eaglebaseball4

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Apr 3, 2018
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Just a lowly medical student here considering anesthesia among other specialties. One concern I possibly have is finding a job close to where I am from. I grew up in a very rural mountainous area on the east half of the US, and have looked on the websites of several hospitals within 50 miles of my hometown. It seems as if none of them have more than 50 beds, and only about half have surgical services for patients. I would think this would mean very few jobs for anesthesia in the area. Does anyone have any experiences or thoughts with rural areas/small hospitals and anesthesia? I am not opposed to working in a bigger city, but would like to have the option to return close to home one day and still continue my profession. Thanks.
 

BLADEMDA

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In this specialty, Anesthesiology, we need patients undergoing surgery at a fairly decent volume to make a living. Most of the 50 bed hospitals will be rural CRNA only practices.

I recommend you expand the distance from your hometown by at least 100 miles and look for at least a medium sized city. Typically, hospitals over 100-150 beds utilize Anesthesiologists. If you are stuck on returning home I think you will need to pick another specialty.
 
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Sep 29, 2018
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There are a few things you need to really look at when picking a specialty:

1) Do I like the work?

2) Do I like the money?

3) Do I like the hours/lifestyle?

4) Can I get a job in a place I want to live?

As you get older, money will likely mean the least in this equation (within reason). If you wanted sports ortho, and went FP, instead, you’re talking about a big money difference. The differences between OB/gyn, FP, general IM, Psych, Anesthesia, and General Surgery (no bariatrics), will not be enough to make a HUGE difference in your standard of living.

If you’re married, and your spouse is from the same rural area, having to go somewhere else for a job can be a HUGE stress on the marriage. Think hard about it.

Also, keep in mind that an FP in a rural area (low cost of living) can probably live as well as an Anesthesiologist making a good deal more in an urban or expensive suburban setting.

I did the “rural” thing for about 6 months, years ago. It was what I had always wanted to try, and one of the reasons I went into medicine, so I could have a big farm/ranch, and live in a small town.

This was a “town” of about 20k people, but was 1-1/2 to 2 hours from any large city. It was pretty much a NIGHTMARE.

The surgeons were spotty (quality) and there were only a few. Translation, you had to pick your battles, and ended up putting up with some questionable behavior, both personal and professional. We’d have (on a Tuesday/Wed) a pretty sparse schedule for Friday. Then, a couple of the ortho Docs would throw on 3-4 knees/hips on obese/htn/diabetic pt’s who hadn’t seen a Doc in years, with ?? EKG’s, and you’d end up hustling trying to get these pt’s preop clearance, in 2 days, rather than the surgeons just showing the common courtesy of scheduling them 2-3 WEEKS out.

Very slow surgeons. Questionable surgical talent. Patients with poor medical care. The patients in town with good money made a point to drive the 100 miles to the “good” hospital.

I had one partner (and he was only there for 12 months before he had enough), and there were also 4 CRNA’s. Because of a mickey mouse surgery center in town, we BOTH had to be there during the week. That meant once every two weeks (alternating weekends), I could actually leave town. Otherwise, you were stuck there, and you had to find your OWN locums to actually get a full week off (at a cost of $10-$12k).

Add to that the fact that you either end up (in a rural area) with CRNA’s who either don’t want you there, or are so incompetent that you HAVE to be there and bail them out constantly. The hospital wasn’t that busy, but you could NOT get away from it.

I left the place for a “suburban” job, and for the past 10 years have worked in a “city” of about 200k, with a coverage area of 500k plus.

It’s hard to find a good anesthesiology rural job. Not impossible, but hard.

Decide what you want more, to live in a rural area, or to be an anesthesiologist. If you really want Anesthesia, consider small cities of 100-200k. You’ll find good jobs, that make good use of your skills, while still living in an area with a “small town feel”.

It’ll be a compromise, but you’re simply not going to have as much luck trying to be an Anesthesiologist (or a pedi endocrinologist, or an Infectious Disease Doc) in a rural area.

In the meantime, don’t take my word for it. Call some of these small hospitals. Ask to speak with the head of “physician recruitment” or the hospital CEO (they are much more involved with recruiting physicians in small hospitals), and see what they have to say. They may even promise you money if you have any interest in primary care.

I wish you the best, and am not trying to rain on your plans, but consider what I said above.

Money, area, lifestyle/hours, marriage. These will ALL come into play regarding “job satisfaction”, NOT just the “work” itself. Good luck.
 
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Twiggidy

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There are a few things you need to really look at when picking a specialty:

1) Do I like the work?

2) Do I like the money?

3) Do I like the hours/lifestyle?

4) Can I get a job in a place I want to live?

As you get older, money will likely mean the least in this equation (within reason). If you wanted sports ortho, and went FP, instead, you’re talking about a big money difference. The differences between OB/gyn, FP, general IM, Psych, Anesthesia, and General Surgery (no bariatrics), will be not be enough to make a HUGE difference in your standard of living.

If you’re married, and your spouse is from the same rural area, having to go somewhere else for a job can be a HUGE stress on the marriage. Think hard about it.

Also, keep in mind that an FP in a rural area (low cost of living) can probably live as well as an Anesthesiologist making a good deal more in an urban or expensive suburban setting.

I did the “rural” thing for about 6 months, years ago. It was what I had always wanted to try, and one of the reasons I went into medicine, so I could have a big farm/ranch, and live in a small town.

