Questioning anesthesia as a career

[jetproppilot]

I'm sitting here in my living room writing. My girlfriend has to work tomorrow, I don't. She's asleep upstairs, I'm not.
Rage Against The Machine fills the air around me. I can see....no...that's an understatement.... I can
FEEL
Zach de la Rocha bolt out Bulls On Parade
in my living room
TONIGHT!!!
The song is literally playing as I post this.

I have a message I'd like to share.

Yeah, medicine is changing.

A lotta

DICTATION

is happening from people we as doctors

would rather

HAPPILY IGNORE....

insurance companies....

paraprofessionals....

blah blah blah

This post isn't about the struggles of our profession.

This post is about the fact that

Jesus Christ I've been in private practice for

SIXTEEN YEARS NOW AND I STILL

LOVE MY JOB.

After sixteen years, I still awaken spontaneously on work days at

5 AM.

And I don't just awaken.

I awaken

EAGER.

Because I love my job. I

LOVE

being an

ANESTHESIOLOGIST,

dudes.

It's important to me that you know that.

---

Members don't see this ad.

 

[Limetime]

Inspiring as always Jet, thanks for sharing!

 

[dhb]

I'm happy to work as an anesthesiologist but i don't see myself doing it for more than 10y...

 

[imfrankie]

I enjoy taking care of the patients and would do it for less money

 

[scudrunner]

That's what it' all about, Jet.

 

[Gimlet]

Blasting Rage while your GF is trying to sleep....that's ballsy, Jet!

 

[countingdays]

Blasting Rage while your GF is trying to sleep....that's ballsy, Jet!

 

[amidoinitrite]

as match day approaches, this makes me happy. Thanks bud

 

[pgg]

I love everything about anesthesia, except the bits that happen at 2:30 AM.

 

[geogil]

This post does me some good as I chug my way through internship second guessing my choice to even pursue medicine, but feeling trapped by debt.

 

[pd4emergence]

Here's my take:
Anesthesiology is the coolest specialty around. Mostly the good stuff. Mostly taking care of patients, doing procedures, and immediate gratification because you get to see your interventions, or drugs, or blocks work. It's physiology in real life and real time. No clinic, no dictations, no h and p's. Ive got 4 big cases tomorrow to start. Circ arrest aorta, a big ant/post neck case, a big stem to stern back, and a cabg. It's gonna be a good day and I can't wait to get there.

 

[cincincyreds]

I love everything about anesthesia, except the bits that happen at 2:30 AM.

I don't worry about 230am anymore as I leave by 5pm. You should too as it will improve the quality of your life.

 

[pgg]

I don't worry about 230am anymore as I leave by 5pm. You should too as it will improve the quality of your life.

Hire CRNAs to cover all the nights, weekends, and OB, right?

 

[jetproppilot]

This post does me some good as I chug my way through internship second guessing my choice to even pursue medicine, but feeling trapped by debt.

Sounds like you need to go to the Family Medicine forum and read my post...btw I received an infraction for resurrecting it....

Uhhhhhhh......MODERATORS WHO GAVE ME AN INFRACTION.....

READ THIS INDIVIDUAL'S POST.

I'M NOT TRYING TO, AS YOU PUT IT,

"FLAME"

ANYBODY.

I'm posting

THE TRUTH

about salaries,

and how said salaries are important to

DEBT LADEN STUDENTS.

INFRACTION?

HAHAHAHAHA

No man.

The Thruth.

For a

DEBT FILLED STUDENT LIKE THE DUDE THAT POSTED THIS OP.

And SDN is

CENSORING ME

because I choose to share

MY OPINION

about med students and their fears about paying off

TWO HUNDRED LARGE

MODERATORS,

SEND ME ALL THE INFRACTIONS YOU FEEL THE NEED FOR.

When you're done with your little gate-keeping, power filled

MINUTE,

Read this dude's

ORIGINAL POST, MAN.

NOBODY TALKS FINANCIALS IN MED SCHOOL.

NOBODY.

AND YOU'RE GONNA GIVE ME AN INFRACTION FOR POSTING "WHY MAKE 150k WHEN 450k IS OUT THERE?"

