed in everything but tiny rural hospitals.

So is the future bright? Does a starting salary of 300-400k sound good? Do you think you can live on that? Are there any major changes coming to healthcare landscape to justify the doom and gloom? Not lately. I’d say if you went into medical school today, over a career of 30 years you will gross pretax $10-15 million. Invest wisely and you’ll have a healthy nest egg by 45.

Don’t let anyone talk you out of anesthesia. It’s the best job there is. It’s very well compensated. Even if it became slightly less compensated it would still be VERY well compensated. No overhead, no advertising, no follow up, only medicine. And then drive home in your Porsche to a wife who is more likely than not absolutely gorgeous. Enjoy getting out of work the same time your kids are getting home from school, so you see them grow up. Your kids will be rich, intelligent, and likely physically attractive given the wife. That’s a recipe for being popular. I was the worlds biggest nerd in high school. My daughter was just selected the Prom Queen.

Anesthesiology is the career most consistent with the American Dream. Just avoid the booze, don’t somehow get addicted to drugs, and don’t have affairs. Those are the only things that will make it fall apart.

I am not sure if you are trolling or just overly optimistic but it's not that simple. you have to look past just the words dying field, and ask yourself why is it a dying field. it's like how we had a very sick patient and everytime we bought him to the OR we thought he'd die, but he kept surviving thru it, until he didnt. just because you survived the previous doom/gloom doens't mean you will survive this one. We are producing far too many CRNAs and anesthesiologists and CRNAs are getting too much independence and these changes will have long term effects. It's not about if it will crash, but when. we lived in a bull market for a decade now, our compensation can easily tank (cause we are 99% employees), when the market crashes and the government goes bankrupt.

It's also stupid to just look at salary. How many hours are you working? How hard are you working/how many rooms are you covering? Making 300k working 40 hrs a week covering 1 room is not the same as making 400k working 60 hrs a week covering 4 rooms. Sure your salary went up, but other things went up as well. Sure you may get home at 3pm at the same time as your kids, but this isn't the norm. Many doctors can do that too especially if they open their own clinic. Optho is a lifestyle specialty with minimal emergencies.

There'll be good jobs in every field, but to the med students entering the field, i wouldnt bet on getting those jobs.

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Anesthesiology is one of the fields where middle men, Gi docs, ortho docs, etc that take a big cut of your pie. We are viewed as providers who are easily replaced.

The field isn't dying but the paradigm has changed for being the type of doctor who owned his/her own practice and collected the revenue to the type of doctor who works for an employer. This adds Anesthesiology to the list of hourly employee workers. In addition, the bean counters want cheaper providers and higher supervision levels.

As long as you understand all the dynamics involved in this specialty you can choose it for your career. But, in no way is Anesthesiology the same field it was just 10 years ago.

Anesthesiology is not what I would recommend to those in the top 1/3 of their class with step scores over 245.
 
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I am not sure if you are trolling or just overly optimistic but it's not that simple. you have to look past just the words dying field, and ask yourself why is it a dying field. it's like how we had a very sick patient and everytime we bought him to the OR we thought he'd die, but he kept surviving thru it, until he didnt. just because you survived the previous doom/gloom doens't mean you will survive this one. We are producing far too many CRNAs and anesthesiologists and CRNAs are getting too much independence and these changes will have long term effects. It's not about if it will crash, but when. we lived in a bull market for a decade now, our compensation can easily tank (cause we are 99% employees), when the market crashes and the government goes bankrupt.

It's also stupid to just look at salary. How many hours are you working? How hard are you working/how many rooms are you covering? Making 300k working 40 hrs a week covering 1 room is not the same as making 400k working 60 hrs a week covering 4 rooms. Sure your salary went up, but other things went up as well. Sure you may get home at 3pm at the same time as your kids, but this isn't the norm. Many doctors can do that too especially if they open their own clinic. Optho is a lifestyle specialty with minimal emergencies.

There'll be good jobs in every field, but to the med students entering the field, i wouldnt bet on getting those jobs.

You think I’m the one who is trolling. I read your entire response, but you lost a lot of credibility when you proposed the US government could go bankrupt.

I got news for you. US treasury bonds have the lowest yield in the world for a reason. Government debt is the gold standard (no pun intended) for safe harbor assets. And it rests on the assumption that if the US economy is bankrupt, essentially the world is literally coming to an end and no assets are safe.

The problem with saying “anesthesia is a dying field 25 years ago” isn’t that there were some long term negative indicators. That’s true of all medicine. The major problem with the statement was that it was on its face preposterous. Yet here we are, discussing the same thing. 25 years later.

