Only 6% of anesthesia residents actually regret their specialty choice

[pgg]

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Youre missing the point.

When you work 10 plus years to be able to be qualified for a job, you should not be working on someone else's terms.
The article mentions several ways to LOSE YOUR CAREER. This can happen to you even if you dont believe so. All you need is some anonymous complaints backed up by some body and you are "Toast". Those furloughed employees are not facing a career loss. and if they lose their 59K per year job with 5 weeks vacation, It aint hard to find another one.

The point of the article - right there in the headline - was explicitly "job security" not "are physicians paid what they deserve".

If you're determined to not see the distinction, I'm not sure I can help you by explaining it differently.

 

[MirrorTodd]

Youre missing the point.

When you work 10 plus years to be able to be qualified for a job, you should not be working on someone else's terms.
The article mentions several ways to LOSE YOUR CAREER. This can happen to you even if you dont believe so. All you need is some anonymous complaints backed up by some body and you are "Toast". Those furloughed employees are not facing a career loss. and if they lose their 59K per year job with 5 weeks vacation, It aint hard to find another one.

That's a fairly presumptuous statement.

 

[psychbender]

Every anesthesiologist in the United States with an unsuspended license, no felony convictions, and a non-egregiously-bad trail of malpractice claims can find a job in a matter of days - if not hours. It may take a couple months to secure a license in a new state, but even in that worst case surely there's some locums work to be done somewhere in the same state.

This depends entirely on how flexible one is on the type of job one is willing to accept. I cannot stand majority ACT practices, and am in one of the only predominently physician practices in my state. If I lost my job, I could easily join (or do locums with) one of the several 100% 4:1 coverage, high call practices within an hour's drive that are recruiting, but I won't. I could continue to have decent income, but it would require relocation, or substantial time away from family for locums.

Sent from my SM-G930V using SDN mobile

 

[GravelRider]

The point of the article - right there in the headline - was explicitly "job security" not "are physicians paid what they deserve".

If you're determined to not see the distinction, I'm not sure I can help you by explaining it differently.

Well job security can mean more than just having the ability to find any job. I honestly didn’t read the blog post, but I can guess the theme is less a “woe is me” about being a doctor and more a recommendation to be prepared for life’s uncertainties. If someone lost his or her job and had to resort to doing travel locums for extended periods of time because of a noncompete while raising young children at home, it could present a pretty difficult hardship despite always being able to find a job somewhere.

 

[deleted171991]

Every anesthesiologist in the United States with an unsuspended license, no felony convictions, and a non-egregiously-bad trail of malpractice claims can find a job in a matter of days - if not hours. It may take a couple months to secure a license in a new state, but even in that worst case surely there's some locums work to be done somewhere in the same state.

What I'm getting at is that apparently the phrase "job security" means to WCI what "soulcrushing taxes" means to that cartoonist. It's ridiculous.

You know that I have a ton of respect for you, but the first paragraph above is ridiculous. First of all, when a malignant employer or supervisor (more and more of both) causes one to leave, it's not that easy to maintain one's good name. Those people are experts in badmouthing you "between the lines" to a future employer. I have seen it happen to good people, enough to prevent one from getting a quality job.

Many anesthesiologists who are unhappy with their jobs qualify for all of your criteria, and then some, and still they can't find a significantly better job within commuting distance, BECAUSE OTHERWISE THEY WOULD HAVE TAKEN IT LONG TIME AGO!

I posted that link so that future physicians (and anesthesiologists) know what they are getting into (not to compare a career in medicine with one at McDonald's). Kids have this idyllic view of a career in medicine (and anesthesiology, the object of this thread), and the earlier they wake up the better.

 

[pgg]

You know that I have a ton of respect for you,

Mutual, I mean that sincerely.

but the first paragraph above is ridiculous. First of all, when a malignant employer or supervisor (more and more of both) causes one to leave, it's not that easy to maintain one's good name. Those people are experts in badmouthing you "between the lines" to a future employer. I have seen it happen to good people, enough to prevent one from getting a quality job.

