What is up with the Anesthesiology Forum???

[HealthHare]

I've been periodically viewing the Anesthesiology forum and I've noticed that it is really depressing. It seems like all they talk about is the eminent death of their specialty to NPs and healthcare reform. I was actually considering Anesthesiology as a future specialty for myself, but now I'm not so sure.
Has anyone else read some of the threads on Anesthesiology? What are your thoughts?

---

Members don't see this ad.

 

[tweek125]

That could explain why Anesthesiology has one of the highest rates of drugs abuse and suicide. I would hate to know that my specialty would eventually be taken over by a NP, especially after so many years of training.

 

[HealthHare]

That could explain why Anesthesiology has one of the highest rates of drugs abuse and suicide. I would hate to know that my specialty would eventually be taken over by a NP, especially after so many years of training.

That's a fair point, but what I want to know is how true are these claims.
Is this really how the future of Anesthesiology looks or is this mere speculation. I considered posting this question on the Anesthesiology forum, but I had a "strange" feeling that I would incur a certain response.

 

[DrBowtie]

Self selected population. The core posters tend to alienate others with opposing viewpoints. Same as any other forum.

 

[tweek125]

From what I've been told from the doctors I've asked, the job outlook for CRNAs is a lot better than for anesthesiologists. Both are trained in delivering anesthesia. And for every 1 anesthesiologist you can have multiple CRNAs.

But I can't imagine a medical doctor of any type being denied a job. A pay decrease? maybe. But not an entire medical specialty becoming obsolete.

However, it still makes me worry about considering anesthesiology as something to pursue, since I'd hate to participate in 12+ of schooling and accumulate enormous debt just to find out I could be doing the same job with only 8 years of schooling and have minimal debt, if any once I started my occupation.

 

[deleted307836]

It's probably best to go to medical school with the goal of becoming a "physician" in mind, not an anesthesiologist/other specialist -- for the sake of flexibility and freedom.

Browsed through one of the threads, and lol'ed at this post:

http://forums.studentdoctor.net/showpost.php?p=9999867&postcount=22

6. When obamacare/CRNA BS hits you, have a good chunk of change in the bank so that you can walk into a practice happy with a 300k salary.

I really hope they'll be happy with their paycut to 300k and that it won't cause them too much distress.

 

[tweek125]

hahahaha. 300k?! that's like, the same as a Mcdonald's drive-thru operator, right? DAMN YOU OBAMACARE!!!

i'm going to go out on a limb here and say that the poster in that forum was a republican...haha

 

[HealthHare]

One thing I have noticed is that it appears that both Anesthesiologists and CRNAs seem to have little respect for each other. This is probably a generalization, but it would not surprise me if this were the case. That is not the type of environment that I would want to work in. Its just sad to hear about these things going on.

 

[HealthHare]

It's probably best to go to medical school with the goal of becoming a "physician" in mind, not an anesthesiologist/other specialist -- for the sake of flexibility and freedom.

Browsed through one of the threads, and lol'ed at this post:

http://forums.studentdoctor.net/showpost.php?p=9999867&postcount=22

I really hope they'll be happy with their paycut to 300k and that it won't cause them too much distress.

 

[morning]

hahahaha. 300k?! that's like, the same as a Mcdonald's drive-thru operator, right? DAMN YOU OBAMACARE!!!

i'm going to go out on a limb here and say that the poster in that forum was a republican...haha

I totally know a UPS driver who makes 300k.

 

[tweek125]

I totally know a UPS driver who makes 300k.

Brown? more like green!

 

[deleted307836]

I totally know a UPS driver who makes 300k.

Time to bring out the charts!

 

[Hoody]

One thing I have noticed is that it appears that both Anesthesiologists and CRNAs seem to have little respect for each other..

Only on SDN.

 

[LawNonTrad]

I think the notion that anesthesiology will disappear as a profession is rather improbable. The specialty was created for a reason. For years beforehand, nurses provided anesthesia. Physicians and other decision-makers obviously saw a need for the anesthesiologist with didactic knowledge to provide extra expertise and special care of patients during anesthesia. Obviously CRNAs are qualified to perform anesthesia, just like PAs are qualified to perform routine exams. But I think that on the average, the anesthesiologist performing or supervising the anesthesia will notice more important things than the CRNA, and the physician performing the physical exam is more likely than the PA to notice important or unusual things about the patient that could prove later to be critical. So CRNAs have their place, just like anesthesiologists do. I'd be inclined to think that you can find bad apples in both professions.

Regarding a salary decrease, I don't think that you'll ever see the average anesthesiologist's salary fall to the CRNA's level. What do CRNA's average, 150k maybe? Anesthesiologists have averaged over 300k for years, so they make about double the amount of money that CRNAs do. I think that people realize that they need to keep the salary of the anesthesiologist substantially above the salary of the CRNA otherwise people who know they are interested in anesthesiology might take the CRNA path instead of the MD path. If you know you want to do anesthesia but you know that the salaries will be comparable for MDAs and CRNAs, why would you put yourself through the hassle of medical school when you could be done 3 years earlier with a CRNA certification?