This was a “town” of about 20k people, but was 1-1/2 to 2 hours from any large city. It was pretty much a NIGHTMARE.

The surgeons were spotty (quality) and there were only a few. Translation, you had to pick your battles, and ended up putting up with some questionable behavior, both personal and professional. We’d have (on a Tuesday/Wed) a pretty sparse schedule for Friday. Then, a couple of the ortho Docs would throw on 3-4 knees/hips on obese/htn/diabetic pt’s who hadn’t seen a Doc in years, with ?? EKG’s, and you’d end up hustling trying to get these pt’s preop clearance, in 2 days, rather than the surgeons just showing the common courtesy of scheduling them 2-3 WEEKS out.

Very slow surgeons. Questionable surgical talent. Patients with poor medical care. The patients in town with good money made a point to drive the 100 miles to the “good” hospital.

I had one partner, and there were also 4 CRNA’s. Becsuse of a mickey mouse surgery center in town, we BOTH had to be there during the week. That meant once every two weeks (alternating weekends), I could actually leave town. Otherwise, you were stuck there, and you had to find your OWN locums to actually get a full week off (at a cost of $10-$12k).

Add to that the fact that you either end up (in a rural area) with CRNA’s who either don’t want you there, or are so incompetent that you HAVE to be there and bail them out constantly. The hospital wasn’t that busy, but you could NOT get away from it.

I left the place for a “suburban” job, and for the past 10 years have worked in a “city” of about 200k, with a coverage area of 500k plus.

It’s hard to find a good anesthesiology rural job. Not impossible, but hard.

Decide what you want more, to live in a rural area, or to be an anesthesiologist. If you really want Anesthesia, consider small cities of 100-200k. You’ll find good jobs, that make good use of your skills, while still living in an area with a “small town feel”.

It’ll be a compromise, but you’re simply not going to have as much luck trying to be an Anesthesiologist (or a pedi endocrinologist, or an Infectious Disease Doc) in a rural area.

In the meantime, don’t take my word for it. Call some if these small hospitals. Ask to speak with the head of “physician recruitment” or the hospital CEO (they are much more involved with recruiting physicians in small hospitals), and see what they have to say. They may even promise you money if you have any interest in primary care.

I wish you the best, and am not trying to rain on your plans, but consider what I said above.

Money, area, lifestyle/hours, marriage. These will ALL come into play regarding “job satisfaction”, NOT just the “work” itself. Good luck.
This hits every nail directly on the head.

If you really want to be an anesthesiologist the best would be to work in a medium sized area within distance of your family in a rural area as said above. Being immediately close to family is nice, but in all honesty when you’re working you wont see much of them anyway, especially if the call burden is high (which can be quite high in rural areas because they can’t get anyone out there for regular coverage). Use you weekend when you’re not working to either have family come to you or to go visit family.
 
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eaglebaseball4

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Apr 3, 2018
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Thank you all for your replies. I can now definitely see some of the negative but valid realities of trying to become a rural anesthesiologist. I will use what you have told me to make my decision when the time comes. Truth be told, you are 100% correct about expanding my region and knowing that I will still be able to visit on weekends when I am off. There are several hospitals within 100 miles and I could see how it could work at one of these hospitals. Thanks again!
 

mmag

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Aug 19, 2006
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If the state you are considering allows for unsupervised CRNAs, it'll be very difficult to find actual rural critical care hospitals that will hire you because they make $$$ off CRNAs from Medicare Rural Pass through. Even the non-critical care hospitals will have a dominate cadre of CRNAs who will fight tooth and nail to keep out anesthesiologists and hold the hospital hostage by threatening to quit en-mass. If anesthesiologist is required, you'll be on call or back up call (for the CRNAs) every night because the hospital is going to hire the minimum number of physicians (usually 1).
The way the system is set up now, the deck is stacked against anesthesiologists who want to go rural. The only feasible setup is if your spouse is a surgeon and they can help you negotiate because they have more leverage being highly desirable in a rural area.
 
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deleted682700

I have worked in small town in Ohio, Indiana and California For 20 years. Some places can not recruit. Anybody who comes is welcomed and treated very well. Relaxed pace /amount of work. The administrator and surgeons come to you And they need you. You can get premium pay. Liability is lot easier to manage and stress is greatly reduced. The local politician, clubs, cops all know what car you drive and they leave you alone.

Downside, you are on call everyday, not many like to be in that situation. You do bread and butter cases, Risk loosing skills that you trained. Expansion potential is limited to the upside. No intellectual stimulation.

Children cannot have good education. Spouse has few Opportunity to shop / sightseeing and when you age may not be able to find all the specialized medical care.

Eventually if you want to leave this , find difficulties into adjusting to more sicker and faster pace and also finding opportunities.
 
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Just a lowly medical student here considering anesthesia among other specialties. One concern I possibly have is finding a job close to where I am from. I grew up in a very rural mountainous area on the east half of the US, and have looked on the websites of several hospitals within 50 miles of my hometown. It seems as if none of them have more than 50 beds, and only about half have surgical services for patients. I would think this would mean very few jobs for anesthesia in the area. Does anyone have any experiences or thoughts with rural areas/small hospitals and anesthesia? I am not opposed to working in a bigger city, but would like to have the option to return close to home one day and still continue my profession. Thanks.

Is that you [deleted]?
Rural... mountainous... eastern half of the country... gotta be [deleted]. You should be more vague about where you are from if you are trying to stay anonymous. :pompous:;)
 
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