Private practice if cardiac and critical care trained?

[NunquamDormio]

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I'm in Fellowships for Critical Care and Cardiothoracic Anesthesia. The training I'm getting is excellent and I find both fields interesting. However, I am losing interest in academic life and afraid that I'll be so sub-specialized when I graduate that I'll only be able to work in massive academic centers like the one I'm at now.

Will private practice even be an option for me when I graduate? Does anyone know if there are private practice, or "acadivate" positions out there for anesthesiologists with dual training? And if so, are there any that have enough incentives to justify the extra year of training?

 

[Gaseous Clay]

Assuming no red flags, you're easy to work with and a team player, I'd find you to be an excellent candidate to join our private practice. I do not see any reason a practice would find you "undesirable" because you have two fellowships under your belt.

BTW, we are looking to hire for 2019 so feel free to message me if interested (located in Georgia).

 

[deleted87051]

If you’re willing to give up critical care, your options are wide open. If you must practice CCM, most of your choices will be in academics.

 

[Psai]

Assuming no red flags, you're easy to work with and a team player, I'd find you to be an excellent candidate to join our private practice. I do not see any reason a practice would find you "undesirable" because you have two fellowships under your belt.

BTW, we are looking to hire for 2019 so feel free to message me if interested (located in Georgia).

I am noncardiac or critical care trained but am excellent

 

[deleted162650]

I am noncardiac or critical care trained but am excellent

At what??

 

[Southpaw]

What @nimbus said. Really wish a lot of the critical care trainees would survey the market before such an undertaking, unless they all just want to stay in academics. Private practice anes CC is very few and far between. However, the year of cardiac is increasingly useful.

To the question at hand, if you’re a normal person and a team player the world is your oyster. If not, well....

 

[psychbender]

You can most definitely find a job doing cardiac in the private sector once you're done with training. The real issue is adding critical care into the mix. There are very few private mixed anesthesiology and critical care opportunities out there. If you want to work on the east coast, and don't mind covering CRNAs in the OR, there is a group in Bethlehem, PA that may suite you. They have a group of CCM-trained anesthesiologists, and I met one partner that is dual CT/CCM trained. There's also a group in Missoula, MT, and OAG in Oregon. Other than that, you're really going to have to know someone, get lucky, or try to carve out what you want by piecing together different jobs (like FT CCM and locums cardiac, or FT cardiac anesthesia with locums CCM on weekends and vacation).

I have also seen some CT jobs advertised, where the CT anesthesiologists have the option to pick up additional time in the CTICU (one hiring now in Winchester, VA), or include rounding in the ICU before cases start (or in the afternoon). One of those practices might interest you, although I imagine those CTICUs are not going to be like what you are used to in academics.

 

[Gaseous Clay]

I am noncardiac or critical care trained but am excellent

Are you looking for a job?

 

[sethco]

Not much to add to above. There are few practices where you can do both but you have to look hard. @bigdan is both cardiac and ICU trained and able to do both. I have one person in my practice that is dual trained but he doesn't have any opportunity to do both in our practice. I asked him about dual opportunities in my state, out of curiosity, and the only possibilities were academic. He currently doesn't do any ICU, but does a very high volume of cardiac like the rest of us. I would never call an ICU fellowship a year wasted, as I still think it has value even if he doesn't ever practice in the unit. If you are interested in practicing in the DFW area doing primarily Cardiac, drop me a PM.

 

[NunquamDormio]

Assuming no red flags, you're easy to work with and a team player, I'd find you to be an excellent candidate to join our private practice. I do not see any reason a practice would find you "undesirable" because you have two fellowships under your belt.

BTW, we are looking to hire for 2019 so feel free to message me if interested (located in Georgia).

Do you guys cover ICU and do cardiac cases?

 

[T-burglar]

I doubt that training itself will hold you back from finding *A* job somewhere. I don’t think that combo is weird and possibly a red flag some some multi fellowship paths I’ve seen.

But like others have said - private practices Are mostly lookin for someone to bang it out in the OR. Any time you spend out of the OR during heavy operating hours is a gap in staff coverage of the OR that needs to be filled by others, unless you do it during vacation weeks lol.


