Perceived Lifestyle of the Anesthesiologist

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GasDaddy

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A lot of medical students really believe that anesthesiologists just read the newspaper all day. I thought I'd make a thread pointing out the not so positive aspects of the field. I think it gives people a better idea of what they are getting themselves into.

1) you have to be at the hospital eary everyday for the rest of your life, even as an attending. anywhere from 6:00-6:30. At my hospital, the attendings are there right at 645-7am. And you have to do whats best for the group.... that can often mean skipping out on lunch or not taking a break at all and essentially being a factory worker, if you're set up at a busy hospital.

2) There is no way to avoid call as an attending, unless you're REALLY established in the group. And when you take call, you have to stay in the hospital. No way to get around it. I have heard residents talk about getting locum jobs and avoiding call altogether. I don't know the details on that. My friends dad is an established attending with over 20 years experience in a group in the south and has a great set up, but still takes call regularly and has to be away from his family to stay at the hospital. The guy is ALWAYS tired.

3) When **** hits the fan, you have to step in and take care of business. You better have seen some wild wild cases before you decide to take the big step into this field. Otherwise you will be in for QUITE a few surprises and will see how stressful it really is. People's lives are quite literally right in your hands. You definately deal with some wild situations and need to be able to think quick.

4) If financial rewards are your thing.... here is something to munch on... according to dr. ronald miller, on an article that can be found online written in 2002 for the ASA....

http://www.asahq.org/Newsletters/2002/12_02/whatsNew12_02.html


he mentions, "several indicators suggest that we may not be creating new knowledge as rapidly as other specialties. Our National Institutes of Health (NIH) funding is less than many other specialties."

"most of the funding is directed to less than 20 of the more than 100 training programs in the United States. "

"Thirty years ago, Richard J. Kitz, M.D., and Julien F. Biebuyck, M.D., stated, “A discipline not continually engaged in an active and imaginative program of research is dead, and will not advance and will probably deteriorate in general standards and efficiency.”"


Read the article, get a better idea and maybe people can post with their opinions. But Dr. Miller mentions that the anesthesiologist of the future is geared heavily towards being the hospitalist of the future, since perioperative management seems to be the one aspect of the field that is pretty much secure for the future. Even pain management is very slowly being gobbled up by other specialties. Anesthesiologists still take most of the spots, though.

He also mentions that Anesthesiology has retained its power through the ASA and other political means. Which may or may not be a good sign, depending on how you look at it. Ultimately, you need political power, but how long can political power ensure the security of the future?


Something to munch on. Hope I didn't offend the more established people on here.

-GasDaddy

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Something to munch on. Hope I didn't offend the more established people on here.

-GasDaddy

Not me...maybe some of the bitter attendings and attendings to be.....what you said is what I know already....but which many don't want to accept as the future.
 
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It is quite possible to get jobs without call, whether it be locums, pain, or ambulatory. Also, our group allows some of the older guys to not take call, but of course they make less. And yes there is call from home.
 
Thank you for starting this thread.

I think it's important to consider the negatives of any career you are considering.

I'm a PGY 3 in gen surg, considering switching. Anestheisa is one area I'm considering.

My reasons for my sudden unhappieness include the following

1. I'm finding there are a lot of operations I really don't like to do. I like mucking around in the abdomen, don't like vascular and HATE laparoscopy (which is rapidly expanding). But I still like the OR environment.

2. I'm growing increasingly intolerate of rounds and clinic, and dealing with pts and families in any more than just the briefest interactions.

3. I'm starting to hear about the types of phone calls attendings get from their pts when on call (sometimes even when not on call)

4. I've never been so totally fatigued in my life, as a more senior resident I"m now working 15 hours days with less in house call. More of that time is in the OR. I have unbelievable back pain most of the time. I can feel my health decline becuase I can't eat properly and am too exausted to go to the gym. As PGY 1-2, I'd go after I left the hosptial post call (always at a defined time).

5. I have less of a social life than I ever did. At least with in house call, you know when you can leave and can plan accordingly. Now I am at the mercy of the add on case. Since you can't predict what day some ED pt will need to be added on, you can never know when you can leave the hosptial and cannot make plans to do anything. THe past 2 saturdays I was going to just round, but wound up staying all day...thanks to the add on.

6. The more I learn about reimbursement the more I think it is ridiculous. Did you know that a mediport pays more than a lap chole, an appy, a hernia, or a mastectomy? that is crazy...who comes up with this stuff?