Sure, CRNAs make more than some primary care providers, but that's really an apples to oranges comparison. CRNAs are specialized providers. Internists and family practicioners and pediatricians all make substantially more than their PAs and NPs do, just as anesthesiologists make substantially more than CRNAs. I don't see the reason for the CRNA hate.

 

[gettheleadout]

I really hope they'll be happy with their paycut to 300k and that it won't cause them too much distress.

I will be ecstatic if I can get to make 300k as a doctor, whatever specialty I end up in.

 

[tweek125]

Also, a lot of the "studies" that show unsupervised CRNA care to be equivalent to anesthesiology care, and others that predict CRNAs to take over the profession, are sponsored by the AANA. talk about bias.

 

[Charles_Carmichael]

Also, a lot of the "studies" that show unsupervised CRNA care to be equivalent to anesthesiology care, and others that predict CRNAs to take over the profession, are sponsored by the AANA. talk about bias.

The problem is when the lay public and lawmakers see studies like that, they're not going to take note of conflicts of interest, flaws of methodology, etc. They're just going see "CRNAs provide equal/superior care compared to physicians and are cheaper" and act on that.

 

[Darthvinder]

I totally know a UPS driver who makes 300k.

"I love my fed-ex guy cause he's a drug dealer and he doesn't even know it...and he's always on time."

10 points for who said it... and no googling.

 

[HealthHare]

I still think the notion that CRNAs will overtake AAs in the specialty is more based on speculation than actual evidence. Don't forget that it is primarily the doctors who are leading the field in terms of research and improving techniques. Eliminating sources of innovation would do nothing to help improve patient care. As long as Anesthesiologist continue to prove their worth they should be able to remain in demand.

 

[amakhosidlo]

"I love my fed-ex guy cause he's a drug dealer and he doesn't even know it...and he's always on time."

10 points for who said it... and no googling.

Mitch Hedberg

 

[ButImLETired]

I've had this conversation with a few people (anesthesiology is one of the fields I'm strongly considering) and my impressions are:

1) A lot of it is hype and people complaining for the sake of complaining. In the environments I've been in, MDs and CRNAs have gotten along just fine.

2) I have found that especially in academic centers the CRNAs are often there to relieve the anesthesiologists so they can have decent hours. Even during residency, the hours aren't nearly as bad for anesthesia as they are for, say, surgery (and remember, you need one anesthesiologist per surgery!). This is in part thanks to CRNAs taking over the basic, not-too-challenging procedures that just take time.

3) At least here, the CRNAs allow the residents to be in the good "teaching cases"- the more complex, elaborate surgeries. Meanwhile, CRNAs can take the bread and butter stuff.

4) There are PLENTY of things CRNAs can't do, and if you're at a decent hospital, they won't be allowed to do them. MD anesthesiologists won't lose their jobs because we're still better qualified to do, say, a complex transplant case or a very difficult trauma case.

5) Let's not forget that you can also subspecialize in stuff like critical care (running the SICU), pain medicine, peds, etc. Correct me if I'm wrong, but CRNAs can't do these things.

So, take this with a grain of salt because I'm getting this as a third party, but in my experience it has seemed to be a positive (or at least not super negative) phenomenon. Of course, I've only been in big academic hospital settings- I'm sure the CRNA thing is a much bigger problem at smaller community hospitals and private practices, where the big complicated MD-only cases aren't really done. But anesthesiology as a field can't and won't die. It may be moved farther and farther away from the smaller practice settings and into the bigger hospitals, but we'll see if that happens.

And as always, OP, consider what you see on SDN carefully. People enjoy the anonymity of the internet not in small part because they get to complain and whine without retribution or (personal) judgment, so there's a great deal of negativity here. When I was applying to med school, there was a lot of negativity about the application process- but it wasn't nearly as painful as people said it would be, just tedious. Then I read tons of posts about how horrible and miserable and soul-draining med school is, and while I certainly have my bad days, I have still found med school to be really, really cool. And of course, let's not forget the "medicine is going to hell" posts written by people "wanting to give advice so we don't make the same mistake" but really just wanting to vent their frustrations. So if you see a forum and the general mood seems to be negative, assume it's because of some herd behavior type of situation and ask REAL anesthesiologists around you who work in a practice setting you're interested in how they are doing with the CRNA thing.

 

[ButImLETired]

Oh, and as a final point, one of the main reasons why I'm interested in anesthesia is that I love the people who go into it. They are some of the more chill, normal people around but they have nerves of steel, which I really respect. They're the people you want around in a crisis. And EVERY anesthesiologist I've met (yes, every single one, with n=10 or so) absolutely adores his/her job and recommends it strongly. Again, this is in a big hospital setting, so this may not apply to every situation. But I really do appreciate seeing how happy they are.