To med students out there weighed down with

TWO HUNDRED LARGE PLUS

in student loans?

I GET AN AN INFRACTION FOR

"FLAMING?"

No man.

We all have opinions.

I believe med students need to be educated better about the balance between

THEIR STUDENT LOAN DEBT AND

HOW THEIR CHOSEN SPECIALTY IS GONNA HELP THEM

OR HURT THEM

WITH SAID

DEBT.

Certain specialties in medicine pay

MORE.

Certain specialties pay

LESS.

I didn't make the rules.

IF YOU ARE 200k or more in student loan debt, monetarily,

THE SPECIALTY YOU SELECT WILL DRAMATICALLY EFFECT YOUR

MONETARY LIFE.

Now, it's obviously

POLITICALLY INCORRECT FOR ME TO TELL YOU THAT SINCE, WELL,

I've received an infraction from SDN

for posting my concerns about med students out there with alotta debt,

their specialty choices, and how their specialty choice will affect the

REST OF THEIR LIFE.

INFRACTION FOR ME.

FOR THAT.

Looks like we've got a Buncha

NAIVE MODERATORS.

Wait, whats that

FREEDOM OF SPEECH AMENDMENT?

I'm sorry.... I forgot which number...

 

[jetproppilot]

Sounds like you need to go to the Family Medicine forum and read my post...btw I received an infraction for resurrecting it....

Uhhhhhhh......MODERATORS WHO GAVE ME AN INFRACTION.....

READ THIS INDIVIDUAL'S POST.

I'M NOT TRYING TO, AS YOU PUT IT,

"FLAME"

ANYBODY.

I'm posting

THE TRUTH

about salaries,

and how said salaries are important to

DEBT LADEN STUDENTS.

INFRACTION?

HAHAHAHAHA

No man.

The Thruth.

For a

DEBT FILLED STUDENT LIKE THE DUDE THAT POSTED THIS OP.

And SDN is

CENSORING ME

because I choose to share

MY OPINION

about med students and their fears about paying off

TWO HUNDRED LARGE

MODERATORS,

SEND ME ALL THE INFRACTIONS YOU FEEL THE NEED FOR.

When you're done with your little gate-keeping, power filled

MINUTE,

Read this dude's

ORIGINAL POST, MAN.

NOBODY TALKS FINANCIALS IN MED SCHOOL.

NOBODY.

AND YOU'RE GONNA GIVE ME AN INFRACTION FOR POSTING "WHY MAKE 150k WHEN 450k IS OUT THERE?"

To med students out there weighed down with

TWO HUNDRED LARGE PLUS

in student loans?

I GET AN AN INFRACTION FOR

"FLAMING?"

No man.

We all have opinions.

I believe med students need to be educated better about the balance between

THEIR STUDENT LOAN DEBT AND

HOW THEIR CHOSEN SPECIALTY IS GONNA HELP THEM

OR HURT THEM

WITH SAID

DEBT.

Certain specialties in medicine pay

MORE.

Certain specialties pay

LESS.

I didn't make the rules.

IF YOU ARE 200k or more in student loan debt, monetarily,

THE SPECIALTY YOU SELECT WILL DRAMATICALLY EFFECT YOUR

MONETARY LIFE.

Now, it's obviously

POLITICALLY INCORRECT FOR ME TO TELL YOU THAT SINCE, WELL,

I've received an infraction from SDN

for posting my concerns about med students out there with alotta debt,

their specialty choices, and how their specialty choice will affect the

REST OF THEIR LIFE.

INFRACTION FOR ME.

FOR THAT.

Looks like we've got a Buncha

NAIVE MODERATORS.

Wait, whats that

FREEDOM OF SPEECH AMENDMENT?

I'm sorry.... I forgot which number...

If you're interested, please google

Why make 150k when 450k is out there.

I wrote that

A WHILE AGO

WHY MAKE 150K WHEN 450K IS OUT THERE?

 

[Yangkower]

I don't understand the controversy. As a resident who is 230+ in debt, family practice wasn't even an option. I think I would have actually been happy doing family practice but would never be able to get out of debt with the average pay, short of working on a reservation or in Afghanistan.