I would definitely like to hear more about what people in your field don't like about it. I'd hate to switch and then regret it. Personally, I'm an early bird so getting up early doesn't bother me (at least you can just go to the OR...no rounds!) and in house call doesnt' bother me either (you know at 7 am or whatever time, your relief is there and now whatever comes in is someone else's problem)

Any info you guys have on anesthesia reimbursement would be appreciated too.
 
Read this thread.

It contains a lot of information you need.

The difference between surgery and anesthesia in terms of building a practice is this....as a surgeon, you cater to primary care folks for referrals.....as an anesthesiologist, you cater to surgeons and hospital administrators for their referrals....
 
It contains a lot of information you need.

no it doesn't. :rolleyes:

you should read this thread, though:

http://forums.gasforums.net/showthread.php?t=325186

this is the **** you need to know when you're coming out of residency. the other thread just basically preaches to you how to be a good little soldier and fall in line, which you should already have learned in med school and residency... with no guarantees. or, maybe, just maybe, some of you actually still do need to learn the hard way when you finish residency...
 
Supercut,

FWIW....my perspective is of someone who has been in practice for 10 years...Boarded in anesthesia and CCM....practiced in the military...as a sole provider...and in an academic setting (voted teacher of the year....chairmen of the education committee)...currently own my practice....in the process of obtaining ownership of other practices if luck holds....

Then there is the other perspective...

Old resident who has no practice experience..not boarded...no job yet...and who has moved from career to career...trying to find a nich.
 
Given what's been said then, is the OP discouraging folks from entering this field, citing that it's "dead?" Yes, I saw the part about anesthesiologists becoming the new "hospitalists." But the whole gist of the thread seems, well, negative frankly. I'm not trying to argue or disagree I'm just honestly curious about the OP's opinion, and militarymd's, as two people who are in the field and have experience: should people like me (third year med students) be thinking of going into anesthesiology?
 
James T.

enter the field if you find it interesting....if you would be willing to do it for 90,000 a year....if you would be willing to do it 80 hours a week....if you're willing to have no recognition do it...

I did.
 
Old resident who has no practice experience..not boarded...no job yet...and who has moved from career to career...trying to find a nich.

That's a great line to recruit new anesthesiologists that may just happen to be non-trad. Just role out the welcome mat why don't you?

Am I to believe that being "old" contributes to being worthless? Is having previous life experience vs. going straight from undergrad a sure sign of moving from career to career, trying to find a niche? Or, maybe just a detour because of a youthful overexuberant <sp?> undergrad experience years ago? I only ask because the brush you are painting with seems to have very broad strokes.
 
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Most people end up in groups whose priorities are aligned with their own. Some people like to work like dogs, drive fancy cars, take expensive vacations and retire early. Others like more balance in their daily lives. In anesthesia you CAN choose.

I am at a level 1 trauma center, but we have 16-18 people to share call. Typically I take night call once or twice a month, starting at 1700 and finishing at 0700. I am in house. 60% of the time I finish around midnight and then sleep all night. 30% of the time I sleep 2-4 hrs. 10% of the time, about twice a year, I am up all night. I take 2nd and 3rd call two or 3 times a month as well. these can be more strenuous than night call. I start at 0700 and finish between 1900 and midnight. After these days, I have the day off or just a couple of short, easy cases. I take call 1 weekend/month and also typically average 1 weekday off or nearly off (finish by 10am) every week. So I have some 15-16 hour days but also have lots of days off or nearly off to enjoy the sunshine and outdoor activities. "average" noncall days are 0700 to 1400 or 1700. Vacation varies from 8-11 weeks per year. We are FFS with a call stipend from the hospital. Some of my partners take less vacation and make more money than me.

I have been in 3 other practices before this one. They all offered better lifestyle with less night/evening/weekend work than my current job. I chose this one for location+income. I still consider the lifestyle very good. We have a lot of partners so our schedule is very flexible. Whenever I want or need a day off, I can find someone to take my place. Most days I enjoy being in the OR so I consider the anesthesia lifestyle to be very good. The only other field I might consider is Rays and that only because the money is better. To the OP, I am most certainly not always tired. Most days I feel great and enjoy running and riding my bike.
 
A lot of medical students really believe that anesthesiologists just read the newspaper all day. I thought I'd make a thread pointing out the not so positive aspects of the field. I think it gives people a better idea of what they are getting themselves into.

