Peds Anesthesia More Prestigious

[kidmd44]

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I have enjoyed reading this forum from afar and have finally decided to contribute to it. I am currently a 3rd year pediatric resident in an ICU-heavy program and will be starting an anesthesia residency in 2006, the ultimate goal being peds anesthesia. Here is my question:

Why don't more graduating anesthesia residents consider pediatric anesthesia? One might think that an ego-centric person would gravitate toward pediatric anesthesia because of the perception that any specialty prefaced by the word "PEDIATRIC" seems more prestigious than its adult counterpart (e.g. cardiovascular surgeon vs. PEDIATRIC cardiovascular surgeon; heme-onc doc vs. PEDIATRIC heme-onc, etc.). As a pediatrician myself, I am unsure if this perception is well-founded. I just love to work with kids, and that's my own personal thing.

So what is it? Are the cases not as interesting? Is the money not as good? Or is it simply personal choice, as it is for me?

 

[Private Pyle]

my understanding is that THEY ARE LOADED. so can't be the money. I have thought about pediatric anesthesia actually. I much prefer innocent, honest kids to slimy, caniving, judgemental, cynical, contemptous, republican, overweight, heavy breathing, crooked eyeglass wearing, facial and body hair having icky adults. but i hate people, that's "just my thing" 😉


PS. there's plenty of dudes going into peds anesth....i dont think there's a shortage. much like many subspecialties, there's few to pick from, and a lot of cash to share. weeeeee

 

[VentdependenT]

I have enjoyed reading this forum from afar and have finally decided to contribute to it. I am currently a 3rd year pediatric resident in an ICU-heavy program and will be starting an anesthesia residency in 2006, the ultimate goal being peds anesthesia. Here is my question:

Why don't more graduating anesthesia residents consider pediatric anesthesia? One might think that an ego-centric person would gravitate toward pediatric anesthesia because of the perception that any specialty prefaced by the word "PEDIATRIC" seems more prestigious than its adult counterpart (e.g. cardiovascular surgeon vs. PEDIATRIC cardiovascular surgeon; heme-onc doc vs. PEDIATRIC heme-onc, etc.). As a pediatrician myself, I am unsure if this perception is well-founded. I just love to work with kids, and that's my own personal thing.

So what is it? Are the cases not as interesting? Is the money not as good? Or is it simply personal choice, as it is for me?

People may do it for a number of similar reasons but I highly doubt that prestige is of any major motivational concern.

 

[Tollway]

my understanding is that THEY ARE LOADED. so can't be the money. I have thought about pediatric anesthesia actually. I much prefer innocent, honest kids to slimy, caniving, judgemental, cynical, contemptous, republican, overweight, heavy breathing, crooked eyeglass wearing, facial and body hair having icky adults. but i hate people, that's "just my thing" 😉

I find it funny and at the same time saddening that our own fellow doctors can support the democratic party. The democrats give CRNAs the right to practice without MD supervision and take more of our tax money away to give to people who do not work (see county hospital population), I cannot fathom based on those 2 areas alone why you would support the democratic party (and MDs in general).

 

[kidmd44]

my understanding is that THEY ARE LOADED. so can't be the money. I have thought about pediatric anesthesia actually. I much prefer innocent, honest kids to slimy, caniving, judgemental, cynical, contemptous, republican, overweight, heavy breathing, crooked eyeglass wearing, facial and body hair having icky adults. but i hate people, that's "just my thing" 😉

I find it funny and at the same time saddening that our own fellow doctors can support the democratic party. The democrats give CRNAs the right to practice without MD supervision and take more of our tax money away to give to people who do not work (see county hospital population), I cannot fathom based on those 2 areas alone why you would support the democratic party (and MDs in general).

 

[Private Pyle]

tollway, my understanding of politics, and life in general is rudimentary at best, BUT, I think it makes sense that the way you make decisions that impact EVERYONE should NOT be done according to what applies specifically for you, or what is in YOUR best interest. When I decided to become a doctor, I did not sell out all of my philosophical beliefs. I will put a few dollars into helping out the brothaman, and the otherman. just because a political party, which has a lot of other sides to it, is kind to doctors, doesn't mean i'm going to choose them to represent the country. I have the ability to put myself in other people's shoes. obviously I'm not naive, and I know when i'm being taken advantage of...but all I'm saying is I am willing to bend in order to help others (so what if they're screw ups, can't we all just get along, be happy, and smoke rocks)..