Many anesthesiologists who are unhappy with their jobs qualify for all of your criteria, and then some, and still they can't find a significantly better job within commuting distance, BECAUSE OTHERWISE THEY WOULD HAVE TAKEN IT LONG TIME AGO!

I posted that link so that future physicians (and anesthesiologists) know what they are getting into (not to compare a career in medicine with one at McDonald's). Kids have this idyllic view of a career in medicine (and anesthesiology, the object of this thread), and the earlier they wake up the better.

Well, I guess it's true that I'm the Larson glass half full kind of guy.

One key area where our experiences may diverge is in how we look at the difficulty of relocating. I've never had any kind of anchor to any one particular place. I've moved with my family, had my kids change schools, uprooted everything half a dozen times in the last 20 years. The last 10 years as an anesthesiologist earning a wage that most people here would consider insulting (though my benefit package is pretty good). So many glass-half-empty people on this forum are living and working in predominantly high cost of living coastal urban areas, often ACT practices with terrible supervision environments, for less money than they could be earning a little ways inland, and I don't get why they won't move. The glass-half-full'ers in those places seem to accept it all as the paradise tax for where they're living.

Anyway, for the purposes of this thread, it seems the notion of "job security" to WCI has a meaning that is worlds different to the average American - and the premeds and med students who are looking at medicine and our specialty.

What your and others' rebuttals to my arguments all have in common is that they are encumbered by a bunch of preconditions
- "within commuting distance"
- not "4:1 coverage"
- "pretty difficult hardship despite always being able to find a job somewhere"

Hell, Mr. S is apparently in a panic with his notion that we're all an anonymous complaint away from LOSING OUR CAREERS.

Job security to normal people means "will I be laid off and be unable to find work" or "will I have to file for unemployment" or "will I need to learn a new trade" ... and these are simply not questions that any reasonable physician can answer yes to.

Medicine has amazing job security. Are the job as wonderful as they were in the 1980s or 2000s, no. Does ACT work suck, yes. Are AMCs evil oppressive wealth-extracting middlemen, yes. Are great jobs and groups still out there, yes. Fewer than there used to be, sure.

 

[Man o War]

I know numerous anesthesiologists who have done things so egregious I was sure they’d never find work again. They found something else with absolutely no problem.
If you have a list of conditions, yes you are going to struggle to find work right away. That goes for any career on the planet for the most part.
Hell, even with a list of conditions you will find something- it will just take longer.

 

[Mr.S]

The point of the article - right there in the headline - was explicitly "job security" not "are physicians paid what they deserve".

If you're determined to not see the distinction, I'm not sure I can help you by explaining it differently.

There really is no need to be condescending.
My point(and so was the articles) was we are a bad outcome, a malignant employer , a complaint or 2 away from career loss usually unjustifiably. Have you not READ or heard about physicians who have lost their career for frivolous reasons? This is especially true for Anesthesiology

 

[GravelRider]

Mutual, I mean that sincerely.



Well, I guess it's true that I'm the Larson glass half full kind of guy.

One key area where our experiences may diverge is in how we look at the difficulty of relocating. I've never had any kind of anchor to any one particular place. I've moved with my family, had my kids change schools, uprooted everything half a dozen times in the last 20 years. The last 10 years as an anesthesiologist earning a wage that most people here would consider insulting (though my benefit package is pretty good). So many glass-half-empty people on this forum are living and working in predominantly high cost of living coastal urban areas, often ACT practices with terrible supervision environments, for less money than they could be earning a little ways inland, and I don't get why they won't move. The glass-half-full'ers in those places seem to accept it all as the paradise tax for where they're living.

Anyway, for the purposes of this thread, it seems the notion of "job security" to WCI has a meaning that is worlds different to the average American - and the premeds and med students who are looking at medicine and our specialty.

What your and others' rebuttals to my arguments all have in common is that they are encumbered by a bunch of preconditions
- "within commuting distance"
- not "4:1 coverage"
- "pretty difficult hardship despite always being able to find a job somewhere"

Hell, Mr. S is apparently in a panic with his notion that we're all an anonymous complaint away from LOSING OUR CAREERS.