What time do you want to meet up in 25 more years to have the exact same discussion?

Godot is going to show up before your doomsday scenario comes to pass.
 
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I'm just going to break down why people are coming at you.....

Well guess what, it’s 25 years later and anesthesiology is still one of the highest paying fields of medicine. I live in a beach town, and if anything we have a SHORTAGE of both anesthesiologists AND CRNAs. This is true in large portions of the country as baby boomers retire. Both MDs and CRNAs continue to command exceptionally high salaries.

I argue the salaries are high because of the hours worked. Even in private practice, we work longer hours than most other physicians and given that many of us are paid based on unit, ie paid by the hour, we make more money. Also, Laguna Beach isn't the same as Pismo Beach. What I'm saying is, there could be a reason there's a shortage in your beach town.

To give you some perspective if you’re a medical student still choosing, I make 33-45% more than my brother who is a very well compensated ophthalmologist.

Your brother is probably home A LOT more than you are and therefore enjoying his salary a lot more.

It’s like that old Seinfeld routine about them constantly making new cars but not making new parking spaces. The US population is expanding at a good clip, but residency class sizes are flat. The population is also aging (making them more surgery prone). Surgery is also the cash cow of all hospitals. Without it, many would go under. Guess what, MDs will always be needed in everything but tiny rural hospitals.

False statement and comparison. We've shown that there has been an increase in residents graduating and an increase in anesthesiology residencies. Now before you get all excited, that's not because there is a "need" for anesthesiologists. It's because some hospitals are hip to the game. More residents just mean more cheap labor. All the residents graduate and want to go to certain areas of the country where they struggle to find a job or just take a poor job. Again, back to your "beach town but we have a shortage" statement, why don't you have a line of residents down the road applying at your group?

So is the future bright? Does a starting salary of 300-400k sound good? Do you think you can live on that? Are there any major changes coming to healthcare landscape to justify the doom and gloom? Not lately. I’d say if you went into medical school today, over a career of 30 years you will gross pretax $10-15 million. Invest wisely and you’ll have a healthy nest egg by 45.

Don’t let anyone talk you out of anesthesia. It’s the best job there is. It’s very well compensated. Even if it became slightly less compensated it would still be VERY well compensated. No overhead, no advertising, no follow up, only medicine. And then drive home in your Porsche to a wife who is more likely than not absolutely gorgeous. Enjoy getting out of work the same time your kids are getting home from school, so you see them grow up. Your kids will be rich, intelligent, and likely physically attractive given the wife. That’s a recipe for being popular. I was the worlds biggest nerd in high school. My daughter was just selected the Prom Queen.

Anesthesiology is the career most consistent with the American Dream. Just avoid the booze, don’t somehow get addicted to drugs, and don’t have affairs. Those are the only things that will make it fall apart.

This last part is just a little fun trolling by yourself which is fine because this is the internet and the internet is supposed to be fun. "Are there major changes coming to healthcare....?" Uh, have you been paying attention to what's happening in Washington? People on both sides of the aisle are doing their best to screw up the healthcare system and it will directly affect the way we are compensated. I agree our salaries are good but they're also good in a handful of other fields where you may not have as much clinic, the job is procedure based, and you need at the mercy of a surgeon, and I agree with @BLADEMDA that if I take a second look at what I was able to achieve on Step 1 and not have one miserable day of med school sway my decision I could be a whole lot happier today. Im happy-ish because I do make great salary but that's at the mercy of what I consider not the greatest job. Currently, of the three (money, location, time) I'm sacrificing my time and it's getting old.

I'll give you that part about the hot wife. My lady is fine and our daughter is going to be fine, which means my next investment will likely be a shotgun ;)

You also correct for just about ANY field. Don't do drugs, get married once, and I'll add ONE mortgage and just about 99.9% of us will be fine in the end.
 
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The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.

Lol, jesus
 
The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.

I took the blue pill.
 
The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.

Descartes called, he says “there is no demon”
 
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The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.

Got any blue pills in your fancy coastal town that can’t get a doc? I’ll be beating down the door now to sign up!!
 
I'm just going to break down why people are coming at you.....



I argue the salaries are high because of the hours worked. Even in private practice, we work longer hours than most other physicians and given that many of us are paid based on unit, ie paid by the hour, we make more money. Also, Laguna Beach isn't the same as Pismo Beach. What I'm saying is, there could be a reason there's a shortage in your beach town.