PS. if the above sounds simplistic or dumb, it's cuz i dont know squat. but like forrest gump said: "i am not a smart man, but I know what love is".......

 

[MD Dreams]

I don't think it's a matter of republican or democrat. They both have their pluses and minuses. I think it's a matter of leadership. "President" Bush is not a leader, he's a puppet, a disgrace to this country. I'm neither republican nor democrat and in the past I've voted for both depending on whom I thought would be the better leader. However, I would rather vote for the prince of darkness than to vote or support Bush, even if it means paying more taxes and compromising job security.

By the way, I don't think the taxes we pay now, even if they are less than might be in the future, go towards the non-working man considering there are 42 MILLION americans without health insurance in the number one country in the world. I think they go towards missles and bombs and next generation fighter planes, and money to fuel airforce one so that Bush can take his month long vacations at his ranch while people are getting blown away as he's cooking his famous Barbeques.

I know this is an anesthesiology forum, and I apologize, I just couldn't resist.

 

[VentdependenT]

Can we please keep this simple. These soapbox vituperations are slamming through my considerable migrane threshold.

 

[jetproppilot]

Why don't more graduating anesthesia residents consider pediatric anesthesia? One might think that an ego-centric person would gravitate toward pediatric anesthesia because of the perception that any specialty prefaced by the word "PEDIATRIC" seems more prestigious than its adult counterpart (e.g. cardiovascular surgeon vs. PEDIATRIC cardiovascular surgeon; heme-onc doc vs. PEDIATRIC heme-onc, etc.).

😕

I've been in practice since 1996 and I've never heard that one.

 

[Atropine]

Why don't more graduating anesthesia residents consider pediatric anesthesia? One might think that an ego-centric person would gravitate toward pediatric anesthesia because of the perception that any specialty prefaced by the word "PEDIATRIC" seems more prestigious than its adult counterpart (e.g. cardiovascular surgeon vs. PEDIATRIC cardiovascular surgeon; heme-onc doc vs. PEDIATRIC heme-onc, etc.). As a pediatrician myself, I am unsure if this perception is well-founded. I just love to work with kids, and that's my own personal thing.

ABSOLUTELY! After multiple placebo controlled, double blind RCTs, we have statistically significant results suggesting that surprisingly, the simple act of treating children and adding those extra syllables add prestige to an MD's CV. See Journal of Udumass 10:250. ***** et al named these confounding results the 'minor extra syllable syndrome' and also extrapolated their data to conclude that physicians should add syllables to the names of their respective specialties to increase prestige.

Sincerely,

Dr. Stanley MiltonBradley Collins Jr. MD, DDS, DMD, FACP, MPH, JD, MBA, CEO, CFO
Pediatric Geriatric anesthesiologist extraordinaire

 

[UTSouthwestern]

While pediatric anesthesiology is a very enjoyable field, there are a few factors to consider before entering a pedi fellowship.

First, what type of practice are you looking at joining? If you want to do sick pedi patients/pedi hearts, you are likely looking at a large children's hospital in a major metropolitan area. That means overnight and weekend calls, ER coverage, etc.

If you plan to go into private practice in a non-major children's center, there are fewer groups that cover exclusively pediatric cases, so you will still be doing at least some adults. As a side note, one group in Dallas does pediatric anesthesia at a large hospital, but to supplement their income, also covers the OB service. Kind of a nice combination.

What you will see is that private anesthesiology groups (non-pedi fellowship trained), encroaching on your turf to do the privately insured/cash paying, ASA 1 & 2 cases at the shiny, new surgery center down the road that they just happen to cover. For the sicker patients, they will point the way to the children's center and pedi group to cover (and rightfully so). For the uninsured patients, they will also point the way to the center (not rightfully so). In essence, the private, non-fellowship trained guys are getting privately insured patients in exchange for doing those cases in a more comfortable, catered environment for the surgeons.

You will still get a large portion of well insured patients, but also a large portion of uninsured cases. At first you will not mind when you see those $400-600K annual paychecks, but as the wear and tear of calls, sick patients crashing and coding on you, and the seemingly endless supply of uninsured patients keeps coming, you will begin to question the structure of the situation. As Jet has said in the recent past, anesthesiologists do not just walk into a windfall of that size without working considerable hours and numbers of cases, and to make that $400+, you will be working very, VERY hard, unless you join a group with a 70%+ private insurance rate.

