Is there an easy out if anesthesia gets completely overrun in 15-20 years?

[yungspleen]

Applying to anesthesia this year. Don't think CRNA's will completely tank the job market any time soon (if ever) and I'm sure I'll have plenty of job offers coming out of residency. I'd probably do a cardiac fellowship for extra security. It's hard not to think of worst-case-scenario even if I don't 100% think it is likely. However, let's say CRNA's do start taking all cardiac cases independently (there's already some that do) and that just turns into 1 physician managing 4-5 CRNAs and the field becomes saturated. What is my out? Apply for a pain fellowship? Work in an ICU? How can I make sure I'll always have a solid source of income (at least >300k) no matter what happens to the field during my career. Thanks in advance!

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[dchz]

FIRE?

 

[yungspleen]

FIRE?

Lol I guess that's 1 option. Although I'd like a solid income past the age of 45

 

[deleted697127]

Applying to anesthesia this year. Don't think CRNA's will completely tank the job market any time soon (if ever) and I'm sure I'll have plenty of job offers coming out of residency. I'd probably do a cardiac fellowship for extra security. It's hard not to think of worst-case-scenario even if I don't 100% think it is likely. However, let's say CRNA's do start taking all cardiac cases independently (there's already some that do) and that just turns into 1 physician managing 4-5 CRNAs and the field becomes saturated. What is my out? Apply for a pain fellowship? Work in an ICU? How can I make sure I'll always have a solid source of income (at least >300k) no matter what happens to the field during my career. Thanks in advance!

Someone get this guy a beer.

 

[yungspleen]

Someone get this guy a beer.

I never said it's going to happen, I'm talking worst case scenario. I'm sure you were the same person telling everyone who was concerned about the VA giving CRNA's autonomy to drink a beer. Never hurts to be cautious when it's your career

Edit: Also I 100% hope you're right and I'm being overly anxious and stressed. I think anesthesia's an awesome field and I'd love to look back in 30 years and realize I was being unnecessarily paranoid.

 

[IMGASMD]

Pick something you like. If you’re that concerned, do something else. No one knows what’s going to happen.
Health care as you know it, also may be different.
If you dread going into work, maybe it’s not the right field for you.

 

[yungspleen]

Pick something you like. If you’re that concerned, do something else. No one knows what’s going to happen.
Health care as you know it, also may be different.
If you dread going into work, maybe it’s not the right field for you.

Solid advice. I think my surgery rotation made me nervous as most cases were being run by CRNAs but it could just be a regional thing.

 

[aneftp]

The worst that’s gonna to happen is u do ur own case. Crna do their own cases

remember there simply isn’t enough staff RIGHT NOW.

what makes u think there is enough staffing in the future?

anesthesia is a lot like Emergency medicine. No one works Monday-Friday (5 days a week) plus takes calls for weeks on in a row.

most anesthesia peeps have days off. 3-4 day weekends. 7-8 weeks vacation.

you really think crnas who make 180-200k (4 days week) with no calls no weekends. And 6-7 weeks paid off. Those same crnas know if they work flat fee 52-54 hours a week at amc for 275k-300k including nights and weekends. They be running back to their 4 day a week job cause adjusted for hours and nights. It’s the same freaking pay.

 

[deleted126335]

Marry rich

 

[MikeMerk-MtS]

Applying to anesthesia this year. Don't think CRNA's will completely tank the job market any time soon (if ever) and I'm sure I'll have plenty of job offers coming out of residency. I'd probably do a cardiac fellowship for extra security. It's hard not to think of worst-case-scenario even if I don't 100% think it is likely. However, let's say CRNA's do start taking all cardiac cases independently (there's already some that do) and that just turns into 1 physician managing 4-5 CRNAs and the field becomes saturated. What is my out? Apply for a pain fellowship? Work in an ICU? How can I make sure I'll always have a solid source of income (at least >300k) no matter what happens to the field during my career. Thanks in advance!

Yes, your "out" would be to do something outside of the OR like ICU or pain.

If you're worried about the job market in 15-20 years from now I would consider a different field. Noone has a crystal ball but if you're going to second guess your career stability throughout your career it's just not worth it.

 

[ryanjmy]

However, let's say CRNA's do start taking all cardiac cases independently

This absolutely will not happen in the next 2 decades. You vastly underestimated how hard cardiac is and how much positive impact a cv anesthesiologists has on the case. Outcome data is being tracked. Nobody wants to be a 1 Star program. I assume there will be financial incentives or penalties for institutions based on outcomes if there isn’t already.