1) you have to be at the hospital eary everyday for the rest of your life, even as an attending. anywhere from 6:00-6:30. At my hospital, the attendings are there right at 645-7am. And you have to do whats best for the group.... that can often mean skipping out on lunch or not taking a break at all and essentially being a factory worker, if you're set up at a busy hospital.

2) There is no way to avoid call as an attending, unless you're REALLY established in the group. And when you take call, you have to stay in the hospital. No way to get around it. I have heard residents talk about getting locum jobs and avoiding call altogether. I don't know the details on that. My friends dad is an established attending with over 20 years experience in a group in the south and has a great set up, but still takes call regularly and has to be away from his family to stay at the hospital. The guy is ALWAYS tired.

3) When **** hits the fan, you have to step in and take care of business. You better have seen some wild wild cases before you decide to take the big step into this field. Otherwise you will be in for QUITE a few surprises and will see how stressful it really is. People's lives are quite literally right in your hands. You definately deal with some wild situations and need to be able to think quick.

4) If financial rewards are your thing.... here is something to munch on... according to dr. ronald miller, on an article that can be found online written in 2002 for the ASA....

http://www.asahq.org/Newsletters/2002/12_02/whatsNew12_02.html


he mentions, "several indicators suggest that we may not be creating new knowledge as rapidly as other specialties. Our National Institutes of Health (NIH) funding is less than many other specialties."

"most of the funding is directed to less than 20 of the more than 100 training programs in the United States. "

"Thirty years ago, Richard J. Kitz, M.D., and Julien F. Biebuyck, M.D., stated, “A discipline not continually engaged in an active and imaginative program of research is dead, and will not advance and will probably deteriorate in general standards and efficiency.”"


Read the article, get a better idea and maybe people can post with their opinions. But Dr. Miller mentions that the anesthesiologist of the future is geared heavily towards being the hospitalist of the future, since perioperative management seems to be the one aspect of the field that is pretty much secure for the future. Even pain management is very slowly being gobbled up by other specialties. Anesthesiologists still take most of the spots, though.

He also mentions that Anesthesiology has retained its power through the ASA and other political means. Which may or may not be a good sign, depending on how you look at it. Ultimately, you need political power, but how long can political power ensure the security of the future?


Something to munch on. Hope I didn't offend the more established people on here.

-GasDaddy


I think you answered your own question.

Need some advice about getting Anesthes

--------------------------------------------------------------------------------

Hey guys,
Im currently a 3rd year med student at St. Georges Univ (foreign med school) and am interested in anesthesiology. I got a 225/91 on step 1. my grades in basic sciences werent that great, about a 2.85 or so. i really want to do anesthes for the lifestyle, more hands on approach, and being able to live a good life. it seems my school is able to match anesthes well, but i hear its getting really competitive lately. so my questions.....

what should i do to get an anesthes residency? am i in ok shape? board scores ok?

how is the lifestyle for anesthes? do u really have that much free time? i hear so many different stories about that. it looks like u cant ever get away from being on call. how often do u have to be on call as a working anesthesiologist?

do u have to work in a group or can u work alone for a hospital?

what about salaries? how much do u make on average? i hear varying answers about this?

will we have a job for life and still get paid wel and have a good lifestyle for our lifetimes?


sorry guys, this is all over the place. i reallly never have time to post. im in the ER at my hospital now. im oncall today, im doing my first rotation in medicine. anyhow, i appreciate any replies and help. i really thinki awnt to do anesthes, but really want to make sure i know what im getting into. thanks gyus
-gasdaddy
 
Another thing that is a drawback in my opinion is the constant exposure to fluoroscopy and xrays in the OR. you better get your superlead! god, that is annoying. talk about occupational hazard. i feel sorry for the interventional radiology guys!
 
toughlife, it took me a year to get the answers to those questions and to fully see the worst side of anesthesiology first hand in the hospital, so I can then see if I am suited for this field. I'm a 4th year applying to anesthesiology right now. I still feel there is a lot that I don't know and will never know until I am actually an anesthesiology resident. that being said, i thought i'd make that post for the 3rd years and even the 4th years who are also applying to anesthesiology who still have absolutely no idea what they are getting themselves into. why go into something if you haven't explored every aspect of it. and a good way to guage if you are well suited for a field is if you know and can deal with its most negative aspects. please correct me if i am wrong.

as you can see, those were all questions I had when i started, and the hype of anesthesiology being a well paid super lifestyle field definately was on my mind. now i realize that reality is very different than a lot of the hype surrounding the field right now.
 
