To young attendings: Do you regret choosing anesthesiology?

[hununuh]

CRNAs will continue to push to replace anesthesiologists as evident by the recent ridiculous AANA statement. Frankly, what AANA claims disgusts me, but at the same time, I am very disappointed to see that ASA is not responding in any meaningful way. This gives me very little hope regarding the future of the specialty, and makes me think that I chose the wrong field. I chose Anesthesiology because I loved the clinical aspect of it. I always knew the issues regarding CRNA, but did not know it was this terrible. If this keeps up, I can't help but to think that I will be treated as equal to nurses despite going through medical school and residency.

I am finishing up my PGY-1 year, so I believe I still can switch into a different field, should I decide to do that. But before I make any rash decision, I wanted to see what younger attendings think about the future of this field.

Do you regret choosing Anesthesiology?
Do you see yourself having a decent job for the next 30 years?
Do you see CRNA = MD in the near future where you will be treated like "just another CRNA"? (Or, CRNAs calling themselves "I am Dr. ABC, and I will be your anesthesiologist" while practicing independently)
If you could go back to medical school, would you still choose Anesthesiology?

No offense to older attendings, but I wanted to get feedback from attendings who have more skin in the game, as older attendings will likely retire in a decade or so, and won't be affected by this whole CRNA debacle as much.

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[deleted162650]

Please refer to the 17 other threads with exactly the same title.

 

[T-burglar]

There are lots of days I wish I chose cardiac surgery or structural heart cardiology

 

[WholeLottaGame7]

CRNAs will continue to push to replace anesthesiologists as evident by the recent ridiculous AANA statement. Frankly, what AANA claims disgusts me, but at the same time, I am very disappointed to see that ASA is not responding in any meaningful way. This gives me very little hope regarding the future of the specialty, and makes me think that I chose the wrong field. I chose Anesthesiology because I loved the clinical aspect of it. I always knew the issues regarding CRNA, but did not know it was this terrible. If this keeps up, I can't help but to think that I will be treated as equal to nurses despite going through medical school and residency.

I am finishing up my PGY-1 year, so I believe I still can switch into a different field, should I decide to do that. But before I make any rash decision, I wanted to see what younger attendings think about the future of this field.

Do you regret choosing Anesthesiology?
Do you see yourself having a decent job for the next 30 years?
Do you see CRNA = MD in the near future where you will be treated like "just another CRNA"? (Or, CRNAs calling themselves "I am Dr. ABC, and I will be your anesthesiologist" while practicing independently)
If you could go back to medical school, would you still choose Anesthesiology?

No offense to older attendings, but I wanted to get feedback from attendings who have more skin in the game, as older attendings will likely retire in a decade or so, and won't be affected by this whole CRNA debacle as much.

No
Yes (but I hope to not have to work for 30 years)
Maybe
Yes

There were articles on the Great CRNA Takeover back in the 1980s. It'll never happen. Will anesthesiology be the same in 20 years? Probably not. Will any medical specialty be the same in 20 years? Probably not. Adapt and overcome.

 

[secretasianman]

I do. I am good at what I do and take satisfaction in that. But, I cannot stand the fact that we cannot use free market forces with insurance companies and also the existence of AMCs whose only purpose is to skim off physicians and add zero value.

 

[DrZzZz]

Do you regret choosing Anesthesiology?
Do you see yourself having a decent job for the next 30 years?
Do you see CRNA = MD in the near future where you will be treated like "just another CRNA"? (Or, CRNAs calling themselves "I am Dr. ABC, and I will be your anesthesiologist" while practicing independently)
If you could go back to medical school, would you still choose Anesthesiology?

1. No. Not at all.
2. Decent, yes. As good (financially) as it is now, probably not.
3. I work in an opt-out state. The only places they work independently are tiny rural hospitals where most docs don't want to be. I do have concerns about the future because of their lobbying power combined with the naivete of most patients and the greediness of hospitals. But I don't think I'll ever be without a job because of this.
4. I wouldn't go back to medical school. But yes, if I started over, I would still pick anesthesiology.

It's nice to ask the newer attendings for their opinion, but I think we're all a bit naive compared to our more experienced colleagues who've been doing this longer. Don't devalue their opinions, as they've been in the trenches a lot longer.