Job security to normal people means "will I be laid off and be unable to find work" or "will I have to file for unemployment" or "will I need to learn a new trade" ... and these are simply not questions that any reasonable physician can answer yes to.

Medicine has amazing job security. Are the job as wonderful as they were in the 1980s or 2000s, no. Does ACT work suck, yes. Are AMCs evil oppressive wealth-extracting middlemen, yes. Are great jobs and groups still out there, yes. Fewer than there used to be, sure.

To be fair, the intended audience of WCI is not “normal people” who may be furloughed or have to file for unemployment. The audience is doctors. Job security has a different meaning for different people. Your current great job could change for the worse and it be outside of your control. Your physician only gravy train could turn into a 4:1 Q4 nightmare. Be ready for the change. The advice (I think) is intended to make people as flexible as you say you have been...save for a rainy day, don’t spend too much on that “doctor house,” and be aware that this career may look a whole lot different in 20 years.

That guy in the other thread may be in a financially bad spot if he takes a zero money down mortgage and doesn’t find a job in that area after a 3 year residency. Assuming your current situation is “secure” allows people to make risky financial decisions.

 

[deleted171991]

Most people wouldn't call having to relocate on a regular basis as job security.

@Mr.S is correct about malignant employers. We live in a country where defamation is not properly punished, and we've all seen scenarios where a physician is bullied by his department based on unproven accusations from nurses. We are all just one accusation/lie away from having our career destroyed. Again, I have seen it happen to the best and nicest.

@GravelRider is spot on about the link I posted.

 

[pgg]

There really is no need to be condescending.
My point(and so was the articles) was we are a bad outcome, a malignant employer , a complaint or 2 away from career loss usually unjustifiably. Have you not READ or heard about physicians who have lost their career for frivolous reasons? This is especially true for Anesthesiology

You're right, my apologies.

I've of course heard stories of lost careers, spiteful blacklisting, etc but these stories are notable in large part because they're rare. I don't know any in life outside SDN - though I've encountered more than a few (like @Man o War wrote above) who just keep on keepin' on despite marginal practice, drug problems, criminal convictions, and other issues.

 

[Mr.S]

Mutual, I mean that sincerely.



Well, I guess it's true that I'm the Larson glass half full kind of guy.

One key area where our experiences may diverge is in how we look at the difficulty of relocating. I've never had any kind of anchor to any one particular place. I've moved with my family, had my kids change schools, uprooted everything half a dozen times in the last 20 years. The last 10 years as an anesthesiologist earning a wage that most people here would consider insulting (though my benefit package is pretty good). So many glass-half-empty people on this forum are living and working in predominantly high cost of living coastal urban areas, often ACT practices with terrible supervision environments, for less money than they could be earning a little ways inland, and I don't get why they won't move. The glass-half-full'ers in those places seem to accept it all as the paradise tax for where they're living.

Anyway, for the purposes of this thread, it seems the notion of "job security" to WCI has a meaning that is worlds different to the average American - and the premeds and med students who are looking at medicine and our specialty.

What your and others' rebuttals to my arguments all have in common is that they are encumbered by a bunch of preconditions
- "within commuting distance"
- not "4:1 coverage"
- "pretty difficult hardship despite always being able to find a job somewhere"

Hell, Mr. S is apparently in a panic with his notion that we're all an anonymous complaint away from LOSING OUR CAREERS.

Job security to normal people means "will I be laid off and be unable to find work" or "will I have to file for unemployment" or "will I need to learn a new trade" ... and these are simply not questions that any reasonable physician can answer yes to.

Medicine has amazing job security. Are the job as wonderful as they were in the 1980s or 2000s, no. Does ACT work suck, yes. Are AMCs evil oppressive wealth-extracting middlemen, yes. Are great jobs and groups still out there, yes. Fewer than there used to be, sure.

