Is the future really that bleak?

[W222]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

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[n2bait]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

You WILL be able to pay off your loans if you go into anesthesia(I will have almost 300K debt myself after residency). The real future compensation will likely be between the two scenarios you described (probably closer to today's pay than 1/4th of today's).

Go into a field because you like it, not because of some predictions on an online forum. For instance, if you you really like the passing gas, but decide to go into radiology because you percieve greater stability in pay... you will end up regretting your decision if and when outsourcing films is allowed.

 

[VentdependenT]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

I dunno but I sure like what I'm doing.

 

[VentdependenT]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

I dunno but I sure like what I'm doing.

 

[Coastie]

Vent,

maybe this has been discussed in other threads, but why didn't Rush fill this year? Everything I've heard about your place is positive....

I dunno but I sure like what I'm doing.

 

[YupGypsy]

Check this out

http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=61971

Less than $60k, is this guy serious?

And what happened to that "pissing contest" thread y'all had awhile back?

 

[huron]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

Independent practice means than if you go into anesthesiology despite your 8+ years of Medical education after college you will get paid little more than, the nurse who considers them selves to be your equal. Your pay will be the same as someone with a master level education. I.E. our salaries will stabilize in the 60K to 90K range. When every nurse with the ambition to earn a few more bucks goes to CRNA school and the CRNA schools increase in size and number to keep up with the demand until, CRNA salaries and your salary decrease until they are the same as any other advance practice nurse salary in the 60K to 90K range.

 

[MacGyver]

Independent practice means than if you go into anesthesiology despite your 8+ years of Medical education after college you will get paid little more than, the nurse who considers them selves to be your equal. Your pay will be the same as someone with a master level education. I.E. our salaries will stabilize in the 60K to 90K range. When every nurse with the ambition to earn a few more buck goes to CRNA school and the CRNA schools increase in size and number to keep up with the demand until, CRNA salaries and your salary decrease until the are the same as any other advance practice nurse salary in the 60K to 90K range.

I agree thats the worst case scenario but I dont think the salaries will be THAT low. Note that there is some "upside" to that situation. If MDAs and CRNAs are both making 90k, who in their right mind would hire a CRNA? Its clear that MDAs would have an advantage in the job market at that point.

Of course, by the time it gets that bad, the vast majority of anesthesiology residency programs will have closed due to lack of interest in the field, allowing CRNAs to dominate even more in numbers.

 

[MacGyver]

Independent practice means than if you go into anesthesiology despite your 8+ years of Medical education after college you will get paid little more than, the nurse who considers them selves to be your equal. Your pay will be the same as someone with a master level education. I.E. our salaries will stabilize in the 60K to 90K range. When every nurse with the ambition to earn a few more buck goes to CRNA school and the CRNA schools increase in size and number to keep up with the demand until, CRNA salaries and your salary decrease until the are the same as any other advance practice nurse salary in the 60K to 90K range.

I agree thats the worst case scenario but I dont think the salaries will be THAT low. Note that there is some "upside" to that situation. If MDAs and CRNAs are both making 90k, who in their right mind would hire a CRNA? Its clear that MDAs would have an advantage in the job market at that point.

Of course, by the time it gets that bad, the vast majority of anesthesiology residency programs will have closed due to lack of interest in the field, allowing CRNAs to dominate even more in numbers.

 

[MacGyver]

Independent practice means than if you go into anesthesiology despite your 8+ years of Medical education after college you will get paid little more than, the nurse who considers them selves to be your equal. Your pay will be the same as someone with a master level education. I.E. our salaries will stabilize in the 60K to 90K range. When every nurse with the ambition to earn a few more buck goes to CRNA school and the CRNA schools increase in size and number to keep up with the demand until, CRNA salaries and your salary decrease until the are the same as any other advance practice nurse salary in the 60K to 90K range.

I agree thats the worst case scenario but I dont think the salaries will be THAT low. Note that there is some "upside" to that situation. If MDAs and CRNAs are both making 90k, who in their right mind would hire a CRNA? Its clear that MDAs would have an advantage in the job market at that point.

Of course, by the time it gets that bad, the vast majority of anesthesiology residency programs will have closed due to lack of interest in the field, allowing CRNAs to dominate even more in numbers.

 

[VentdependenT]

Vent,

maybe this has been discussed in other threads, but why didn't Rush fill this year? Everything I've heard about your place is positive....

Dunno my man.

We seem to always have a couple of spots open post match. I walked up to the secretary and she had mountains of applicants flooding in for the scramble. I asked her who they were gonna pick and why we didn't fill.

She said the list was "short." Whatever that is all about. Then she said they were "taking their time" with the scramble apps.

I'm certainly in no position of power and I am definitely not in any formal association with "recruitment" so I'm not just not able to explain the gameplan over here.

Regardless it seems we get solid classes with our most recent seniors having 100% board pass rate.

 

[VolatileAgent]

Check this out

http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=61971

Less than $60k, is this guy serious?

And what happened to that "pissing contest" thread y'all had awhile back?

basically, i read that he's willing to pay $250K for someone with experience... and fresh out of residency dudes/dudettes need not apply.

 

[proman]

Re-read it. He's looking for a job.

 

[EtherMD]

After reading some of the posts in this forum, its seems like there are two possible realities in the future of anesthesiologly (and medicine in general). Either anesthesia docs will be getting payed 1/4 of what they make now or things will stay the same.

What is the most likely scenario? Frankly, I won't be able to afford to pay my loans at what some say I will be making in the future.

