the fall of anesthesiology?

[MedicinePowder]

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i know that for years maybe even decades the same fears have circulated about the field and have been discussed ad nauseum on this forum, but for the first time personally i heard a negative outlook on the field and this came from a ca-3. according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future. However, she did say she would still recommend the field for third and fourth year med students students, but that for cats still in undergrad she wouldn't.

any anesthesia residents out there? what's ure input?

 

[Noyac]

i know that for years maybe even decades the same fears have circulated about the field and have been discussed ad nauseum on this forum, but for the first time personally i heard a negative outlook on the field and this came from a ca-3. according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future. However, she did say she would still recommend the field for third and fourth year med students students, but that for cats still in undergrad she wouldn't.

any anesthesia residents out there? what's ure input?

Sounds like job security!

 

[VolatileAgent]

...for the first time personally i heard a negative outlook on the field and this came from a ca-3....

well, there ya go. we're doomed.

 

[ultm8frisbee]

i know that for years maybe even decades the same fears have circulated about the field and have been discussed ad nauseum on this forum, but for the first time personally i heard a negative outlook on the field and this came from a ca-3. according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future. However, she did say she would still recommend the field for third and fourth year med students students, but that for cats still in undergrad she wouldn't.

any anesthesia residents out there? what's ure input?

**** I better recertify my rank order list, Family Practice here I come. Thanks for the heads up.

 

[bigdan]

There are 45 people viewing this forum right now; it looks like A LOT of us are going down!

dc

 

[jetproppilot]

i know that for years maybe even decades the same fears have circulated about the field and have been discussed ad nauseum on this forum, but for the first time personally i heard a negative outlook on the field and this came from a ca-3. according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future. However, she did say she would still recommend the field for third and fourth year med students students, but that for cats still in undergrad she wouldn't.

any anesthesia residents out there? what's ure input?

OK. Last time I'm gonna say this, because every time I say this, I'm cutting my own throat by downplaying critics.

Here's Jetproppilot's response to the CA-3 comment (aside: jet has been in this business for nearly ten years, and jet heard the same worries when he emerged from residency in 1996)

OK, HERES MY OFFICIAL, SERIOUS RESPONSE:



THERE IT IS. JET'S OFFICIAL RESPONSE TO ANESTHESIA "DYING" FOR DOCTORS.

concerned resident: "Jet, why the laugh-avatar response?"

JET: "Anesthesia sites keep proliferating. GI docs want us to cover their site for UGIs, LGIs, ERCPs. Rad-onc doctors want us to keep their kids still so they can zap the tumors. Cardiologists want us in their suite for their lengthy-EP studies. ICUs/ERs want us available for "difficult" intubations. CT/MRI sites want us."

"OK, ALL PERIPHERAL SITES, WE'LL JUST CLOSE DOWN THE OR SO WE CAN ACCOMODATE EVERYONE'S NEEDS!!! "

Bottom line, the request for anesthesia FAR exceeds current anesthesia-provider supply.

At our hospital, we routinely, because of anesthesia-provider paucity (and lack of payment for said procedure) tell GI docs, cardiologists, scared ER docs, and rad-onc docs that we just dont have enough to go around.

And ya know what the result of that is gonna be?

Hospitals, most of which are big-money-corporate companies, will augment anesthesia groups monetarily.

Think about it.

Hospitals are no more than.....SLUM LORDS. They "rent" space for patients, procedures, operations, etc.

THEIR ENTIRE EXISTANCE IS DEPENDENT ON DOCTORS , RIGHT???

I mean, without doctors, who attract, admit, and treat patients, there is no business. And thats what hospitals are looking for. Business. Patients. Money. Sorry to burst your bubble, medical philanthropists, but thats where its at. C-notes.

Back to anesthesia....YOU CAN'T PROVIDE A QUALITY ANESTHESIA SERVICE IN A METROPOLITAN AREA WITHOUT ANESTHESIOLOGISTS.

So heres a translation:

Your (slum-lord) hospital wants to attract Rad-Onc physicians, who are gonna bring big-paying patients to your hospital for treatment, and, by the way, said rad-onc docs want the anesthesia service to cover their cases, BUT, anesthesia docs arent reimbursed well for said-procedure?

Guess what.

If said-hospital is smart, they'll keep their anesthesia docs happy with ample monetary augmentation so they can keep the cancer-patients coming to their (slum-lord) hospital.

Bottom line??????

Their is a HUGE demand for our services.

Procedure not well reimbursed from an anesthesia perspective???

No problem, if you have business savvy, and recognize the importance of your services, and recognize people/companies are making BIG CASH off said provided-procedures/services.