Your brother is probably home A LOT more than you are and therefore enjoying his salary a lot more.



False statement and comparison. We've shown that there has been an increase in residents graduating and an increase in anesthesiology residencies. Now before you get all excited, that's not because there is a "need" for anesthesiologists. It's because some hospitals are hip to the game. More residents just mean more cheap labor. All the residents graduate and want to go to certain areas of the country where they struggle to find a job or just take a poor job. Again, back to your "beach town but we have a shortage" statement, why don't you have a line of residents down the road applying at your group?



This last part is just a little fun trolling by yourself which is fine because this is the internet and the internet is supposed to be fun. "Are there major changes coming to healthcare....?" Uh, have you been paying attention to what's happening in Washington? People on both sides of the aisle are doing their best to screw up the healthcare system and it will directly affect the way we are compensated. I agree our salaries are good but they're also good in a handful of other fields where you may not have as much clinic, the job is procedure based, and you need at the mercy of a surgeon, and I agree with @BLADEMDA that if I take a second look at what I was able to achieve on Step 1 and not have one miserable day of med school sway my decision I could be a whole lot happier today. Im happy-ish because I do make great salary but that's at the mercy of what I consider not the greatest job. Currently, of the three (money, location, time) I'm sacrificing my time and it's getting old.

I'll give you that part about the hot wife. My lady is fine and our daughter is going to be fine, which means my next investment will likely be a shotgun ;)

You also correct for just about ANY field. Don't do drugs, get married once, and I'll add ONE mortgage and just about 99.9% of us will be fine in the end.

You got a number?
 
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The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.

The truth is that it's simulated turtles all the way down, man.
 
Uhhhh, kinda creepy dude. (You sound like Trump)



Is there really no way for you to opt out of OB? At both my first gig and my current gig it’s very easy to opt out of OB (and there’s no financial penalty for doing so).
Nope, nothing short of resignation. Sadly doing OB is tied to all the things people actually want to do. I won't be shocked if a handful burnout within the next few years.

Trust me, my dude, I would've opted out a long time ago.
 
Nope, nothing short of resignation. Sadly doing OB is tied to all the things people actually want to do. I won't be shocked if a handful burnout within the next few years.

Trust me, my dude, I would've opted out a long time ago.

Well we could still use a cardiac guy and we have plenty of blue pills to go around.
 
The reason why we have a shortage is there is no anesthesia residency program nearby, despite our having a nearby medical school. I’m at in a medium sized city in between bigger cities. It’s hard to draw people away from the bigger cities.
 
The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.
I contacted the anesthesia tech where you work and he said the leaking sevo vaporizer will be fixed by tomorrow. You're welcome.
 
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I'm coming from a radiology perspective but I think working together between specialties is paramount to taking back some of the power as physicians in medicine. The commoditized, "employee" fields especially need to cooperate in some fashion, though exactly how I'm not sure. Many people in radiology don't see the forest through the trees and freak out about AI but are selling out to private equity at an alarming rate and ruining the field. Based on this thread it's clear the same threat of corporate medicine poses a similar threat to anesthesia and EM. Hopefully physicians wake up and find a way to maintain the profession.

Every specialist thinks that every other specialty is overpaid.
 
Why don't small private practice anesthesia groups merge into 2-3 large groups per state? By having an oligopoly of physician-owned groups, anesthesiologists would have more clout against hospitals/insurers and compliance costs, etc would be shared among a larger group.
 
Why don't small private practice anesthesia groups merge into 2-3 large groups per state? By having an oligopoly of physician-owned groups, anesthesiologists would have more clout against hospitals/insurers and compliance costs, etc would be shared among a larger group.

Because there’s no buy out. It’s all about the buy out. Everything else is - - - - - - - -
 
The most oppressive action any person can take is to try and change a person’s perception of reality.

Reality is a subjective construct arrived at by neurons encased in a shell of bone, living in the dark, whose only knowledge of the objective world comes via distant emissaries sending signals along fallible wires.

You think I’m denying reality? There is no thing as objective truth.


One question for ya.... Is that absolutely true???
 
I tell most students that come through that they need to avoid anesthesia, unless they really want to do pedi or pain. The corporations have quickly ruined it. Yes, they took over EM years ago, but at least those guys can sign up for 3-4 12-hour shifts a week, and call it done.

OTOH, with anesthesia, they’re going to tell you how much call to take, how late to work, how many weekends, etc. Cancel a few too many cases?? You’re being “difficult”. Tell off the primadonna surgeon who’s been giving you grief for months?? You’re “difficult”.

