Pain from a lifestyle (pay, hours, etc.) stand point

[Agast]

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But are you a baller and enjoying 3 months of vacay? Even taking 2 months for maternity leave was a big hit for me.

 

[BobBarker]

No, I probably take 4 - 5 weeks. Same I did at the hospital.

 

[Laryngospasm]

Additional points to add:

There is a large uptick for procedures across all procedural specialties. The volume is there and the cases are generally safer (outside of life saving procedures) from a procedural standpoint. While there is access to less invasive treatment options, the patients are older and fragiler. Many treatments still require a certain depth of anesthesia and the risks of that do not decrease substantially even if the procedures are less invasive as you are still managing the ABCs after induction, intraop, on emergence, and in PACU. This means you still need to consider the risks you take on for each case outside of healthy, elective cases at an ASC.

Having been in and continuing to be in various practice settings for both pain and anesthesia, there are many places that pay significantly more but you have no backup or are supervising a high numbers of AAs/CRNAs. This comes at a significant risk and you have to be honest with yourself about your risk tolerance. At the end of the day, if something goes wrong, many RNs, surgeons, physicians, and patients blame anesthesiologists by default. Whether or not a case has merit is a different discussion, but be prepared to justify everything you do. The amount of risk I carry as a pain physician who performs all the more advanced procedures is significantly less than the risk I carry as an anesthesiologist for an obese patient with DM and a-fib undergoing a "routine" laparoscopic procedure at an ASC. Additionally, you do not get to choose what cases you do as an anesthesiologist once you're on the clock. It's easy to say you'll turn down every case that is not medically optimized. It's not something you'll do regularly in actual practice outside of academia due to various influencing factors.

I've started reviewing more cases on the litigation side for pain and anesthesia. The anesthesia side is certainly more devastating and typically there are variables outside of the anesthesiologist's control that led to suboptimal outcomes. The pain cases are usually due to egregious mistakes and lack of recognition for the safety zones -- more litigation comes from opioid prescribing habits.

Lastly, 850K with 3 months vacation only working 60 non-call hours per week is not a typical compensation package -- majority of anesthesiologists are not working that few hours with 3 months vacation to hit this number.

What Dr. Mamba said times 100x. I have done and currently do both.
The risk for anesthesia cases of off the charts at a level one center these days. Constant battle to prevent disaster and often failing. Stress level much higher in anesthesia.. so many variables to try and control and you can be blamed for just one thing you missed in a massive chart with just a few minutes to do your preop. You are literally the only one trying to prevent disaster.. everyone else is a sheep rushing headlong into it. “Come on doc.. why can’t we go with a k that’s 2.8?” “It was just a piece of toast?” And on and f….ng in. Nothing quite like the feeling of being treated like crap for trying to protect the patient. Strangely surgeons often aren’t smart enough to realize that we are paid by the case as well, are only trying to prevent harm where we can, and we get no pleasure from messing up patients and surgeons schedules and often making our own day longer as a result as well.
Dont forget Long nights of stressful call where you are treated like a glorified janitor. You will pay heavily for that 850k.