Private practice feasible for average anesthesiologist?

[sebsvenmdc]

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Dear All,

Today, I heard an Attending remark that private practice is very difficult to do in the US...his reasoning was that one has to be very efficient to do well. It kind of got me worried because I have been thinking about a career in anesthesiology, and specifically, private practice. My question is: is it possible in your opinion for an average (in terms of talent) anesthesiologist to make it in private practice or is it relegated to an elite top percentage...something that would be surprising to me. If PP doesn't work out, most can "fall into" (although I was under the impression that academic attendings are ahead of PP anesthesiologists) teaching hospitals et cetera?

 

[GasEmDee]

Dear All,

Today, I heard an Attending remark that private practice is very difficult to do in the US...his reasoning was that one has to be very efficient to do well. It kind of got me worried because I have been thinking about a career in anesthesiology, and specifically, private practice. My question is: is it possible in your opinion for an average (in terms of talent) anesthesiologist to make it in private practice or is it relegated to an elite top percentage...something that would be surprising to me. If PP doesn't work out, most can "fall into" (although I was under the impression that academic attendings are ahead of PP anesthesiologists) teaching hospitals et cetera?

Don't really understand this. Most anesthesiologists are in private practice. I work in both an academic setting and a private practice. Need to be more efficient in the later, for certain, but that is what most people do. Its not difficult. Maybe he is just really, really slow?

 

[IlDestriero]

Dear All,

Today, I heard an Attending remark that private practice is very difficult to do in the US...his reasoning was that one has to be very efficient to do well. It kind of got me worried because I have been thinking about a career in anesthesiology, and specifically, private practice. My question is: is it possible in your opinion for an average (in terms of talent) anesthesiologist to make it in private practice or is it relegated to an elite top percentage...something that would be surprising to me. If PP doesn't work out, most can "fall into" (although I was under the impression that academic attendings are ahead of PP anesthesiologists) teaching hospitals et cetera?

Private practice requires efficiency or you will get killed, by the surgeons and your partners. It can be learned by almost anyone, like any other skill. However, it is not taught very well in residency. You have to see what others do and modify your practice. Read the Jet Pearl on pushing your room. It can be done. I try to do it when I am not on call and whenever I'm in an ASC, to try to get out a bit early. All those saved minutes add up quickly. In the room, asleep, awake, prompt turnover, repeat. Could easily be an hour. Academics attracts the best and the worst and is usually the model of inefficiency. The elite programs tend to favor the former over the latter. The PP world is full of great former academic anesthesiologists that couldn't stomach the inefficiency anymore.

 

[Bertelman]

Dear All,

Today, I heard an Attending remark that private practice is very difficult to do in the US...his reasoning was that one has to be very efficient to do well. It kind of got me worried because I have been thinking about a career in anesthesiology, and specifically, private practice. My question is: is it possible in your opinion for an average (in terms of talent) anesthesiologist to make it in private practice or is it relegated to an elite top percentage...something that would be surprising to me. If PP doesn't work out, most can "fall into" (although I was under the impression that academic attendings are ahead of PP anesthesiologists) teaching hospitals et cetera?

1) How do you know you will be an average anesthesiologist?

b) yes, if by "elite top percentage" you mean the top 85%.

 

[sebsvenmdc]

Hey, thanks for all of the comments, guys! I appreciate the feedback. I guess it just seemed (or perhaps I misread) that the attending was implying that the type of efficiency required to thrive in PP is a skill that a good number of anesthesiologists might not have. He certainly seemed smart and skillled...and not overly inefficient. Perhaps he was misrepresenting the actuality.

 

[sebsvenmdc]

1) How do you know you will be an average anesthesiologist?

b) yes, if by "elite top percentage" you mean the top 85%.

Being an average anesthesiologist would be a worst case scenario...I hope to be a great one! I strive for excellence and work very hard. Academically, I'm definitely above average! Clinically, I'm not so special...need to improve on this one a lot!

 

[sebsvenmdc]

Private practice requires efficiency or you will get killed, by the surgeons and your partners. It can be learned by almost anyone, like any other skill. However, it is not taught very well in residency. You have to see what others do and modify your practice. Read the Jet Pearl on pushing your room. It can be done. I try to do it when I am not on call and whenever I'm in an ASC, to try to get out a bit early. All those saved minutes add up quickly. In the room, asleep, awake, prompt turnover, repeat. Could easily be an hour. Academics attracts the best and the worst and is usually the model of inefficiency. The elite programs tend to favor the former over the latter. The PP world is full of great former academic anesthesiologists that couldn't stomach the inefficiency anymore.

That's reassuring! Thanks for the advice! I'm definitely up for the challenge, but I wanted to know what kind of odds I was facing even if I give the career my max effort! It's encouraging that you think this is a skill that can be learned by most.

 

[Voodoo]

It took me a couple months to break a lot of the bad (i.e. inefficient) habits from residency. Just watch your partners and pick up tips where you can. Residencies in general do a poor job in preparing upcoming grads for life in private practice. Most groups realize this and break you in over a period of time where they don't schedule you in high turnover rooms or keep you away from those certain surgeons.

Don't sweat it - you'll do fine and just remember that patient care comes first. If you think a particular practice is unsafe, do not do it to "cut corners" just because partner X does it all the time and hasn't gotten burned so far. Rely on your training, keep efficiency in the back of your mind, and you'll go far.