 

[coffeebythelake]

1. No. I love anesthesiology. I love the medicine and pharmacology of it. I love doing procedures. I love working with residents and my colleagues.
2. Yes.
3. No. They can call themselves Queen of England for all I care.
All propaganda. The fact that they have to make such outrageous lies to make themselves appear equivalent goes to show how much they have to hide. AANA talk big but their training is still far behind, and they have no intention of actually improving their education, skill set and standards. They are legends in their own minds.
4. Maybe. I always thought about Emergency Medicine and Radiology, both with their own set of problems.

 

[IMGASMD]

No
Yes
No
Yes

 

[coffeebythelake]

AANA: 'Despite Having Much Less Training CRNAs Also Equivalent to Neurosurgeons, Fighter Pilots, and LeBron James' | GomerBlog

"Where is the research proving CRNA’s can't fly jets as well as fighter pilots? I haven’t seen it so we should be allowed to independently fly jets, drop bombs and stuff.

gomerblog.com

 

[drdan4]

Things may not be great but that is NOT the reason to avoid the field.

Listen, some day you or your kid or family member is going to need Anesthesia..it's almost inevitable. Those that have been practicing for awhile understand the HARM that terrible Anesthesia can do. Do you want a Solo CRNA or an MD with a 1:8 ratio taking care of your loved one? Because that is where we are headed if we let things go to Hell.

Get into the field and try your best to advocate change for benefit of your patients through Action.

Saddens me to see so many young guys working for AMCs Supervising as their first gig. Yes..ofcourse you had no choice. Boo!

 

[IMGASMD]

Saddens me to see so many young guys working for AMCs Supervising as their first gig. Yes..ofcourse you had no choice. Boo!

So few pp left. Even they exist, as the older partner retires, more temptation to sell. Last pay day. Or the group is so exclusive, unless you have a connection, you will never see it. On top of a long partnership track (7 is the longest I’ve interviewed at).

So one has to decide between a mediocre salary from AMC now until forever. Or possibly get screwed for a few years with partnership track salary and still don’t get to the partner position then get raped again.

No solutions, just observations.

 

[CyrusHabs7695]

There are lots of days I wish I chose cardiac surgery or structural heart cardiology

Any specific reason why CT surgery?

 

[Man o War]

I’m an older guy so I won’t answer- but to give you some context this doom and gloom has been going on for decades. Same conversations were being had way back when.
Plenty of surgeons refuse to work with anesthesia nurses. I couldn’t believe how anti CRNA the surgeons are at my current job when I first showed up. They had such bad experiences with them during training or at other hospitals they aren’t having it here. I had a patient just yesterday make me promise an anesthesia nurse wouldn’t touch her because they botched her epidural so bad when she gave birth.
Also for context, modern CRNAs are weaker than previous generations. So that isn’t going to help them in their crusade for acceptance as equals.

 

[Man o War]

And BTW STOP HELPING THESE PEOPLE. If you’re contractually required to train them, do the bare minimum.

 

[IMGASMD]

Also for context, modern CRNAs are weaker than previous generations. So that isn’t going to help them in their crusade for acceptance as equals.

And older ones are old school. They know “their place”. It sounds horrible, but they really do. They understand their scope of practice, they know when they’re in trouble and would call ahead of time.

It’s the young ones, who have been brainwashed, are dangerous.

And BTW STOP HELPING THESE PEOPLE. If you’re contractually required to train them, do the bare minimum.

One of my partners would put the crazy militant ones in the most vanilla room, just so he doesn’t have to train them to do anything that they want to do...

 

[PainDrain]

First off. Work is work. Unless you get paid to play golf or whatever your passion some days are going to suck. The sooner you accept this fact the better. Millennials seems to think work should be some party atmosphere where everyone is chill, there is free lunch, ping pong and free draft beer after 3pm. F-that. Suck it up and do your job.

Second. For the next 20 years you will have a job. I am not so much worried about CRNAs as I am AI. Artificial intelligence will eventually replace a large number of physicians; especially in radiology, pathology and anesthesia. I foresee a day where we bring the patient to the OR and intubate and then leave for several hours while a computer algorithm adjusts the anesthetic and we get paged for wakeup. Also, if the job market in the US completely tanks due to crnas there is always Australia or Canada (they laugh at the fact we let nurses into the fray).

Lastly, long ago I accepted the fact that I will never have a net worth over ten million. I am ok with that. I am happy to pay off my loans and live a comfortable existence. I could have easily sold my soul and started a pill mill but I chose a different path. I can sleep easy at night.

 

[Man o War]

And older ones are old school. They know “their place”. It sounds horrible, but they really do. They understand their scope of practice, they know when they’re in trouble and would call ahead of time.

It’s the young ones, who have been brainwashed, are dangerous.