Maybe things will change, but who knows, maybe the world will end in 2012 and my debts will be forgiven.

 

[jetproppilot]

I don't understand the controversy. As a resident who is 230+ in debt, family practice wasn't even an option.

Maybe things will change, but who knows, maybe the world will end in 2012 and my debts will be forgiven.

AND I'M THE PARIAH

BEEN GIVEN AN

INFRACTION

For

conveying

MY BELIEFS.

It's obvious

SDN HAS ALOTTA YOUNG, NAIVE MODERATORS THAT DONT REMEMBER

THAT IT'S OK TO EXPRESS YOURSELF WITH

SPEECH

IN THIS U S OF A COUNTRY

WITHOUT FEAR OF INFRACTION

 

[jetproppilot]

AND I'M THE PARIAH

BEEN GIVEN AN

INFRACTION

For

conveying

MY BELIEFS.

It's obvious

SDN HAS ALOTTA YOUNG, NAIVE MODERATORS THAT DONT REMEMBER

THAT IT'S OK TO EXPRESS YOURSELF WITH

SPEECH

IN THIS U S OF A COUNTRY

WITHOUT FEAR OF INFRACTION

btw,

I EXPECT A PUBLIC EXPLANATION

TO WHY

I RECEIVED AN SDN INFRACTION

FOR REPOSTING

"why make 150K when 450k is out there?"

 

[Trisomy13]

Get a grip

 

[Gern Blansten]

Jet's keyboard after this thread:

 

[Gern Blansten]

Let’s get to the point! Here’s what you need to know when using the SDN Forums:

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I am not a moderator, but I suspect that the public explanation lies within the forum rules. I have seen it enforced numerous times against multiple parties. I doubt you were singled out. Since you used to be a moderator, I would have thought you would be familiar with this rule.

 

[Bertelman]

Jet, didn't you receive some heat the first time you posted that thread?

Did you think the FM forum and/or moderators had changed their outlook since you last posted?

 

[yappy]

I'll bite.

Who makes 450?

Dont FP make ~200k?

I think alot of the students assume that they wont be making the higher salary in the future that alot of specialists enjoy today. So they default to fields that they think fits them more. What is your outlook on your field?

 

[IlDestriero]

I'll bite.

Who makes 450?

Dont FP make ~200k?

I think alot of the students assume that they wont be making the higher salary in the future that alot of specialists enjoy today. So they default to fields that they think fits them more. What is your outlook on your field?

His point was that if you're in big debt you need to seriously look into other options and consider fields that pay better. 450 is a reasonable income to expect in anesthesia after a few years, I know many making significantly more. Salaries may decline, but we'll be paid well for some time, and if necessary I'd change jobs to secure a fair wage. One possibility for academics is to improve efficiency and work more, we have an opportunity to work harder and better to protect our income if necessary.

 

[jetproppilot]

Jet, didn't you receive some heat the first time you posted that thread?

Did you think the FM forum and/or moderators had changed their outlook since you last posted?

I don't care about "The Rules",

Whatever that means.

I'm surprised, Bertel,

at your reflection (read:UNINFORMED )

Wow.

This isn't about

SPECIFIC

numbers.

This is about the

FACT THAT

Primary Care Doctors are

UNDERPAID.

Med students aren't dumb,

G.

They gravitate to the benjamins.

They will SPECIALIZE.

Where's the love for the

Primary Docs?

Uhhhhhhhhhhhhhhhhh

MEDICARE?

OBAMA?

YEARD?

Current day

there is none.

THAT'S

why everyone wants to be a

Specialist.

INCLUDING ME.

 

[jetproppilot]

Blasting Rage while your GF is trying to sleep....that's ballsy, Jet!

Thankfully my THUGNESS

didn't awaken her!

 

[yappy]

I see - that is a good point. I agree with the sentiment. Though, It's difficult for premedical students to really place any bets because of the fast pace of change that occurs.

I did some looking around and what you say is true . The 2010 MGMA physician compensation report:

Median Anesthesiology = $423,547

In addition - one specialty that blew me away was dermatology: Mohs Surgery with a median income of $602,016.