You may not get paid by well by medicare by providing anesthesia for some procedure, but if the (slum-lord) hospital you practice in is smart, they'll make you happy monetarily, so they can keep the patient-pipeline coming.

Is my viewpoint cynical??

Yes.

Does my viewpoint protect my "portion" of the cash, when in fact, the hospital is making big-bucks off procedures that pay my group pennies????

ALSO YES.

Agin, bottom line, there is a HUGE demand for anesthesia and a SHORT SUPPLY of providers.

And that problem is not gonna be fixed overnight.

 

[toughlife]

OK. Last time I'm gonna say this, because every time I say this, I'm cutting my own throat by downplaying critics.

Here's Jetproppilot's response to the CA-3 comment (aside: jet has been in this business for nearly ten years, and jet heard the same worries when he emerged from residency in 1996)

OK, HERES MY OFFICIAL, SERIOUS RESPONSE:



THERE IT IS. JET'S OFFICIAL RESPONSE TO ANESTHESIA "DYING" FOR DOCTORS.

concerned resident: "Jet, why the laugh-avatar response?"

JET: "Anesthesia sites keep proliferating. GI docs want us to cover their site for UGIs, LGIs, ERCPs. Rad-onc doctors want us to keep their kids still so they can zap the tumors. Cardiologists want us in their suite for their lengthy-EP studies. ICUs/ERs want us available for "difficult" intubations. CT/MRI sites want us."

"OK, ALL PERIPHERAL SITES, WE'LL JUST CLOSE DOWN THE OR SO WE CAN ACCOMODATE EVERYONE'S NEEDS!!! "

Bottom line, the request for anesthesia FAR exceeds current anesthesia-provider supply.

At our hospital, we routinely, because of anesthesia-provider paucity (and lack of payment for said procedure) tell GI docs, cardiologists, scared ER docs, and rad-onc docs that we just dont have enough to go around.

And ya know what the result of that is gonna be?

Hospitals, most of which are big-money-corporate companies, will augment anesthesia groups monetarily.

Think about it.

Hospitals are no more than.....SLUM LORDS. They "rent" space for patients, procedures, operations, etc.

THEIR ENTIRE EXISTANCE IS DEPENDENT ON DOCTORS , RIGHT???

I mean, without doctors, who attract, admit, and treat patients, there is no business. And thats what hospitals are looking for. Business. Patients. Money. Sorry to burst your bubble, medical philanthropists, but thats where its at. C-notes.

Back to anesthesia....YOU CAN'T PROVIDE A QUALITY ANESTHESIA SERVICE IN A METROPOLITAN AREA WITHOUT ANESTHESIOLOGISTS.

So heres a translation:

Your (slum-lord) hospital wants to attract Rad-Onc physicians, who are gonna bring big-paying patients to your hospital for treatment, and, by the way, said rad-onc docs want the anesthesia service to cover their cases, BUT, anesthesia docs arent reimbursed well for said-procedure?

Guess what.

If said-hospital is smart, they'll keep their anesthesia docs happy with ample monetary augmentation so they can keep the cancer-patients coming to their (slum-lord) hospital.

Bottom line??????

Their is a HUGE demand for our services.

Procedure not well reimbursed from an anesthesia perspective???

No problem, if you have business savvy, and recognize the importance of your services, and recognize people/companies are making BIG CASH off said provided-procedures/services.

You may not get paid by well by medicare by providing anesthesia for some procedure, but if the (slum-lord) hospital you practice in is smart, they'll make you happy monetarily, so they can keep the patient-pipeline coming.

Is my viewpoint cynical??

Yes.

Does my viewpoint protect my "portion" of the cash, when in fact, the hospital is making big-bucks off procedures that pay my group pennies????

ALSO YES.

Agin, bottom line, there is a HUGE demand for anesthesia and a SHORT SUPPLY of providers.

And that problem is not gonna be fixed overnight.

Money always has and always will make the world go around.

 

[jetproppilot]

Money always has and always will make the world go around.

Sorry, Toughlife cynics.

Read Tough's response. Then read it again.

And WELCOME TO REALITY.

 

[The_Sensei]

... according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future...

Is this some sort of bizarre scare tactic to dissuade people from going into anesthesia? If is isn't, cut and paste this statement onto a new text document, print said document and put in long term storage. Ten years from now, remove document and show it to this "expert" and the big wigs at her institution. Have a good laugh at it all!

 

[MedicinePowder]

Is this some sort of bizarre scare tactic to dissuade people from going into anesthesia? If is isn't, cut and paste this statement onto a new text document, print said document and put in long term storage. Ten years from now, remove document and show it to this "expert" and the big wigs at her institution. Have a good laugh at it all!

you have to lack intelligence to think my post had some pathetic ulterior motive. i don't have any reason to think a graduating ca-3 at a major academic institution in southern california would just compile a set of garbage to tell me. that was her honest input, gathered from speaking with the residency director and others in the department, and therefore i wanted to see what others thought.