Absolutely 100% agree. Part of the reason they’re weaker is they don’t realize their limitations.

 

[Section31]

No.
Yes.
No.
Yes.

I make a great living doing a job I love. Why would I change a thing?

 

[DrZzZz]

And older ones are old school. They know “their place”. It sounds horrible, but they really do. They understand their scope of practice, they know when they’re in trouble and would call ahead of time.

It’s the young ones, who have been brainwashed, are dangerous.

Mostly agree. But I've also worked with several older CRNAs who absolutely don't know their place and think they don't need to be told anything because they've been doing it for so long. Had one, who if I had to guess is in their late 60's early 70's who gave me **** for pushing induction meds on "our" patient. I guess some of my older partners let this slide. I told em if they wanted to work independently, there's other places in the state they can do that.

 

[Consigliere]

I’m an older guy so I won’t answer- but to give you some context this doom and gloom has been going on for decades. Same conversations were being had way back when.
Plenty of surgeons refuse to work with anesthesia nurses. I couldn’t believe how anti CRNA the surgeons are at my current job when I first showed up. They had such bad experiences with them during training or at other hospitals they aren’t having it here. I had a patient just yesterday make me promise an anesthesia nurse wouldn’t touch her because they botched her epidural so bad when she gave birth.
Also for context, modern CRNAs are weaker than previous generations. So that isn’t going to help them in their crusade for acceptance as equals.

The fact that you refer to them as anesthesia nurses, like I do, warms my heart.

 

[Man o War]

The fact that you refer to them as anesthesia nurses, like I do, warms my heart.

Always introduced to patients this way too.

 

[abolt18]

First off. Work is work. Unless you get paid to play golf or whatever your passion some days are going to suck. The sooner you accept this fact the better. Millennials seems to think work should be some party atmosphere where everyone is chill, there is free lunch, ping pong and free draft beer after 3pm. F-that. Suck it up and do your job.

Second. For the next 20 years you will have a job. I am not so much worried about CRNAs as I am AI. Artificial intelligence will eventually replace a large number of physicians; especially in radiology, pathology and anesthesia. I foresee a day where we bring the patient to the OR and intubate and then leave for several hours while a computer algorithm adjusts the anesthetic and we get paged for wakeup. Also, if the job market in the US completely tanks due to crnas there is always Australia or Canada (they laugh at the fact we let nurses into the fray).

Lastly, long ago I accepted the fact that I will never have a net worth over ten million. I am ok with that. I am happy to pay off my loans and live a comfortable existence. I could have easily sold my soul and started a pill mill but I chose a different path. I can sleep easy at night.

But who will move the table up and down???

 

[IMGASMD]

But who will move the table up and down???

Siri, table up.

Table down.
Sorry sir, you did not say Siri.

 

[T-burglar]

I’m a ct anesthesiologist and some days the surgery looks like it would be more fun than doing the echo and the lines . Similarly with the transcatheter valves and coronaries

 

[BLADEMDA]

I’m a ct anesthesiologist and some days the surgery looks like it would be more fun than doing the echo and the lines . Similarly with the transcatheter valves and coronaries

Interventional Cardiology is the present and future:

1. Cardiac stents
2. TAVR
3. Mitral clip
5. Watchman
6. Stress Tests (bread and butter)

 

[Man o War]

Interventional Cardiology is the present and future:

1. Cardiac stents
2. TAVR
3. Mitral clip
5. Watchman
6. Stress Tests (bread and butter)

Agree with this. I just couldn’t stomach the lifestyle. It’s also more patient contact than I prefer.
If one can deal with these 2 things plus the long residency/fellowship, this is the way to go.

 

[pgg]

You'd have to gut out an IM residency first just to get to the fellowship.


I enjoy the day to day practice and don't regret choosing anesthesiology at all.

I'm confident that for the remainder of my career, I'll be able to find a job that has enjoyable working conditions, at an hourly rate acceptable to me. When my .mil time is done, I will be very geographically flexible - I think this is key.

I'm less confident that when I'm 80 that I'll get my own anesthesia provided by or at least directed by a physician. Of course, it'll probably be a mid-level who sees me in the ER, a computer that reads my CT, a PA who does my surgery, and a online-degreed technologist who does my autopsy.

 

[dhb]

The huge drawback for me that isn't much talked about is the total lack of control over your schedule.
You can't cancel a couple of patients from clinic to leave earlier or to take a day off, you have to negociate with you collegues for vacation, a short day can become a long one anytime an emergency comes through the door etc etc...
If i were to start over i'd probably chose a specialty that is seen as bringing in revenue rather than being a cost. Being able to bill patients outside of a hospital setting is also important imo.

