What are the various outpatient anesthesiology job opportunities?

[stsa84]

Hey all, M3 here. I've been interested in general PM&R up to this point, but after a recent rotation have fallen in love with pain management. I really like clinic, love the procedures, and am surrounded by anesthesiology residents and gas-trained pain fellows who are really talking up the benefits of being a gas-trained vs. PM&R pain doc. I'm not sure yet which path I'm going to pursue as my route to pain management.

Knowing how competitive pain fellowships are, my question today is: what other jobs, besides chronic pain, are available to anesthesiologists, that are outpatient based and provide a good mix of procedures and (I'm saying it) lifestyle? From what I gather, regional anesthesia is a comparable gig. What other job opportunities, both for general gas docs and fellowship trained, are based outside the OR and give decent flexibility for family life?

As always, I greatly appreciate the insight. Thanks.

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[IanMcGalt]

Hey all, M3 here. I've been interested in general PM&R up to this point, but after a recent rotation have fallen in love with pain management. I really like clinic, love the procedures, and am surrounded by anesthesiology residents and gas-trained pain fellows who are really talking up the benefits of being a gas-trained vs. PM&R pain doc. I'm not sure yet which path I'm going to pursue as my route to pain management.

Knowing how competitive pain fellowships are, my question today is: what other jobs, besides chronic pain, are available to anesthesiologists, that are outpatient based and provide a good mix of procedures and (I'm saying it) lifestyle? From what I gather, regional anesthesia is a comparable gig. What other job opportunities, both for general gas docs and fellowship trained, are based outside the OR and give decent flexibility for family life?

As always, I greatly appreciate the insight. Thanks.

The best jobs in anesthesia involve a lot of kitchen scheduling. I don't mean 'best' morally. I mean highest pay for least work. The current kitchen schedulers are selling their jobs to investors who want to take money from people actually doing the work too, so you might have to be an MBA or independently wealthy to get a kitchen scheduling job in the future.

 

[stsa84]

The best jobs in anesthesia involve a lot of kitchen scheduling. I don't mean 'best' morally. I mean highest pay for least work. The current kitchen schedulers are selling their jobs to investors who want to take money from people actually doing the work too, so you might have to be an MBA or independently wealthy to get a kitchen scheduling job in the future.

What do you mean by "kitchen scheduling"? I haven't encountered that term before. I'm not adverse to working hard...I plan to, and don't think I'd be satisfied with a job that didn't require this. I've loved my experience in pain management (which has been extremely procedure driven, definitely not a pill mill practice (maybe 1 out of 20 clinic patients are on opioids, and our attendings place a strong emphasis on weaning those patients down/off), and am simply wondering if there are any other legitimate, "moral" settings in which an anesthesiologist could practice that would be entirely or mostly outpatient. If you could clarify your statements, for a 3rd year med student with a lot to learn, I'd appreciate it. Thanks.

 

[PianoMedic]

Kitchen Scheduling is a term I am familiar with because it was used in "The Rape of Emergency Medicine." Emergency rooms always have to be covered, but not all ERs can get doctors to cover 24 hours a day. So these "kitchen schedulers" will convince administrators to give them the contract for the ER. They promise to fill the shifts and they get paid by the hospital for that service. They then in turn take a portion of that money for themselves and pay the physicians out of the remainder. The kitchen schedulers of anesthesia would be AMCs in my opinion. They get the contract for a hospital to provide the anesthesia care, then try to make as much money as possible. So anesthesiologists and CRNAs are overhead (read: an expense). That is how you get these larger supervision ratios, to make more money. (Credit to FFP for introducing me to "The Rape of Emergency Medicine". Awesome read that everyone in medicine should look into. Link to the page for the pdf: http://www.aaemrsa.org/resources/rape-of-em.)

As to your original question: I am an M1, so my opinion may not hold much weight. I'm not actually familiar with many outpatient anesthesiology jobs. The anesthesiologists that I have shadowed will sometimes work at an orthopedics outpatient surgical center. They are still doing OR type anesthesia cases, though. So, I would make certain that you really really enjoy anesthesiology as a specialty, not just pain medicine. You will get some of the pain medicine in residency, but my anesthesiologist mentor specifically went into anesthesiology because she hated clinics. If you go into anesthesiology you will spend a lot of time in the OR. Much of anesthesiology, not all but much, occurs in the OR. GI centers, OB cases and some cardioversions are other places that might be outpatient. I am not as familiar with those parts of anesthesiology, however. Hope at least some of this is useful to you.

 

[Sirach38]

Hey all, M3 here. I've been interested in general PM&R up to this point, but after a recent rotation have fallen in love with pain management. I really like clinic, love the procedures, and am surrounded by anesthesiology residents and gas-trained pain fellows who are really talking up the benefits of being a gas-trained vs. PM&R pain doc. I'm not sure yet which path I'm going to pursue as my route to pain management.

Knowing how competitive pain fellowships are, my question today is: what other jobs, besides chronic pain, are available to anesthesiologists, that are outpatient based and provide a good mix of procedures and (I'm saying it) lifestyle? From what I gather, regional anesthesia is a comparable gig. What other job opportunities, both for general gas docs and fellowship trained, are based outside the OR and give decent flexibility for family life?