Then there is the other perspective...

Old resident who has no practice experience..not boarded...no job yet...and who has moved from career to career...trying to find a nich.

That's a great line to recruit new anesthesiologists that may just happen to be non-trad. Just role out the welcome mat why don't you?

Am I to believe that being "old" contributes to being worthless? Is having previous life experience vs. going straight from undergrad a sure sign of moving from career to career, trying to find a niche? Or, maybe just a detour because of a youthful overexuberant <sp?> undergrad experience years ago? I only ask because the brush you are painting with seems to have very broad strokes.

I'm not trying to recruit anyone, and if one were going to recruit....one should be themselves...as they would on the internet....that ways you recruit similar type of people...as nimbus pointed out.

And...I'm not painting anything....the post was simply pointing out the "perspectives" of the relative opinions posted...FWIW

A lot of people like to read into things.
 
toughlife, it took me a year to get the answers to those questions and to fully see the worst side of anesthesiology first hand in the hospital, so I can then see if I am suited for this field. I'm a 4th year applying to anesthesiology right now. I still feel there is a lot that I don't know and will never know until I am actually an anesthesiology resident. that being said, i thought i'd make that post for the 3rd years and even the 4th years who are also applying to anesthesiology who still have absolutely no idea what they are getting themselves into. why go into something if you haven't explored every aspect of it. and a good way to guage if you are well suited for a field is if you know and can deal with its most negative aspects. please correct me if i am wrong.

as you can see, those were all questions I had when i started, and the hype of anesthesiology being a well paid super lifestyle field definately was on my mind. now i realize that reality is very different than a lot of the hype surrounding the field right now.

Anesthesiology sucks... you all should immediately withdraw your applications! Please?:laugh:
 
i think the op is a medicalstudent who looks at his/her futurelifestyle under the assumption that he/she will stay in an academic center with all its benefits and disadvantages....
i work in a smaller (200 beds) hospital, big enough to be interesting, small enough to be personable. no, i do not take night call, my partners are happy to earn that money , yes, when i work i work hard but i have control over what i do .
i do think the most stress is generated due to lack of control over ones workenvironment , at least i perceived it that way during intership/residency/fellowship....
my take on it is that its better to be the captain of a tugboat than the deckscrubber on the queen mary;)
fasto
 
Just to comment....

As an "old resident" who left anesthesiology (for various reasons), I now find myself with numerous options.

With an MD license, I can:

1) Retrain in another specialty

2) Work as a hospitalist for decent pay and my own schedule

3) Get into industrial work. For example, it was pointed out to me that a physician who trained on two years post-graduate is now the worldwide head of Research and Development for a major pharmaceutical conglomerate.

Alternative careers are rarely preached in medicine, as we have all been trained to follow the "traditional" path. But there are many, many options to those that do not complete a residency. One simply has to know where to look for them.
 
I find this post quite humerous.... esp cus I am applyin right now

The truth is I have about 15 docs in my family. Many of them medicine and few anesthesia.

Here are the perks with anesthesia, from my point of view

No three years of any crap before you can really do what you want, we have to only do one year of worthless crap... well im sure it has some value..

you dont bring work home, when your done, your done... and the great thing is when we work, we work... we dont take one hr lunches or bs with the drug reps... simply stated work hard and then play hard...

you can pick up and leave whenever you want, you dont have to worry about leaving pts behind

you dont usually ever work weekends unless you choose to or take call maybe once a month, you usually dont have a choice in medicine or other fields

Finally you enjoy what you are doing. I maybe a naive young medical student. In medicine no matter what you do you will make excellent money if you know how and even if dont know how, trust you will not starve and yes you can drive a benz.....

anywayz this is my piece... I think its funny everytime somebody posts this crap trying to discourage peeps from a field...




Just to comment....

As an "old resident" who left anesthesiology (for various reasons), I now find myself with numerous options.

With an MD license, I can:

1) Retrain in another specialty

2) Work as a hospitalist for decent pay and my own schedule

3) Get into industrial work. For example, it was pointed out to me that a physician who trained on two years post-graduate is now the worldwide head of Research and Development for a major pharmaceutical conglomerate.

Alternative careers are rarely preached in medicine, as we have all been trained to follow the "traditional" path. But there are many, many options to those that do not complete a residency. One simply has to know where to look for them.
 
My badd for the grammitical errors above... im sure you figa out what i am saying...
 
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