 

[ThinkFast007]

I think all anesthesiology residencies should shut down and go on a hiatus after next year. That way there will definitely be a 'shortage' of anesthesiologists in the future 😉

 

[jetproppilot]

i don't have any reason to think a graduating ca-3 at a major academic institution in southern california would just compile a set of garbage to tell me. that was her honest input,

and said post goes into the history books showing how our educational system has failed...

yes, our MD residency programs turn out great clinicians...

but we've yet to turn out a great-clinician-businessman, even in the current anesthesia-deficint-climate.

Yet another testimony to a truly-great-trained-clinician-albeit-naive-to-the-current-anesthesia-climate...

And anesthesiologists yearn to understand why nurses are challenging our territory???? 😱

 

[militarymd]

I'm going to start looking for a PM&R residency right now....

 

[ThinkFast007]

I'm going to start looking for a PM&R residency right now....

can you have one of your partners save me your spot if/and when you do this

 

[Monty Python]

i know that for years maybe even decades the same fears have circulated about the field and have been discussed ad nauseum on this forum, but for the first time personally i heard a negative outlook on the field and this came from a ca-3. according to her, some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future.

I approached the chief CRNA at my hospital for a reference letter in 1992, when I was applying for school. She said, "sure, if you want to be out of a job in 10 years. There will be no CRNA jobs in 10 years."

 

[Danger Man]

some of the big wigs at her institution think the field is losing too much ground (crna battles, GI docs doing their own anesthesia etc.) that the job outlook looks bleak for the future.

First off, there is a lot of BSers in medicine--we all know that, we may even no one or twenty in our hospital, residency program, etc. Second, history has shown that not all "big wigs" know what the hell is going on in their respective fields. Let's take a look:

"Who the hell wants to hear actors talk?"
--H.M. Warner, Warner Brothers, 1927.

"We don't like their sound, and guitar music is on the way out."
--Decca Recording Co. rejecting the Beatles, 1962.

"Louis Pasteur's theory of germs is ridiculous fiction".
--Pierre Pachet, Professor of Physiology at Toulouse, 1872

"Stocks have reached what looks like a permanently high plateau."
--Irving Fisher, Professor of Economics, Yale University, 1929.

 

[iluvkeeley]

i guess its proctology for me

 

[iluvkeeley]

i guess its proctology for me 🙁

 

[The_Sensei]

you have to lack intelligence to think my post had some pathetic ulterior motive. i don't have any reason to think a graduating ca-3 at a major academic institution in southern california would just compile a set of garbage to tell me. that was her honest input, gathered from speaking with the residency director and others in the department, and therefore i wanted to see what others thought.

And you have to lack a brain to swallow the pathetic ramblings of some academician. Perhaps academic anesthesiology in Southern California is feeling the heat, but believe me, the rest of the U.S. of A isn't.

 

[jwk]

I think all anesthesiology residencies should shut down and go on a hiatus after next year. That way there will definitely be a 'shortage' of anesthesiologists in the future 😉

That essentially happened about 15 or so years ago when anesthesia went from a 3 year to a 4 year residency.

 

[VentdependenT]

I just dropped out of residency and am now:


A TOWEL FOLDER AT BALLY'S GYM

 

[apma77]

the outlook for a bally's towelholder is lookin bleak you need to start flipping burgers....i applied to mcdonalds today myself since a ca-3 told me anesthesia looks bleak

 

[militarymd]

 

[PublicHealth]

This is awesome. Where did you get it?

 

[militarymd]

why...the internet...of course🙂

 

[MedicinePowder]

And you have to lack a brain to swallow the pathetic ramblings of some academician. .

just curious, where did u get ur medical degree?

 

[The_Sensei]

just curious, where did u get ur medical degree?

Medical school

 

[HunterGatherer]

Ouch that hurts! I used to hand out towels at Equinox when I first started off as a Personal Trainer. Definitely a better job than the guy that folds towels in the Men's Locker Room though.

I just dropped out of residency and am now:


A TOWEL FOLDER AT BALLY'S GYM

 

[MAC10]

All ERCPs done by GI are done in the OR with Anestheisa at our hospital. This is a new hospital policy (apparently the GI guys got into some trouble with the sedation). There is a resident doing pedi MRIs just about everyday. Even without these there is plenty of work around. I hope these GI and peds residents dont try to do their own sedation when they get out since they werent trained, not for me but for pt safety. I personally dont care to ever do another ERCP but I dont see the trend away from having Anesthesia present for these procedures.