 

[navi86]

I do love my job. Could I see myself doing something else? I love medicine mixed with procedures so I would consider becoming an intensivist, gastroenterologist, etc., but I'm happy with where I'm at as an anesthesiologist. But my area is full of AMCs buying up private practices left and right. They lure in naive new graduates, lie to them about work hours, have them sign nonsensical non-compete clauses to keep them stuck for as long as possible until they can't take it anymore, only to be replaced by the next batch of new graduates. They are treated like disposable bench warmers. My private practice is one of the few left, but who's to say we won't be bought out in the future, or kicked out when our small community hospital inevitably merges with a large hospital system that wants to use their own anesthesiologists. The direction our field is going doesn't look too bright in my opinion, but that may be applicable to most of medicine.

 

[seniormd]

CRNAs will continue to push to replace anesthesiologists as evident by the recent ridiculous AANA statement. Frankly, what AANA claims disgusts me, but at the same time, I am very disappointed to see that ASA is not responding in any meaningful way. This gives me very little hope regarding the future of the specialty, and makes me think that I chose the wrong field. I chose Anesthesiology because I loved the clinical aspect of it. I always knew the issues regarding CRNA, but did not know it was this terrible. If this keeps up, I can't help but to think that I will be treated as equal to nurses despite going through medical school and residency.

I am finishing up my PGY-1 year, so I believe I still can switch into a different field, should I decide to do that. But before I make any rash decision, I wanted to see what younger attendings think about the future of this field.

Do you regret choosing Anesthesiology?
Do you see yourself having a decent job for the next 30 years?
Do you see CRNA = MD in the near future where you will be treated like "just another CRNA"? (Or, CRNAs calling themselves "I am Dr. ABC, and I will be your anesthesiologist" while practicing independently)
If you could go back to medical school, would you still choose Anesthesiology?

No offense to older attendings, but I wanted to get feedback from attendings who have more skin in the game, as older attendings will likely retire in a decade or so, and won't be affected by this whole CRNA debacle as much.

I would quit now if you are so close to graduating from med school. The specialty is a huge mess. I told my daughter who is considering medical school that I would not help her with loans if she went into anesthesia.

 

[CyrusHabs7695]

I would quit now if you are so close to graduating from med school. The specialty is a huge mess. I told my daughter who is considering medical school that I would not help her with loans if she went into anesthesia.

If you had to do it again which field would you pick?

 

[seniormd]

I am concerned that folks are getting bogged down with the CRNA issue. Even without that issue, the specialty is a disaster. We work very long hours with erratic schedules to make a little bit more than other doctors.
Yes I regret it, and of course I would never have picked it had I known. My advisors weren’t honest.

 

[UscGhost]

I absolutely love the specialty. Work life is great..pay is great.

 

[ProRealDoc]

Almost ten years out of training and still enjoying it. Hours can be long a times but I am compensated well for my time and work.

 

[dannyboy1]

I am concerned that folks are getting bogged down with the CRNA issue. Even without that issue, the specialty is a disaster. We work very long hours with erratic schedules to make a little bit more than other doctors.
Yes I regret it, and of course I would never have picked it had I known. My advisors weren’t honest.

Those who work very long hours are usually very well compensated for their time. Plenty of non-call/surgicenter work with very reasonable hours where you can make around 300k. This is your definition of a disaster?

 

[San Marzano]

Two years into private practice and loving it. I make a very comfortable wage, get loads of free time, work with amazing colleagues, have never regretted it for a second. I hated residency and was fully regretting my choice for almost the entire 4 years of it but I'm so glad I stuck it out.

 

[pgg]

I told my daughter who is considering medical school that I would not help her with loans if she went into anesthesia.

 

[K...]

Always introduced to patients this way too.

Just leaned something new...

 

[seniormd]

Those who work very long hours are usually very well compensated for their time. Plenty of non-call/surgicenter work with very reasonable hours where you can make around 300k. This is your definition of a disaster?

Yes. In the surgery centers you become the surgeons’ (or gastroenterologists’) resident. The company model is becoming more common. They (legally) take your money and give you a fraction. If they have any issue with you (and they have no real objective means of evaluating you because they don’t know anesthesia), you’re done.

 

[ProRealDoc]

I am concerned that folks are getting bogged down with the CRNA issue. Even without that issue, the specialty is a disaster. We work very long hours with erratic schedules to make a little bit more than other doctors.
Yes I regret it, and of course I would never have picked it had I known. My advisors weren’t honest.