I presume you may be in the military where its built into the system that you relocate many, many times before your time is up and the military covers the entire cost of relocating. That is entirely different from being given a non-renewal notice, or 90 day termination clause being exercised for BS reasons, group losing the contract, you not making partnership. In the latter scenarion you may have a spouse who is solidly entrenched in their position and they would not be able to find a similar position where you can find work. You may have 2-3 kids solidly entrenched in schools. Thats not job security in my opinion. That is a scary situation and can and do cost marriages. And in corporate medicine you will be signing those kind of contracts.

With respect to learning a new trade. Tell that to the mid 90s anesthesiologist who some had to do another residency. I dont think we will ever be there again, but who knows?
Moreover, finding other lines of work (outside of medicine) would be necessary in the event that you get railroaded by some bad outcomes nobody wants to mess with credentialing and you are out of work. or if you lose your medical license.
These are not imaginary. These are considerations.

 

[epidural man]

You probably havent done enough cases..
Or you just happen to be in a non-malgnant atmosphere (rare). It is very possible though.

Rare????

I work in 4 different ASCs, 3 in private offices, one in a big County funded system, and at a large Academic institution.

Not one of them is a malignant place to work. All of them are pleasant.

I just hate working. I’d rather be playing Tennis, Read Dead Redemption, craps, or just chillin with my family - at any moment when I am working. I’d rather be a rock star than a doctor, or recording artist, or famous pod caster who just interviews people all day.

But since I am a doctor, I can’t imagine doing anything else in medicine..and I’m lucky. I get a good variety in my job.

 

[epidural man]

I presume you may be in the military where its built into the system that you relocate many, many times before your time is up and the military covers the entire cost of relocating. That is entirely different from being given a non-renewal notice, or 90 day termination clause being exercised for BS reasons, group losing the contract, you not making partnership. In the latter scenarion you may have a spouse who is solidly entrenched in their position and they would not be able to find a similar position where you can find work. You may have 2-3 kids solidly entrenched in schools. Thats not job security in my opinion. That is a scary situation and can and do cost marriages. And in corporate medicine you will be signing those kind of contracts.

With respect to learning a new trade. Tell that to the mid 90s anesthesiologist who some had to do another residency. I dont think we will ever be there again, but who knows?
Moreover, finding other lines of work (outside of medicine) would be necessary in the event that you get railroaded by some bad outcomes nobody wants to mess with credentialing and you are out of work. or if you lose your medical license.
These are not imaginary. These are considerations.

The bleakness you point out has NOTHING to do with anesthesia. It has to do with having a Job.

 

[Mr.S]

The bleakness you point out has NOTHING to do with anesthesia. It has to do with having a Job.

Most jobs you can find another job in same city. Only a handful of cities you can do that in the USA in anesthesia. Most jobs wont replace 10-15 qualified people at a moments and replace them with a different set of 10-15 qualified people to save $$$. Most jobs are not bound by regulatory licenses that can be revoked or restricted. Some of Anesthesia problems are shared with by other specialists and sub-specialists but I think we are uniquely in a vulnerable position.

 

[epidural man]

Most jobs you can find another job in same city. Only a handful of cities you can do that in the USA in anesthesia. Most jobs wont replace 10-15 qualified people at a moments and replace them with a different set of 10-15 qualified people to save $$$. Most jobs are not bound by regulatory licenses that can be revoked or restricted. Some of Anesthesia problems are shared with by other specialists and sub-specialists but I think we are uniquely in a vulnerable position.

Not even true.

Before I went to medical school I was a reliability engineer at a semi-conductor plant - the only one in this fairly large town. As the chip market went up and down, this factory would short-sightedly fire whole departments of many highly qualified and educated engineers. Other fields do the same thing.

 

[chocomorsel]

Why do you regret it? Serious question.

I regret not going into Psych frequently. I kinda changed my mind last minute cuz of external influences from others. As in, when I did my ICU rotation, the attending made fun of me for wanting to be a shrink and told me I could do better by not wasting my brain or something to that effect. Plus the fact that my family didn’t think I had enough empathy to be a shrink. Should have ignored everyone and followed my heart.
So here I am, doing a fellowship, in order to get out of the often toxic OR environment and not necessarily making any more money in the long run while still in a very stressful field. Instead, I could have had my own practice, answered to no one, made my own hours and still made damn good money.