 

[yungspleen]

This absolutely will not happen in the next 2 decades. You vastly underestimated how hard cardiac is and how much positive impact a cv anesthesiologists has on the case. Outcome data is being tracked. Nobody wants to be a 1 Star program. I assume there will be financial incentives or penalties for institutions based on outcomes if there isn’t already.

Well thats reassuring. Thank you

 

[bigdan]

If you want an “easy out of anesthesia”, do a fellowship that gets you out of anesthesia. There are several paths, all with a one year fellowship, that will get you a completely separate board certification and allow you a career independent of OR anesthesia.

Pain, ICU, sleep medicine, and palliative care are top of mind; pain and sleep medicine are of particular note because those disciplines bring patients to the hospital/health system (as opposed to waiting for patients to come to you), which puts you in a position of importance.

 

[dhb]

Marry rich

Here sister generous might be a better choice

 

[Consigliere]

Don't think CRNA's will completely tank the job market any time soon (if ever) and I'm sure I'll have plenty of job offers coming out of residency.

Good luck with that, Pollyanna.

 

[anbuitachi]

The worst that’s gonna to happen is u do ur own case. Crna do their own cases

remember there simply isn’t enough staff RIGHT NOW.

what makes u think there is enough staffing in the future?

anesthesia is a lot like Emergency medicine. No one works Monday-Friday (5 days a week) plus takes calls for weeks on in a row.

most anesthesia peeps have days off. 3-4 day weekends. 7-8 weeks vacation.

you really think crnas who make 180-200k (4 days week) with no calls no weekends. And 6-7 weeks paid off. Those same crnas know if they work flat fee 52-54 hours a week at amc for 275k-300k including nights and weekends. They be running back to their 4 day a week job cause adjusted for hours and nights. It’s the same freaking pay.

cant tell if serious. 3-4 day weekends? i dont know anyone full time near me with this schedule. everyone works m-f at least. i get 3 days off next month total

 

[MirrorTodd]

You could always find a state that allows general practice and hang a shingle. Get into consulting or expert witness type stuff (which I honestly dont know how hard it is to get into), find a government facility and contract with them for that job security.

 

[deleted697535]

Wow this certainly is an eye opening thread. You sound like a good guy but maybe you're putting the cart before the horse a little!
You're sure you'll have plenty of job offers, and you'll probably do cardiac for the hell of it anyway?

Gotta applaud balls, you got plenty of em...
But word of advice if you do match, maybe tone that sh1t down for a few years

 

[pgg]

FIRE?

At the very least, the FI part. LBYM, have a FU account, be willing to relocate for work, minimize the number of boats, planes, supercars, vaction homes, ex-wives (ex-husbands are OK as those tend to be profitable) and cocaine consumption.

Being an anesthesiologist isn't a financially perilous life unless you make it so.

 

[deleted697535]

Its cheaper to rent anything that floats, flies or fvcks

 

[deleted162650]

(ex-husbands are OK as those tend to be profitable)

Sending this to my Dad, a family law attorney.

 

[deleted162650]

Rule of 1's:

1 good job
1 mortgage
1 wife
1 expensive hobby
Maximally fund 401k

 

[Iso4ane]

Expert witness for cases of anesthesia malpractice by CRNAs.

 

[secretasianman]

There is no free lunch in medicine. The future is hard to predict for many fields, not just anesthesia. Private equity gets its grubby hands on anything it can.

 

[chocomorsel]

At the very least, the FI part. LBYM, have a FU account, be willing to relocate for work, minimize the number of boats, planes, supercars, vaction homes, ex-wives (ex-husbands are OK as those tend to be profitable) and cocaine consumption.

Being an anesthesiologist isn't a financially perilous life unless you make it so.

These days, ex husbands are just as bad as ex wives. Tides are changing. Stay single people.

 

[pgg]

Stay single people.

 

[deleted162650]

I don't know what that is, but I think I just found my next avatar pic.

 

[pgg]

I don't know what that is, but I think I just found my next avatar pic.

It's the Forever Alone guy

Forever Alone

Forever Alone is a cartoon character image that is used to express loneliness and disappointment with life. It is considered one of the first major "rage comic" characters to be spun off from the original Rage Guy character, which first sprang up on 4chan in 2009.

knowyourmeme.com

 

[aneftp]

cant tell if serious. 3-4 day weekends? i dont know anyone full time near me with this schedule. everyone works m-f at least. i get 3 days off next month total

I meant 3-4 days weekdays.

