I've heard that for areas like CT, peds, OB, ICU, doing a fellowship might give one a job where they would otherwise out of luck. However, aside from Pain Management, do any of these areas make substantially more than just general anesthesia?
To make money in pain management, you really need to run a cash business for procedures. A lot of pain managment is medical, and the insurance companies don't pay squat for this.... they're paying less and less for procedures, too. You can make some serious $$$ in pain, but it can be tough to get a cash practice going.
unfortunately fellowship training doesn't afford a lot of extra cash in anesthesia except pain.
I've often heard that one never makes up the cash lost during the extra year of training even if he/she works for 30 years.
Anesthesia is different than a lot of specialties in that you are paid for time in the OR not for what you are doing in the OR. (correct me if I'm wrong) I've heard a set price paid per 15 mins of anesthesia time.
I don't think that set price changes any if you are doing pedi hearts vs. gall bladders.
One might get extra compensation in private practice if he/she is fellowship trained and there is a need for that training within their practice. If so, I doubt the extra cash is that significant.
As for ICU, I think the billing is really screwed up where these guys work their arse off and don't get any $$ benefit for it. It is kind of like medicine; they can only bill for what they put in their notes and procedures that they do. All the other thinking is free.
In the end, I would only do a fellowship if I was really interested in doing, something like pedi full time or if I wanted to stay in academics. (Not for the money)
MDAs are paid for their time, usually in units of 15 minutes. Yet, there is a baseline value/amount for each case and this varies with complexity and urgency. Thus an emergent pedi heart has a much higher value than an elective lap chole even if both took exactly 1 hour.
I had always been under the impression that other than pain, fellowships don't add monetary value. The dept. chair at Emory said that he has a discounted cash flow model which demonstrates that the net present value of fellowship training is worth about 2 million dollars on average assuming 30 years working as an attending. I never asked him for his model although I should have. I wonder if anyone else remebers hearing this.