Probably what you need in order to do both is find a practice that feels that the extra effort and possibly lost cash that comes with covering an ICU is worth it in what you gain in standing in the hospital

 

[Gaseous Clay]

Do you guys cover ICU and do cardiac cases?

Maybe I misinterpreted your original post. As others have said, to do both CCM and cardiac would be very tough to find in PP. We don’t cover ICU though it certainly feels that way at times. Our Intensivists actually take home call (cover both hospitals in town and an LTAC) so occasionally we get dumped on in the middle of the night to bail them out of an intubation, art line, or CVL.

 

[chocomorsel]

What @nimbus said. Really wish a lot of the critical care trainees would survey the market before such an undertaking, unless they all just want to stay in academics. Private practice anes CC is very few and far between. However, the year of cardiac is increasingly useful.

To the question at hand, if you’re a normal person and a team player the world is your oyster. If not, well....

Some of us want out of the "cranking out cases" in the OR like the patients are a bunch of cattle.
It's so nice now to take a normal lunch break and pee when I want without worrying about delaying things and skipping out in the middle of a case. Do not miss the many days where I was snacking/eating behind the drape or missing lunches too damn often. I am already thin enough. I may gain weight this year, lol.

 

[OB1🤙]

My PP group hires both cardiac and CCM. It exists.

 

[deleted171991]

What @nimbus said. Really wish a lot of the critical care trainees would survey the market before such an undertaking, unless they all just want to stay in academics. Private practice anes CC is very few and far between.

Not only that, but they will always suspect you that you are just using them as a short-term position, while looking for your combined dream job.

CCM is a red flag for PP employers. They also tend to think: this guy couldn't get a better fellowship out of residency, so he went into CCM. (Obviously, this is less likely when combined with hearts.) Just my 2 cents, so that you understand the psychology.

I LOVE (and practice) critical care, and still I think it can easily be a wasted year, especially if one has a cardiac fellowship. Accept it, and you'll be happier. The PP world is full of opportunities for cardiac anesthesiologists. Get a good partnership track position in cardiac anesthesia, and forget CCM.

 

[Southpaw]

My PP group hires both cardiac and CCM. It exists.

Does your group cover the ICU?

 

[Mman]

the reason there is extremely little use for CCM in private practice is that the reimbursement for it is pitiful in comparison to working in the OR. You'd need a sizable subsidy from a hospital to make it a good use of your time financially.

 

[Twiggidy]

Stay in academics.

What’s going to happen is you’re going to join a private practice and do some hearts but the other big parts of you practice will be BS like OB call. That’s not why you did those fellowships. You want to do something like a couple weeks in the OR with mostly hearts and some other stuff and then a couple of weeks in the ICU. This all assumes your primary goal isn’t money. If money is what you seek then join a private practice and do whatever they ask you to do.

 

[OB1🤙]

Does your group cover the ICU?

Yah.

 

[cf817]

I'm in Fellowships for Critical Care and Cardiothoracic Anesthesia. The training I'm getting is excellent and I find both fields interesting. However, I am losing interest in academic life and afraid that I'll be so sub-specialized when I graduate that I'll only be able to work in massive academic centers like the one I'm at now.

Will private practice even be an option for me when I graduate? Does anyone know if there are private practice, or "acadivate" positions out there for anesthesiologists with dual training? And if so, are there any that have enough incentives to justify the extra year of training?

I know of a person who was previously in academics doing both CCM and OR, then decided to go the PP route. She negotiated 4 weeks OR and then stayed on part time to do one week ICU at her old institution. Rare, yes...but can happen.

 

[anes121508]

One of my good friends who is fairly active on this forum (he won't tell me his SN 🙂), is currently job searching with cardiac and ICU fellowship training.

My group is currently looking for a cardiac and ICU trained person. And by my group I mean the people that own me (TeamHealth).

PM me and I'll ask my buddy if it's ok to send you his number. Heck, I bet my group would give you an offer in advance.