 

[Lawpy]

It's the Forever Alone guy

Forever Alone

Forever Alone is a cartoon character image that is used to express loneliness and disappointment with life. It is considered one of the first major "rage comic" characters to be spun off from the original Rage Guy character, which first sprang up on 4chan in 2009.

knowyourmeme.com

Memes and ragecomics

 

[deleted162650]

cant tell if serious. 3-4 day weekends? i dont know anyone full time near me with this schedule. everyone works m-f at least. i get 3 days off next month total

I think we established a while back that you need a new job.

 

[yungspleen]

Wow this certainly is an eye opening thread. You sound like a good guy but maybe you're putting the cart before the horse a little!
You're sure you'll have plenty of job offers, and you'll probably do cardiac for the hell of it anyway?

Gotta applaud balls, you got plenty of em...
But word of advice if you do match, maybe tone that sh1t down for a few years

I wasn't trying to come across cocky. I just think I'd have a good chance matching a top program based on my step. I may suck during residency and get no job offers, who knows. It was more of a commentary on the current job market being fairly strong from what I've heard. And the cardiac fellowship would be for further job security, not to become more competitive at time of finishing residency.

 

[deleted697127]

I wasn't trying to come across cocky. I just think I'd have a good chance matching a top program based on my step. I may suck during residency and get no job offers, who knows. It was more of a commentary on the current job market being fairly strong from what I've heard. And the cardiac fellowship would be for further job security, not to become more competitive at time of finishing residency.

Why would a strong market now make you anxious? You’re worried because you’ll get into a good residency?

Don’t do a fellowship for job security. Do it if you like those cases. One of the things that makes anesthesia great is that it is highly customizable. If you put the time in and network, you can probably find a practice that maximizes doing the stuff you like and minimizes doing what you hate. If you like cardiac, do cardiac. If you like ortho, find a practice that lets you do a lot of ortho. If you love or hate OB, find the practice that has the mix you are looking for. If you hate rounding on pain patients and preopping patients you’ll never take to the OR, find a practice where you won’t have to do that. You’ll be able to find something in the 3-4 range easily almost anywhere. If you want to do everything and are looking to supervise you can probably make a lot more.

I like hanging out with people who are interested in sports. I like ortho cases and regional. Ortho surgery centers have this. As other posters have pointed out, ortho docs tend to make a lot, are happy, and work when they want. The ones i work with don’t usually want to work past 5. Surgery centers let them control who they hire. This is recipe for working with a lot of people who are happy with their jobs. These days tend to be laid back, enjoyable, and profitable. I go home happy. This works for me.

 

[yungspleen]

Why would a strong market now make you anxious? You’re worried because you’ll get into a good residency?

It was more my surgery rotation. The ratio of CRNA's to attendings made me nervous. I know that this hospital was probably an outlier, but if every hospital goes that way, I just get anxious about a collapse of the job market. But the market is strong right now from what I understand.

 

[MikeMerk-MtS]

It was more my surgery rotation. The ratio of CRNA's to attendings made me nervous. I know that this hospital was probably an outlier, but if every hospital goes that way, I just get anxious about a collapse of the job market. But the market is strong right now from what I understand.

Get that bad juju out of here!

 

[Arch Guillotti]

It was more my surgery rotation. The ratio of CRNA's to attendings made me nervous. I know that this hospital was probably an outlier, but if every hospital goes that way, I just get anxious about a collapse of the job market. But the market is strong right now from what I understand.

What was it?

 

[dchz]

You're too old to know who that is...

At least I thought.

 

[vector2]

You're too old to know who that is...

At least I thought.