Though lower than the previous two specialties, but still a decent sum, IM physicians who worked as hospitalists made $ 215,000. So pretty much a 2X or 3X increase in wages depending on what field you enter rather than IM.

His point was that if you're in big debt you need to seriously look into other options and consider fields that pay better. 450 is a reasonable income to expect in anesthesia after a few years, I know many making significantly more. Salaries may decline, but we'll be paid well for some time, and if necessary I'd change jobs to secure a fair wage. One possibility for academics is to improve efficiency and work more, we have an opportunity to work harder and better to protect our income if necessary.

 

[Bertelman]

I don't care about "The Rules",

Whatever that means.

I'm surprised, Bertel,

at your reflection (read:UNINFORMED )

Wow.

It's not my reflection, it's an observation and a sincere question. I'm surprised you can rehash an old topic, then act amazed that you are catching the same kind of heat for the same thing you did in the past.

If you truly don't care about the rules, then you shouldn't care about the punishment for breaking the rules. It's that simple. This is not a discussion about the thread and the topic, just the consequences of doing the same thing and expecting a different outcome.

 

[Gern Blansten]

I take off for 36 hours and Jet's account is on hold. What did I miss?

 

[GoodmanBrown]

I don't understand the controversy. As a resident who is 230+ in debt, family practice wasn't even an option. I think I would have actually been happy doing family practice but would never be able to get out of debt with the average pay, short of working on a reservation or in Afghanistan.

Maybe things will change, but who knows, maybe the world will end in 2012 and my debts will be forgiven.

I'll bite and play devil's advocate here. Is 230K really that bad? It's about what I'll have when I graduate, and I'm not overly worried about it. In the context of being a doctor, it's acceptable.

There are a variety of payment options that tune your monthly payment to your income. This keeps your payments from obstructing other life goals like a house, family, etc. Many jobs that an FM doc would get qualify as public service as well, so you can have the debt forgiven after 10 years.

I have a hunch a bunch of people will call me crazy for thinking the way I do, but so be it.

 

[geogil]

I take off for 36 hours and Jet's account is on hold. What did I miss?

I see a recurring theme on this board, that one-time prolific posters leave, come back, bemoan the state of affairs, make enough waves or ad-hominem attacks and then get banned or suspended. Remember when Copro got banned a while back? I'm not saying Jet should be banned, just noticing a curious trend.

 

[cchoukal]

I'll bite and play devil's advocate here. Is 230K really that bad? It's about what I'll have when I graduate, and I'm not overly worried about it. In the context of being a doctor, it's acceptable.

There are a variety of payment options that tune your monthly payment to your income. This keeps your payments from obstructing other life goals like a house, family, etc. Many jobs that an FM doc would get qualify as public service as well, so you can have the debt forgiven after 10 years.

I have a hunch a bunch of people will call me crazy for thinking the way I do, but so be it.

It's a matter of perspective, I guess. I had right around $200K at a very low interest rate, and on the slowest plan, I still pay $1200/month. You can make the payments income-dependent (but the payments will rise over time regardless of your income), but you'll pay even more interest over time. It may be that the monthly payment is more relevant to you than the total lifetime amount, but that amount will be higher the longer you take/lower your payment. And, obviously, whether or not $1200/month (or $2200/month on the 10 year plan with my principal) is "acceptable in the context of being a doctor" depends on whether doctors will still get paid what they do today, and most people don't think that's likely.

 

[Arch Guillotti]

I see a recurring theme on this board, that one-time prolific posters leave, come back, bemoan the state of affairs, make enough waves or ad-hominem attacks and then get banned or suspended. Remember when Copro got banned a while back? I'm not saying Jet should be banned, just noticing a curious trend.

Copro was never banned.

 

[hb2998]

It's a matter of perspective, I guess. I had right around $200K at a very low interest rate, and on the slowest plan, I still pay $1200/month. You can make the payments income-dependent (but the payments will rise over time regardless of your income), but you'll pay even more interest over time. It may be that the monthly payment is more relevant to you than the total lifetime amount, but that amount will be higher the longer you take/lower your payment. And, obviously, whether or not $1200/month (or $2200/month on the 10 year plan with my principal) is "acceptable in the context of being a doctor" depends on whether doctors will still get paid what they do today, and most people don't think that's likely.

