Thank you for your replies.
I am aware of how narrow minded some people are when it comes to the subject of business in medicine. However, I have no choice but to address the matter since I did get a dual degree and did a bunch of work related to clinical business rather than research. So they will WITHOUT FAIL ask me why I got a dual degree. My answers will be truthfully that 1. I want to manage an anesthesia group and 2. i plan to invest the capital I generate into anesthesia as a venture capitalist, angel (early stage VC basically), and/or securities investor given my unique insights into the field. For part 2, I really would like to have some knowledge about the field and where it's probably going technologically, pharmacologically, and operationally.
I'll echo what Nuts said above...good luck with that. Most residency PDs don't want to hear they are training the next AMG director, even if your laudable goal is to use the capital to reinvest in the specialty rather than your 2nd vacation house.
For the sake of your residency interviews, I might recommend playing down your goals of capital investment, and instead describe your interest in understanding the business side of medicine to have a more secure practice, assist your colleagues in your group practice, and represent anesthesiologists for the hospital, etc. blah blah blah. If you have an interest in capital investment, state it as a side interest. As you describe it above, you almost sound as though you want to make a few bucks off passing gas before you move on to your greatest love, which is investment. That's not likely to be welcomed with open arms. That may have landed the coveted MD/MBA slot, but PDs could give a damn about your future business interests, they only want a warm body and open mind to show up for cases at 0600 and stick around for pre-ops until 1800.
Having said that, here's the deal with anesthesia- if you haven't heard the rumors, fewer and fewer bright young minds are entering academic practice, and even fewer are contributing to applicable clinical research. Discussion of this situation has reached alarmist terms, sometimes suggesting the demise of our specialty. Thus you won't necessarily find the hot new trends like you might find in cardiovascular devices and medication trials. Unfortunately, the money isn't there, nor is the research interest.
It's hard to prove long-term mortality benefits when we only see the patient for a few hours. There are exceptions (like Trasylol). Also notice that the actual drug arsenal of anesthesiologists is quite small, and hasn't changed significantly in recent memory. I'm not even sure if there are any commonly used drugs that are still in the proprietary phase. I think all are now generics, which tells you nothing new has come down the pipes in seven years.
Having exhausted you with all that, here's what I see:
BIS is not a new technology, and has reached and passed it's peak usage. However, the field of anesthesia awareness is just getting started, so I would expect more research and technology in the future.
Probably the only new drug of relevance is Sugammadex, which has not yet been released. I wouldn't expect much from drug development.
There have been several technologies trying to estimate what the PA Cath does in a non-invasive manner, but none have been widely adopted. There is room for improvement in this field, since fewer and fewer PACs are being placed.
There has been a recent influx of new intubation techniques, but this too may be reaching it's peak. Nonetheless, there will always be new developments in this area as managing the airway is probably our most critical and visible task.
Ultrasound technology for nerve blocks is expanding rapidly, and is becoming more commonplace even in private practice. I might expect better/augmented U/S technology to help better identify nerves.
If I were in your position, I might specialize in CV anesthesia, as there will always be money in cardiac disease.
