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

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Y

yungspleen

Full Member
10+ Year Member
Joined
Oct 13, 2014
Messages
518
Reaction score
336
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!
Members don't see this ad.
 
Members don't see this ad :)
yungspleen said:
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!
Click to expand...

Someone get this guy a beer.
 
SnapperRocks said:
Someone get this guy a beer.
Click to expand...

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 said:
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.
Click to expand...

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.
 
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.
 
yungspleen said:
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!
Click to expand...
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.
 
yungspleen said:
However, let's say CRNA's do start taking all cardiac cases independently
Click to expand...

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.
 
ryanjmy said:
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.
Click to expand...

Well thats reassuring. Thank you
 
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.
 
Members don't see this ad :)
yungspleen said:
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.
Click to expand...

Good luck with that, Pollyanna.

🤣🤣🤣🤣🤣
 
aneftp said:
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.
Click to expand...

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
 
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.
 
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
 
dchz said:
FIRE?
Click to expand...
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.
 
pgg said:
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.
Click to expand...
These days, ex husbands are just as bad as ex wives. Tides are changing. Stay single people.
 
chocomorsel said:
Stay single people.
Click to expand...

ForeverAlone.jpg
 
SaltyDog said:
I don't know what that is, but I think I just found my next avatar pic.
Click to expand...
It's the Forever Alone guy

knowyourmeme.com

Forever Alone | Know Your Meme

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 c
knowyourmeme.com knowyourmeme.com
 
anbuitachi said:
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
Click to expand...
I meant 3-4 days weekdays.
 
Newtwo said:
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
Click to expand...

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.
 
Last edited:
yungspleen said:
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.
Click to expand...

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.
 
SnapperRocks said:
Why would a strong market now make you anxious? You’re worried because you’ll get into a good residency?
Click to expand...

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.
 
yungspleen said:
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.
Click to expand...
Get that bad juju out of here!
 
yungspleen said:
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.
Click to expand...

What was it?
 
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.
 
yungspleen said:
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!
Click to expand...
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 ...
 
yungspleen said:
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
Click to expand...
If you already know everything, then why are you asking for advice?
 
yungspleen said:
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
Click to expand...
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.
 
MikeMerk-MtS said:
If you already know everything, then why are you asking for advice?
Click to expand...

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.

Man o War said:
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.
Click to expand...

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.
 
yungspleen said:
Ya I'd be restricted to the west coast which is what worries me.
Click to expand...

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


yungspleen said:
Does going to a top program help significantly or just marginally
Click to expand...

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.
 
yungspleen said:
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.
Click to expand...

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.
 
mmag said:
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.
Click to expand...

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.
 
SaltyDog said:
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.
Click to expand...
Yes the key is "as long as there’s no one skimming off the top."
 
You must log in or register to reply here.

Similar threads

NumTacos
An Alternate Take on Private Equity in Anesthesia
2
Replies
70
Views
5K
ucladoc2b
U
N
Practicing Anesthesia in Florida
Replies
10
Views
596
SRYSPAC
S
Dr. Rude
$15 Million Anesthesia Verdict Connecticut
Replies
49
Views
5K
deleted1183938
D
N
Anesthesia as a Career for Physicians is Over!
Replies
48
Views
4K
gator2886
G
A
Anesthesia out of network, facility and surgeon in network
Replies
24
Views
3K
JStarMD
J
Top