That being said, if I were to go back and pick a subspecialty of anesthesiology to retrain in, it would probably be pedi because as you said, the kids are the best patients to have. Understanding that you will eventually see kids die from their conditions or your errors and that while adults take 5 minutes to crash, kids take 5 seconds, you can keep an even keel and have a great and fulfilling career in pediatric anesthesiology.

 

[kidmd44]

While pediatric anesthesiology is a very enjoyable field, there are a few factors to consider before entering a pedi fellowship.

First, what type of practice are you looking at joining? If you want to do sick pedi patients/pedi hearts, you are likely looking at a large children's hospital in a major metropolitan area. That means overnight and weekend calls, ER coverage, etc.

If you plan to go into private practice in a non-major children's center, there are fewer groups that cover exclusively pediatric cases, so you will still be doing at least some adults. As a side note, one group in Dallas does pediatric anesthesia at a large hospital, but to supplement their income, also covers the OB service. Kind of a nice combination.

What you will see is that private anesthesiology groups (non-pedi fellowship trained), encroaching on your turf to do the privately insured/cash paying, ASA 1 & 2 cases at the shiny, new surgery center down the road that they just happen to cover. For the sicker patients, they will point the way to the children's center and pedi group to cover (and rightfully so). For the uninsured patients, they will also point the way to the center (not rightfully so). In essence, the private, non-fellowship trained guys are getting privately insured patients in exchange for doing those cases in a more comfortable, catered environment for the surgeons.

You will still get a large portion of well insured patients, but also a large portion of uninsured cases. At first you will not mind when you see those $400-600K annual paychecks, but as the wear and tear of calls, sick patients crashing and coding on you, and the seemingly endless supply of uninsured patients keeps coming, you will begin to question the structure of the situation. As Jet has said in the recent past, anesthesiologists do not just walk into a windfall of that size without working considerable hours and numbers of cases, and to make that $400+, you will be working very, VERY hard, unless you join a group with a 70%+ private insurance rate.

That being said, if I were to go back and pick a subspecialty of anesthesiology to retrain in, it would probably be pedi because as you said, the kids are the best patients to have. Understanding that you will eventually see kids die from their conditions or your errors and that while adults take 5 minutes to crash, kids take 5 seconds, you can keep an even keel and have a great and fulfilling career in pediatric anesthesiology.

Thank you for your outstanding reply, UT. You are indeed very professional and I appreciate that.

 

[kidmd44]

ABSOLUTELY! After multiple placebo controlled, double blind RCTs, we have statistically significant results suggesting that surprisingly, the simple act of treating children and adding those extra syllables add prestige to an MD's CV. See Journal of Udumass 10:250. ***** et al named these confounding results the 'minor extra syllable syndrome' and also extrapolated their data to conclude that physicians should add syllables to the names of their respective specialties to increase prestige.

Sincerely,

Dr. Stanley MiltonBradley Collins Jr. MD, DDS, DMD, FACP, MPH, JD, MBA, CEO, CFO
Pediatric Geriatric anesthesiologist extraordinaire

Thank you Atropine!! He'll be here all week, ladies and gentlemen. Be sure to tip your servers before you leave. Thank you, and good night now!

 

[Atropine]

Thank you Atropine!! He'll be here all week, ladies and gentlemen. Be sure to tip your servers before you leave. Thank you, and good night now!

I am truly offended that you did not address me as Dr. "Pediatric" Atropine. I didn't go through pediatrics to be called just Dr. Atropine.

BTW, you're like, so awesome at doing curtain calls! If you become an MC you can add that prestigious title to your name. Way cool duuuude!

 

[UTSouthwestern]

Thank you for your outstanding reply, UT. You are indeed very professional and I appreciate that.

You're welcome. We're all in this together and if we can help each other with problems, help each other to avoid mistakes we have made, or even help with the job/fellowship search, let's make it happen.

 

[kidmd44]

I am truly offended that you did not address me as Dr. "Pediatric" Atropine. I didn't go through pediatrics to be called just Dr. Atropine.

BTW, you're like, so awesome at doing curtain calls! If you become an MC you can add that prestigious title to your name. Way cool duuuude!

Hey, good comeback, man. I liked the extra U's in "duuude."