When I was a student, I wanted this question answered. Now that I have it, I'm providing it for all of you. So, if you are a med student who is wondering about the politics of anesthesia and our future, I'd like to give you an update on where we are currently (at least in Texas). Then you make your own decision: I'm a CA-2 at the Texas Medical Center. I worked with a guest faculty (McCreath) who sits one of the medical economics committees in Texas and routinely debates with CRNAs. She is responsible for chiming in for anesthesiologists during political hearings on billings and practice rights. At first she told me, don't worry, everything in our profession is fine. However after I pressed her, she later conceded that we are in serious trouble but that she didn't want to discourage me as I was in residency. In fact, she said that the CRNAs that she's up against in these hearings on CRNA practice rights and billings routinely look at her in the eyes and say, "I can do everything you can." In front of all these politicians who are listening in, there isn't much she can say to defend that because it's true. In fact, I know CRNAs who do CV cases. Market forces always rule, and in the end, CRNAs who provide cheaper anethesia care just may have equal practice rights and our salaries will be lower. It's simple to understand: market forces always rule. All it takes is a signature on a new bill. With Edwards, Hillary, etc. as president, it would be that much closer and its probably closer than most people realize or want to admit. In fact, look at the quick progression of DNPs, AAs, etc. But you just have to love anesthesia because it's actually fun. You are a real perioperative physician. You are needed in emergencies. You can take away all pain. It's amazing really. If you can love anesthesia for what it is fundamentally (instead of lifestyle, salary, etc.), you won't have anything to worry about. If not, you should probably consider path, rads, derm, and maybe ER at this point in time.