 

[Mr.S]

Not even true.

Before I went to medical school I was a reliability engineer at a semi-conductor plant - the only one in this fairly large town. As the chip market went up and down, this factory would short-sightedly fire whole departments of many highly qualified and educated engineers. Other fields do the same thing.

What is not even true?

Did those short sighted factory owners fire whole departents of many highly qualiied educated engineers and hire the same # of a different set 1 day later?

 

[Mr.S]

I regret not going into Psych frequently. I kinda changed my mind last minute cuz of external influences from others. As in, when I did my ICU rotation, the attending made fun of me for wanting to be a shrink and told me I could do better by not wasting my brain or something to that effect. Plus the fact that my family didn’t think I had enough empathy to be a shrink. Should have ignored everyone and followed my heart.
So here I am, doing a fellowship, in order to get out of the often toxic OR environment and not necessarily making any more money in the long run while still in a very stressful field. Instead, I could have had my own practice, answered to no one, made my own hours and still made damn good money.

You should get the Sunday PRIZE..
Some people GET IT (like yourself) and some people just dont.

 

[deleted171991]

I regret not going into Psych frequently. I kinda changed my mind last minute cuz of external influences from others. As in, when I did my ICU rotation, the attending made fun of me for wanting to be a shrink and told me I could do better by not wasting my brain or something to that effect. Plus the fact that my family didn’t think I had enough empathy to be a shrink. Should have ignored everyone and followed my heart.
So here I am, doing a fellowship, in order to get out of the often toxic OR environment and not necessarily making any more money in the long run while still in a very stressful field. Instead, I could have had my own practice, answered to no one, made my own hours and still made damn good money.

Then maybe the next stop for you should be palliative. You won't work solo, but you will work with the patient's mind and soul, as in psych.

 

[chocomorsel]

Then maybe the next stop for you should be palliative. You won't work solo, but you will work with the patient's mind and soul, as in psych.

Agreed. Except I will still be employed by someone.
Honestly, I think locums May be my answer. What I really want is to be my own boss. And not have to answer to anyone including bending to administration like one often has to do in PP.
However, that being said, as jaded I am about gas, I do realize that I make an excellent living even in light of all the BS that comes along with having to put up w dingus surgeons and being treated like a second class citizen. I don’t have a problem finding a job and even the lowest paying job is still gonna pay a nice chunk of change compared to say, FP. So I try to stay positive in that regard, even though I complain a lot.

 

[Innocent2]

Self reporting has all types of weaknesses. EM is the shortest path to a substantial paycheck. Throw a 6 year residency with dual fellowship on top and you still don't write your own ticket. Lots of risk and ways to bomb out. Delayed gratification (comes with its own problems). I would simply suggest a better survey population would be those five years working as attendings. Checkout Medscape's annual surveys.

 

[Mr.S]

even the lowest paying job is still gonna pay a nice chunk of change compared to say, FP. So I try to stay positive in that regard, even though I complain a lot.

Part of MY problem is I understand the liability associated with this job and I dont feel I am adequately compensated for it even at 90 percentile. I just dont. This is a one mistake job so to speak. HOw much do you pay someone for that?

getting back to what you said.......... FP/IM hospitalist jobs are making 200 an hour. plus they do one week on/ one week off. And they aint gonna kill anyone. Er docs are making 300/hr even though they are reigning those folks in a bit.

 

[Mr.S]

...

 

[chocomorsel]

Part of MY problem is I understand the liability associated with this job and I dont feel I am adequately compensated for it even at 90 percentile. I just dont. This is a one mistake job so to speak. HOw much do you pay someone for that?

getting back to what you said.......... FP/IM hospitalist jobs are making 200 an hour. plus they do one week on/ one week off. And they aint gonna kill anyone. Er docs are making 300/hr even though they are reigning those folks in a bit.