 

[psychbender]

Don't do a fellowship to future-proof your career. Only do one if you are genuinely interested in the field. Additionally, while CCM will get you out of the OR and dealing with militant CRNAs, across the country, midlevels (excuse me, Advanced Practice Providers), are being brought in to the ICU due to the shortage of critical care-trained physicians (hmm, where have we heard a similar story?). Additionally, all of those militant CRNAs were once ICU nurses, with the worst of them being the ones that thought they were too good to be "just an ICU nurse," to quote several of my former unit nurses. Staffing ratios can also suck hard in CCM. Where I am now, it's great, as we put one solo physician in each 12-bed unit. Where I did fellowship, they only brought on another attending and divided the team into two separate ones when the service regularly surpassed 30 patients per day. I did prn work for a staffing company that regularly expected me to care for 20+ critically ill patients (solo) per shift, and interviewed at places that would have had me covering a stable of pseudo-independent critical care NPs managing a 20-30 bed ICU. See also all past Anes-CCM threads about how the job market for combined jobs just sucks. I really enjoy the work and my current job, but I do not recommend this for anyone that is not mentally ready to give up one field for the other, or relocate across country to one of the few places that offers (non-academic) combined jobs.

 

[D P356]

He’s the mascot for MGTOW/Red Pill.

Video games will never break his heart. He’s going his own way.

 

[Consigliere]

But the market is strong right now from what I understand.

Jesus man you are getting some piss poor information.

 

[yungspleen]

Jesus man you are getting some piss poor information.

How? From your profile pic I'm assuming you're the the northeast which I'm aware has a bad job market. Is the rest of the country that bad

 

[10KHertz]

Applying to anesthesia this year. Don't think CRNA's will completely tank the job market any time soon (if ever) and I'm sure I'll have plenty of job offers coming out of residency. I'd probably do a cardiac fellowship for extra security. It's hard not to think of worst-case-scenario even if I don't 100% think it is likely. However, let's say CRNA's do start taking all cardiac cases independently (there's already some that do) and that just turns into 1 physician managing 4-5 CRNAs and the field becomes saturated. What is my out? Apply for a pain fellowship? Work in an ICU? How can I make sure I'll always have a solid source of income (at least >300k) no matter what happens to the field during my career. Thanks in advance!

Pain Medicine is saturated with non ABMS/ACGME charlatans from other fields... That’s not your way out . Ultimately Do what you like, and support/vote for Increased outpatient/private site of service payments to save private practice ...

 

[MikeMerk-MtS]

How? From your profile pic I'm assuming you're the the northeast which I'm aware has a bad job market. Is the rest of the country that bad

If you already know everything, then why are you asking for advice?

 

[Man o War]

How? From your profile pic I'm assuming you're the the northeast which I'm aware has a bad job market. Is the rest of the country that bad

No. If you’re seriously geographically restricted, you’re likely hosed. The residents/fellows who rotate with us have no problem getting good jobs if they want them.

 

[yungspleen]

If you already know everything, then why are you asking for advice?

Lol how did you come to the assumption I know everything when I was asking if the job market is really that bad? All I've heard is that the job market on the coasts in tight but that there's still plenty of job offers in the south and midwest and non-metro areas on the coasts. I never claimed to know everything.

No. If you’re seriously geographically restricted, you’re likely hosed. The residents/fellows who rotate with us have no problem getting good jobs if they want them.

Ya I'd be restricted to the west coast which is what worries me. How likely is it to get a starting job around 300k on that coast? Does going to a top program help significantly or just marginally?I know those offers aren't too hard to come by in the midwest.

 

[deleted162650]

Ya I'd be restricted to the west coast which is what worries me.

“West Coast” is a pretty large/diverse area.

Does going to a top program help significantly or just marginally

Dude, that always helps. Forget the job market for a minute - you should strive to go to the best program possible because you want to be the best anesthesiologist possible.

 

[mmag]

Lol how did you come to the assumption I know everything when I was asking if the job market is really that bad? All I've heard is that the job market on the coasts in tight but that there's still plenty of job offers in the south and midwest and non-metro areas on the coasts. I never claimed to know everything.



Ya I'd be restricted to the west coast which is what worries me. How likely is it to get a starting job around 300k on that coast? Does going to a top program help significantly or just marginally?I know those offers aren't too hard to come by in the midwest.

Not hard to get a 300k job on the west coast. It all depends on how hard/much you want to work for that 300k.

 

[deleted162650]

Not hard to get a 300k job on the west coast. It all depends on how hard/much you want to work for that 300k.

You don’t have to work very hard to make 300k. Even with a lousy payer mix and no hospital subsidy, you can easily hit that working a normal schedule as long as there’s no one skimming off the top.

 

[mmag]

You don’t have to work very hard to make 300k. Even with a lousy payer mix and no hospital subsidy, you can easily hit that working a normal schedule as long as there’s no one skimming off the top.

Yes the key is "as long as there’s no one skimming off the top."