On top of that, in an ACT setting, they’re going to do the hiring of CRNA’s. You think they care if they’re competent?? Heck, no. However, it’ll be your license and money on the line when something goes wrong. They’re not coming after the CEO of “Anesthesia Inc.’s” personal assets...

Hey. Nobody is going to starve doing anesthesia, but when you spend 4 years of Med School and 4 years of residency, only to find that you’re treated little better than the ancillary staff, worried about “losing the contract” every 2-3 years when the bitchy surgeons bitch one time too many, or the CEO is just looking to polish a resume by saying they “cut costs” on anesthesia expenditures, you MIGHT just wonder if it was worth it?? Endocrinology doesn’t get called at 3 in the morning to evaluate someone’s adrenals. Derm doesn’t get called at midnight for a rash.
 
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The grass isn't greener on the EM side. The big CMC (they call them contract management companies) hire a herd of midlevel providers for you to sign off on without actually seeing the patient personally. If the boss doesn't like you, you'll never get to work weekday days. The hospital wants a certain amount of admissions and you are gonna feel the pressure.
Anesthesia has a least the lack of excessive charting going for it. Many clinic based folks have to chart at home cuz corporate makes them see so many pts that they can't keep up during the day.

I tell most students that come through that they need to avoid anesthesia, unless they really want to do pedi or pain. The corporations have quickly ruined it. Yes, they took over EM years ago, but at least those guys can sign up for 3-4 12-hour shifts a week, and call it done.

OTOH, with anesthesia, they’re going to tell you how much call to take, how late to work, how many weekends, etc. Cancel a few too many cases?? You’re being “difficult”. Tell off the primadonna surgeon who’s been giving you grief for months?? You’re “difficult”.

On top of that, in an ACT setting, they’re going to do the hiring of CRNA’s. You think they care if they’re competent?? Heck, no. However, it’ll be your license and money on the line when something goes wrong. They’re not coming after the CEO of “Anesthesia Inc.’s” personal assets...

Hey. Nobody is going to starve doing anesthesia, but when you spend 4 years of Med School and 4 years of residency, only to find that you’re treated little better than the ancillary staff, worried about “losing the contract” every 2-3 years when the bitchy surgeons bitch one time too many, or the CEO is just looking to polish a resume by saying they “cut costs” on anesthesia expenditures, you MIGHT just wonder if it was worth it?? Endocrinology doesn’t get called at 3 in the morning to evaluate someone’s adrenals. Derm doesn’t get called at midnight for a rash.
 
I'm coming from a radiology perspective but I think working together between specialties is paramount to taking back some of the power as physicians in medicine. The commoditized, "employee" fields especially need to cooperate in some fashion, though exactly how I'm not sure. Many people in radiology don't see the forest through the trees and freak out about AI but are selling out to private equity at an alarming rate and ruining the field. Based on this thread it's clear the same threat of corporate medicine poses a similar threat to anesthesia and EM. Hopefully physicians wake up and find a way to maintain the profession.
There is exactly one right thing to do: make hay while the sun is shining, then say goodbye to the entire f-ed up field of medicine. We are just a bunch of puppies barking at a mastodon, and it's beyond naive to think that we can compete with the financial interests of the healthcare industrial complex and the politicians they can buy in Washington. It's too late.
 
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There is exactly one right thing to do: make hay while the sun is shining, then say goodbye to the entire f-ed up field of medicine. We are just a bunch of puppies barking at a mastodon, and it's beyond naive to think that we can compete with the financial interests of the healthcare industrial complex and the politicians they can buy in Washington. It's too late.

I feel like it is perfect time for a physician who is motivated to do some additional work outside of “medicine”...many of us already see the paradigm shift and the future looks bright. With some patience, work, and a little luck this is probably one of the best fields/professions to enter.
 
I contacted the anesthesia tech where you work and he said the leaking sevo vaporizer will be fixed by tomorrow. You're welcome.

I’m really surprised people took this post seriously. It was just a joke.
 
We will never be replaced. Not completely at least.

I agree. Also, if someone is sitting in a central room of monitors it's going to be a physician not a CRNA.

But, we've not even automated an intubation process (like with a robot) yet. It's just very very far off from where we are at today.
I don't know anyone who even uses a servo system for maintaining paralysis with direct twitch monitoring feedback.

How does a pump load itself? AI is very far off. Automating much of our gig is very far off.

Technology will touch us for sure, but in different ways. Not via automating our jobs, IMO.
 
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