Why don't you drop out and get another job if you're so unhappy?

 

[ProRealDoc]

Yes. In the surgery centers you become the surgeons’ (or gastroenterologists’) resident. The company model is becoming more common. They (legally) take your money and give you a fraction. If they have any issue with you (and they have no real objective means of evaluating you because they don’t know anesthesia), you’re done.

I smell a troll.

 

[Gasville]

For those of you that responded and are very happy with your current practice, if you could please elaborate - academic? AMC? PP? If so, physician only? Direction 1:3-4? What region of the country?

 

[Twiggidy]

For those of you that responded and are very happy with your current practice, if you could please elaborate - academic? AMC? PP? If so, physician only? Direction 1:3-4? What region of the country?

Also add do take call? If so do you take in house call? Also how much OB? Those three things have major impact on anesthesiologist happiness. Being able to sleep at home in your own bed is MAJOR.

 

[seniormd]

I smell a troll.

Say what you want. I’m not a troll. I came out of residency a long time ago and it was bad then (very bad) and it’s a tiny bit better now. My colleagues are to embarrassed to admit that it stinks. At age 57, folks should be sleeping on a cot in a hospital 5 nights a month. Forget what I say, look st the surveys. One of the most regrettable specialty choices (pathology also ). The ASA is weak and we are losing.

 

[deleted162650]

Also add do take call? If so do you take in house call? Also how much OB? Those three things have major impact on anesthesiologist happiness. Being able to sleep at home in your own bed is MAJOR.

Wait till you have a few rugrats terrorizing you at home. That OB call room isn’t so bad anymore.

 

[deleted162650]

For those of you that responded and are very happy with your current practice, if you could please elaborate - academic? AMC? PP? If so, physician only? Direction 1:3-4? What region of the country?

Very Happy:

PP
MD Only
West Coast

 

[pgg]

Say what you want. I’m not a troll. I came out of residency a long time ago and it was bad then (very bad) and it’s a tiny bit better now. My colleagues are to embarrassed to admit that it stinks. At age 57, folks should be sleeping on a cot in a hospital 5 nights a month. Forget what I say, look st the surveys. One of the most regrettable specialty choices (pathology also ). The ASA is weak and we are losing.

If you came out of residency a "very long time ago" and didn't make a barnfull of hay in the 2000s you were either in the military or there's something wrong with you.

At age 57 I'm going to be at least half retired. I sure won't be taking in-house cot call 5 times per month. And I was/am in the military.

I understand that some guys have a stable full of ex-wives who need alimony and boat payments to make through their 60s, but there's no reason anesthesiologists can't quit taking brutal q6 in-house trauma/transplant/OB/etc call when they're 25 years deep in their careers. I mean, some people like it and more power to them, but if you hate it, don't do it.

Also, LOL at the way you're attempting to strong-arm your daughter's specialty choice.

The ASA is weak, I agree with you there.

 

[Consigliere]

Very Happy:

PP
MD Only
West Coast

The trifecta!

 

[DM27]

Do you regret choosing Anesthesiology?
No. There is nothing enough I was interested enough in that also did not require me to take my work home with me (field phone calls, have longer-term patient relationships etc.)

Do you see yourself having a decent job for the next 30 years?
Yes, I believe very little will change aside from a likely overall drop in the pay ceiling for the majority of specialties.

Do you see CRNA = MD in the near future where you will be treated like "just another CRNA"? (Or, CRNAs calling themselves "I am Dr. ABC, and I will be your anesthesiologist" while practicing independently)
I think there is a much higher likelihood of false elevation of mid-levels than an actual drop for us. I think the CRNA controversy is not going to go away, but I also do not expect it to have a significant impact on my ability to have a job that allows me to maintain my lifestyle in the coming years.

If you could go back to medical school, would you still choose Anesthesiology?
Yes, for the reasons I stated in my first response. A lot of the fields I would consider were more in the realm of internal medicine, which my wife does, and the pay is absolute garbage compared to what myself and my ex-coresidents and ex-cofellows make. Her former coresidents who then did 3-4 more additional years of training (so thats 6-7 years total) are STILL making less in some scenarios. The ones making more seem to work like dogs and I also are already 3 years behind me (so >$1million) in income.

 

[deleted162650]

The trifecta!

Can’t complain. Only thing I’m missing is the 12wks vaca some of you guys get (I could actually take that much or more if I wanted, but I’m still young and I gots bills to pay).