I would like to see where these FP/IM hospitalists are making 200 an hour. That’s over 400k a year if we are talking 26 weeks. I have done the math. I can barely get that as an ICU doc. Unless you are talking locums without any benefits, they are not making that. I have looked up some of their rates. That’s not the norm.
And... hospitalists do kill people too if you want to put it that way. It just doesn’t happen as quickly and as dramatically as when we do it.

 

[pgg]

Part of MY problem is I understand the liability associated with this job and I dont feel I am adequately compensated for it even at 90 percentile. I just dont. This is a one mistake job so to speak. HOw much do you pay someone for that?

getting back to what you said.......... FP/IM hospitalist jobs are making 200 an hour. plus they do one week on/ one week off. And they aint gonna kill anyone. Er docs are making 300/hr even though they are reigning those folks in a bit.

That one week on / one off is a brutal schedule. If they're really making 200 an hour, I'm glad for them.

ER docs are also paid well, in part because of their brutal schedule. Nights and weekends are when the ERs are full; not so much 10 AM on Tuesdays. I'm glad they are paid well too.


I wrote this once before but I'll just write it again ...

No one gets paid what they "deserve" ... they get paid what market forces dictate is the least that can be offered to get enough people to do the job. (Absent government intervention, e.g. minimum wage laws.)

Athletes with felony convictions and restraining orders from their battered ex-girlfriends get paid $millions. Special ed teachers shop the thrift stores. The world isn't fair. If your sense of self worth or job satisfaction depends on what other people earn at jobs you think are easy, hard, important, trivial, lame, or cool then you're in for a lifetime of heartburn.

We're pretty fortunate to have a cool job, with real impact on others' lives. It has generally positive prestige (though it sure ain't the 1950s any more) and pays us moderately large gobs of money. Don't be upset because the garbage collector who drives by your curb every Tuesday morning is earning a good living.

 

[Stagg737]

I know nothing lasts forever. I just need it to last until I retire

Sorry, but that's an effed up attitude that says you basically dgaf about your future colleagues. Probably wasn't how you meant to come off, but that's the exact attitude that is screwing the current generation of residents over in the future. "Kick the can down the road, because as long as I'm okay they can deal with it later."

 

[dannyboy1]

Sorry, but that's an effed up attitude that says you basically dgaf about your future colleagues. Probably wasn't how you meant to come off, but that's the exact attitude that is screwing the current generation of residents over in the future. "Kick the can down the road, because as long as I'm okay they can deal with it later."

Not at all. What I said is that market forces and reimbursements will be what they are. I have no control over them now or in twenty years from now. I have no ability to do anything with the “can”. I consider myself fourtunate to have a job which I enjoy going to with a salary/hours ratio which I consider reasonable. I hope it lasts but who knows...

 

[epidural man]

Dr Drew has a short discussion of why being a Doctor is terrible - happens on Dax Shepard's podcast Episode 49, Mark 44 minutes. He spends about 4 minutes discussing why being a physician has become the worst job in the world.

It is a must listen for any doctor.

Dr. Drew

 

[Mr.S]

Dr Drew has a short discussion of why being a Doctor is terrible - happens on Dax Shepard's podcast Episode 49, Mark 44 minutes. He spends about 4 minutes discussing why being a physician has become the worst job in the world.

It is a must listen for any doctor.

Dr. Drew

I listened to it.
Dr. Drew is the man.
I agree, it is a must listen.

 

[pgg]

It is a must listen for any doctor.

Dr. Drew

I'd argue it's a must listen for any premed. The more they understand about what they're getting themselves into, the better. I think everyone who's a doctor already is well aware of how terribly dysfunctional the system is.

 

[Mr.S]

I'd argue it's a must listen for any premed. The more they understand about what they're getting themselves into, the better. I think everyone who's a doctor already is well aware of how terribly dysfunctional the system is.

premeds don't wanna hear it.
If you point them in the direction of truth, "somehow you have ill intent."

 

[Trollest]

How about any regrets?

No regerts

 

[deleted162650]

 

[WholeLottaGame7]

How about any regrets?

Odd that that went over your head, given your username...