CA0 here, like anesthesia too... obviously
I agree with cchoukal on his reply to GoodmanBrown, yes, loans are huge part of our future and I'll go even further an say, yes $230K per year is THAT bad. The interest accrued on my loans is $1,689/month. That's just in interest; Thats >65% of my current take home pay as a resident and that's after the fact that my the government is now paying some of interest because I am doing the income based repayment repaying ~$300/month.

As a medstudent (9 months ago), these loans didn't hit home yet (You get a bill for $65,000 from your school --- okay man, put in on the Stafford). I remember those required financial advice conferences we had to attend to qualify for loans. What a joke... "if you pay back $20 a month while in school.. blah blah blah" -- dude I don't have money, thats why I'm getting a loan. It doesn't hit you until you're writing the checks. My point is as a medstudent sometimes $$$$$$ loans seem like nothing (because you don't see the interest), and $ income seem like a lot (because you don't see the expenses/taxes).

If I want to make any headway against my loans, I would have to make $1700 a month just to pay off the interest and that's only because I took $300 out of my current paycheck for the next 4 years to qualify for special benefits. I would probably have to pay ~$6,000 a month to pay off my loans in 10 years once I get out. Thats $72,000 a year, does that make the $240,000 feel smaller? It should.

 

[smq123]

I'll bite and play devil's advocate here. Is 230K really that bad? It's about what I'll have when I graduate, and I'm not overly worried about it. In the context of being a doctor, it's acceptable.

There are a variety of payment options that tune your monthly payment to your income. This keeps your payments from obstructing other life goals like a house, family, etc. Many jobs that an FM doc would get qualify as public service as well, so you can have the debt forgiven after 10 years.

I have a hunch a bunch of people will call me crazy for thinking the way I do, but so be it.

I kind of disagree...but it all sort of depends.

If you're a new FM attending in your first year out, and are geographically tied to the NYC-Philly-DC corridor, and take a strictly outpatient job with no OB, no procedures, no inpatient or ER, and no nursing home, I would say that yes, $230K is a bit onerous. That combination of factors essentially guarantees that you will make about $110K (about the lowest you should ever expect to be paid in FM).

Fortunately, there are a variety of other jobs/practice settings for FM that pay significantly better.

What I tell people who have a fair amount of debt but are interested in primary care is that there are financial incentives that are not available to other specialties. You just have to seek them out.

 

[BLADEMDA]

CA0 here, like anesthesia too... obviously
I agree with cchoukal on his reply to GoodmanBrown, yes, loans are huge part of our future and I'll go even further an say, yes $230K per year is THAT bad. The interest accrued on my loans is $1,689/month. That's just in interest; Thats >65% of my current take home pay as a resident and that's after the fact that my the government is now paying some of interest because I am doing the income based repayment repaying ~$300/month.

As a medstudent (9 months ago), these loans didn't hit home yet (You get a bill for $65,000 from your school --- okay man, put in on the Stafford). I remember those required financial advice conferences we had to attend to qualify for loans. What a joke... "if you pay back $20 a month while in school.. blah blah blah" -- dude I don't have money, thats why I'm getting a loan. It doesn't hit you until you're writing the checks. My point is as a medstudent sometimes $$$$$$ loans seem like nothing (because you don't see the interest), and $ income seem like a lot (because you don't see the expenses/taxes).

If I want to make any headway against my loans, I would have to make $1700 a month just to pay off the interest and that's only because I took $300 out of my current paycheck for the next 4 years to qualify for special benefits. I would probably have to pay ~$6,000 a month to pay off my loans in 10 years once I get out. Thats $72,000 a year, does that make the $240,000 feel smaller? It should.

Correct!!! You boys and girls are getting the Obama screw job. Health care reform shouldnt leave you all out in the cold. Yet, Obama never addresses high medical school tuition and malpractice costs.

IMHO, the Canadian system with all its flaws is vastly superior to Obamacare. Perhaps, Obama wants physicians and the elderly to lead the charge together for our version of Canadian Health care.