Concerned about the future? Welcome to Medicine and Anesthesiology.
The best thing you can do to "insulate" yourself against the Mid-Levels is a FELLOWSHIP in a subspecialty area. While this does not guarantee success it does impove the odds you will find work when others can't; also, you are more likely to be hired in a "socialized" sytem as a Physician Supervisor over Mid-Levels by the hospital.

Critical Care, Pain Mangement, Pediatrics, Cardiac, Neuro with EEG, etc. are all valuable in distinguishing yourself as a "cut above" the average Aneshesiologist.

As for salaries, if you want to earn a Physician level income you need to do Physician level work. This means those ASA 1 and ASA 2 cases might not be around in 10-15 years for an MD/DO to do solo.

What will your income level be? This has been covered by me Ad-nauseum in other posts. My advice to you is distinguish yourself as a Physician and a subspecialist. This way you won't be dependent on the basic anesthesia cases as main justification for employment and salary level.

 

[huron]

I agree thats the worst case scenario but I dont think the salaries will be THAT low. Note that there is some "upside" to that situation. If MDAs and CRNAs are both making 90k, who in their right mind would hire a CRNA? Its clear that MDAs would have an advantage in the job market at that point..

Yes your extra 6+ years of education will probably only get you 10% to 25% more pay than a nurses doing the same jobs.

If your employer is a CRNA, an Anesthesia management company or a greedy hospital administrator it is very likely that they will chose a CRNA over an Anesthesiologist even if the pay is the same. They do not see any difference in the quality of care and would prefer a CRNA who will work for salary and will not challenge their authority and or their cut of the profits by wanting partnership or ownership of the group after working for a year or two.

 

[W222]

My point in posting was that some have basically echoed what HURON is saying, that OR anesthesia as it currently exists is going extinct. The salary issue is a big deal to me as I honestly can't see training for all these years(even if it is in something I love) to simply make what an CRNA makes. I do plan on doing a fellowship but even so its sad to think that I will not be doing what I intended simply because a company can pay a glorified RN less.

 

[Taurus]

This battle of the MD's vs the CRNA's reminds me of Intel vs AMD. You guys are at each other's throats and in the end there are no winners at all. It's like watching a train wreck in slow motion. Sure, you can push for AA's, but as I said before, I think it's a band-aid. If the MD's put out more and the CRNA's put out more and then there are more AA's, you will eventually reach a state of surplus of anesthesia providers which hurts everyone. Physicians have been able to keep their salaries high for such a long time because they have carefully tried to make sure that supply didn't exceed demand. Even if the ASA tried to limit the supply to keep salaries up, the nurses sure as hell won't. They just keep building more schools and pushing out as many nurses as they can. I wouldn't be surprised to one day see CRNA's who can't find jobs. I wonder when do we reach that point of market saturation. 10 years?

 

[EtherMD]

This battle of the MD's vs the CRNA's reminds me of Intel vs AMD. You guys are at each other's throats and in the end there are no winners at all. It's like watching a train wreck in slow motion. Sure, you can push for AA's, but as I said before, I think it's a band-aid. If the MD's put out more and the CRNA's put out more and then there are more AA's, you will eventually reach a state of surplus of anesthesia providers which hurts everyone. Physicians have been able to keep their salaries high for such a long time because they have carefully tried to make sure that supply didn't exceed demand. Even if the ASA tried to limit the supply to keep salaries up, the nurses sure as hell won't. They just keep building more schools and pushing out as many nurses as they can. I wouldn't be surprised to one day see CRNA's who can't find jobs. I wonder when do we reach that point of market saturation. 10 years?

Let us return to reality. Advanced Practice Nurses while adequate anesthetists are not Physicians. They can not function on the same level as a good Physician Anesthesiologist. They can not fully replace an MD and most need help for the difficult cases. No other Country in the Developed World has delegated 100% of O.R. responsibilitis to a Nurse. This should not happen in the USA and won't in most major hospitals.

I have woked with more than 100 CRNA's in my career and the "average" CRNA is not capable of true solo Anesthesia at the same level as the "average" Anesthesiologist. In my opinion, it takes most of them 5-10 years of on the job training to get good at what they do. The rhetoric of the AANA is a long way from reality.

So, while we may have too many Anesthesiologist in the market place for the new supervisory ratio's of 7:1 the specialty is not going away. In particular, the well-trained subspecialist will be needed by hospitals and Nurses to take care of a certain sub-set of patients.

You will have a job and will earn more than a CRNA in any new system.
How much? My guess is $250,000 plus benefits via hospital subsidy for supervising CRNA/AA at a ratio of 6-7:1.

The most important thing you can do is the FELLOWSHIP year. The next thing (in my opinon) is support the AA's as a replacement to the CRNA in the O.R. Third, a good public education campign to get the message out about the value of a Board Certified Anesthesiologist in charge of the Anesthetic.

 

[YupGypsy]

Re-read it. He's looking for a job.

so what kind of anesthesiologist is desperate enough to work under $60k? And he came from US medical school & residency

 

[EtherMD]

so what kind of anesthesiologist is desperate enough to work under $60k? And he came from US medical school & residency

A *****. A new CRNA graduate with no exprience earns $85-$95 per hour (1099). At $60,000 per year he would need to work less than 20 hours a week to earn $60,0000 as a CRNA.

Most employee jobs as an MD/DO pay around $180,000-$220,000 (w-2) for 40 hours per week plus Benefits, health care, retirement, etc. This is a no call position with all holidays off. I know of several jobs avail. at that pay range for 40 hours per week or less.