As always, I greatly appreciate the insight. Thanks.

There is also sleep medicine and addiction medicine which are not anesthesiology fields per say but you can get into these fields after finishing a gas residency. Palliative care is another option. That is all that I can think of in terms of outpatient work from gas.

Pain is probably your best option and shouldn't be to hard to get into if you do well in your gas residency.

Also, it's a bad idea to come into the gas forum asking for options for a "good lifestyle" in gas as this tends to be somewhat of a touchy subject for those of us passionate about anesthesiology. Anesthesiology is not a lifestyle specialty and we don't like to be seen this way. Just a heads up if you're wondering why some of the replies you'll get are not very friendly.

 

[Consigliere]

Kitchen Scheduling is a term I am familiar with because it was used in "The Rape of Emergency Medicine." Emergency rooms always have to be covered, but not all ERs can get doctors to cover 24 hours a day. So these "kitchen schedulers" will convince administrators to give them the contract for the ER. They promise to fill the shifts and they get paid by the hospital for that service. They then in turn take a portion of that money for themselves and pay the physicians out of the remainder. The kitchen schedulers of anesthesia would be AMCs in my opinion. They get the contract for a hospital to provide the anesthesia care, then try to make as much money as possible. So anesthesiologists and CRNAs are overhead (read: an expense). That is how you get these larger supervision ratios, to make more money. (Credit to FFP for introducing me to "The Rape of Emergency Medicine". Awesome read that everyone in medicine should look into. Link to the page for the pdf: http://www.aaemrsa.org/resources/rape-of-em.)

As to your original question: I am an M1, so my opinion may not hold much weight. I'm not actually familiar with many outpatient anesthesiology jobs. The anesthesiologists that I have shadowed will sometimes work at an orthopedics outpatient surgical center. They are still doing OR type anesthesia cases, though. So, I would make certain that you really really enjoy anesthesiology as a specialty, not just pain medicine. You will get some of the pain medicine in residency, but my anesthesiologist mentor specifically went into anesthesiology because she hated clinics. If you go into anesthesiology you will spend a lot of time in the OR. Much of anesthesiology, not all but much, occurs in the OR. GI centers, OB cases and some cardioversions are other places that might be outpatient. I am not as familiar with those parts of anesthesiology, however. Hope at least some of this is useful to you.

I stopped reading here.

 

[deleted171991]

Pain is probably your best option and shouldn't be to hard to get into if you do well in your gas residency.

Umm, I don't know how pain is nowadays but, back when I graduated, it used to be a pain to get into.

 

[Sirach38]

Umm, I don't know how pain is nowadays but, back when I graduated, it used to be a pain to get into.

I hear it is still competitive. My mentor is the pain medicine fellowship director and he says that while competitive, there is definitely a very good chance of getting in if you are an above average resident with good scores etc. Idk how true that is, just what I have heard. Any other thoughts?

 

[stsa84]

Thanks for the thoughts guys. Wasn't trying to ruffle feathers by implying that anesthesiology is a lifestyle specialty, or that I'm looking to make a lot of money with minimal work. As I've stated previously, I simply really enjoyed my pain med rotation, and was wondering if it was unique in the anesthesiology realm. If it is the only specialty that is entirely/mostly outpatient based, I'd love to know. If there are others out there, I'd love to know as well. About as simple as I can make it.

Sirach38 - my fellows on the rotation said it is one of the hardest fellowships to obtain, right up there with cards and GI. How true that is, I don't know. Anectodally, two anesthesiology residents at my school were offered pain fellowships at our program last year. They both had 10+ interviews across the country. One of them took the guaranteed spot at our program, while the other took his chances at other schools, and ended up not matching. From what I gather, it's quite a tough fellowship to land, and shooting for a spot at your institution is your best bet.

 

[Sirach38]

Thanks for the thoughts guys. Wasn't trying to ruffle feathers by implying that anesthesiology is a lifestyle specialty, or that I'm looking to make a lot of money with minimal work. As I've stated previously, I simply really enjoyed my pain med rotation, and was wondering if it was unique in the anesthesiology realm. If it is the only specialty that is entirely/mostly outpatient based, I'd love to know. If there are others out there, I'd love to know as well. About as simple as I can make it.

Sirach38 - my fellows on the rotation said it is one of the hardest fellowships to obtain, right up there with cards and GI. How true that is, I don't know. Anectodally, two anesthesiology residents at my school were offered pain fellowships at our program last year. They both had 10+ interviews across the country. One of them took the guaranteed spot at our program, while the other took his chances at other schools, and ended up not matching. From what I gather, it's quite a tough fellowship to land, and shooting for a spot at your institution is your best bet.

Not implying that you were trying to ruffle feathers, just a heads up to watch the tone of your posts if you want to get friendly responses.

Yes it's one of the more competitive fellowship in gas. But it's not like matching into derm or plastics or something like that. If you are determined to do it and are an above average resident, you can get a spot. This is per my mentor. Of course, I could be wrong.