Reply to thread

About the Ads

Message: <blockquote data-quote="Southpaw" data-source="post: 21848386" data-attributes="member: 50438">I've paid attention to our field since I was a medical student and decided to do anesthesiology.  I tend towards cynicism and 'sky is falling' mentality so in a  lot of ways anesthesia was never a good match for me.  Still, I've enjoyed my career so far.There have been definite changes to the job market in the last 10-15 years for those looking closely enough.   And if you don't think there'll be more negative changes in the next 10-15 years you are simply being illogical.  AMCs came, killed a lot of private practices, and have showed their hand as the money-grubbing Wall Street types they are.  Still, they're here.  They'll pay as little as humanly possible to staff rooms and work you as hard as they can.  There are AMC-type setups in other medical fields also.  EM, Neonatology, Derm, etc.  But to this day, aside from working for a hospital, I don't see this occurring in surgery.There are fewer private practices.  A lot of people think/hope that as AMCs fade then private practices will see a resurgence.  It's unlikely because most hospitals can't find a group of anesthesiologists to reliably staff their ORs without issues.  Or at best you'll see private practices take contracts and become pseudo-AMCs with a pyramid scheme where a few predatory partners are making a killing off of a lot of worker bee anesthesiologists.  This already occurs in parts of the country.  That doesn't sound good for the field to me.  I'm willing to bet there are people on this board on both sides of that coin.So hospitals will move to the hospital-employed model.  Once that occurs then in my opinion the game is over.  You won't go back.  That model, for now, appears better than working for an AMC but still, the end goal is the same.  Pay as little as you can to get as much work as you can out out of the workers.  Unfortunately, hospital employment is occurring across ALL medical fields and in my opinion it's not good for any of us.  However it's one thing to work for the hospital and another thing to be beholden to the hospital.  Anesthesia both works for and is beholden to the hospital.  Surgery may work for the hospital but they are not beholden to them.ACT.  Anesthesiologists have shot themselves in the foot by letting CRNAs do the anesthesia.  Contrast us to GI - it's the exact opposite where midlevels see/workup patients and consult with the physician.  But the GI physician does the scope.  We are the exact opposite.  We see/evaluate and then let the midlevel do the anesthesia.  In my opinion, it's not working out well for us.I've seen one previously MD only group go ACT due to cost.  I've seen lots of private practices go either hospital employed or AMC.  Neither of those things are good for us.  But I don't think anyone can reliably claim that things will improve in the next 10-15 years.  However, the biggest problem in my opinion is that in most places the CRNAs are the ones doing the actual anesthesia.  And in doing so they tend to gain control and power as a group.The VA is letting CRNAs be independent in a time where there is no shortage of anesthesiologists.  The same applies to lots of other states.  How many surgical NPs are actually performing surgery?If I were to advise a medical student today I'd encourage them to either do surgery, or if they can't envision themselves doing surgery, then they should learn business and do an office-based specialty and open their own medical clinic/office.  Do not be dependent on the hospital.  And do the work yourself.  If they want to hire a mid-level, so be it, but the mid-level will work for them and that relationship will be clear.  The roles will never be in question or pseudo-reversed.</blockquote>

Your message may be considered spam for the following reasons:

Your new thread title is very short, and likely is unhelpful.
Your reply is very short and likely does not add anything to the thread.
Your reply is very long and likely does not add anything to the thread.
It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
Your message is mostly quotes or spoilers.
Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
This thread is locked.

Verification

Search

Search

Reply to thread

Search