 

[willen101383]

I see no problem with anesthesiologists bitching over their salaries getting cut. If you are an attending with years of practice making 400k a year, and then get a 100k salary cut that is huge. I dont know how many of you have lived out on your own yet, but having a mortgage, car payment, utilities, etc to pay every month is a huge chunk of change. At my last job I was making about 75k a year. My girlfriend (who I live with and share finances with) makes about the same perhaps a little less. I purchased a car that I could afford to pay off based on my income level. We purchased a house that we could afford based on that level. We go out, do things, buy things based on our income level. If I suddenly took a 33ish percent paycut lets say I would be up $hit creek.

If said anesthesiologist purchased a home, car, vacations, expenses, perhaps a single engine plane they financed according to their salary level....and then got hit with a 100k pay cut that would seriously put them up $hit creek as well...regardless of whether they were making 300k a year. You are suddenly making less than you can afford.

Besides, with 12+ years of education, are you really going to say that it is unrealistic to expect a high salary? I know I would be pissed if I was making 400 for years and then suddenly started making 300....but then again I am a non trad and I dont really still have the starry eyed opinions of a undergrad pre med student.

 

[jvesco22]

Self selected population. The core posters tend to alienate others with opposing viewpoints. Same as any other forum.

x10

...And as always, OP, consider what you see on SDN carefully. People enjoy the anonymity of the internet not in small part because they get to complain and whine without retribution or (personal) judgment, so there's a great deal of negativity here. When I was applying to med school, there was a lot of negativity about the application process- but it wasn't nearly as painful as people said it would be, just tedious. Then I read tons of posts about how horrible and miserable and soul-draining med school is, and while I certainly have my bad days, I have still found med school to be really, really cool. And of course, let's not forget the "medicine is going to hell" posts written by people "wanting to give advice so we don't make the same mistake" but really just wanting to vent their frustrations. So if you see a forum and the general mood seems to be negative, assume it's because of some herd behavior type of situation and ask REAL anesthesiologists around you who work in a practice setting you're interested in how they are doing with the CRNA thing.

Nice post.

/thread

 

[HealthHare]

I've had this conversation with a few people (anesthesiology is one of the fields I'm strongly considering) and my impressions are:

1) A lot of it is hype and people complaining for the sake of complaining. In the environments I've been in, MDs and CRNAs have gotten along just fine.

2) I have found that especially in academic centers the CRNAs are often there to relieve the anesthesiologists so they can have decent hours. Even during residency, the hours aren't nearly as bad for anesthesia as they are for, say, surgery (and remember, you need one anesthesiologist per surgery!). This is in part thanks to CRNAs taking over the basic, not-too-challenging procedures that just take time.

3) At least here, the CRNAs allow the residents to be in the good "teaching cases"- the more complex, elaborate surgeries. Meanwhile, CRNAs can take the bread and butter stuff.

4) There are PLENTY of things CRNAs can't do, and if you're at a decent hospital, they won't be allowed to do them. MD anesthesiologists won't lose their jobs because we're still better qualified to do, say, a complex transplant case or a very difficult trauma case.

5) Let's not forget that you can also subspecialize in stuff like critical care (running the SICU), pain medicine, peds, etc. Correct me if I'm wrong, but CRNAs can't do these things.

So, take this with a grain of salt because I'm getting this as a third party, but in my experience it has seemed to be a positive (or at least not super negative) phenomenon. Of course, I've only been in big academic hospital settings- I'm sure the CRNA thing is a much bigger problem at smaller community hospitals and private practices, where the big complicated MD-only cases aren't really done. But anesthesiology as a field can't and won't die. It may be moved farther and farther away from the smaller practice settings and into the bigger hospitals, but we'll see if that happens.

And as always, OP, consider what you see on SDN carefully. People enjoy the anonymity of the internet not in small part because they get to complain and whine without retribution or (personal) judgment, so there's a great deal of negativity here. When I was applying to med school, there was a lot of negativity about the application process- but it wasn't nearly as painful as people said it would be, just tedious. Then I read tons of posts about how horrible and miserable and soul-draining med school is, and while I certainly have my bad days, I have still found med school to be really, really cool. And of course, let's not forget the "medicine is going to hell" posts written by people "wanting to give advice so we don't make the same mistake" but really just wanting to vent their frustrations. So if you see a forum and the general mood seems to be negative, assume it's because of some herd behavior type of situation and ask REAL anesthesiologists around you who work in a practice setting you're interested in how they are doing with the CRNA thing.

Great insight

It would be wise to take the strong spirited threads like those in the specialty forums with a grain of salt.

 

[willen101383]

I've had this conversation with a few people (anesthesiology is one of the fields I'm strongly considering) and my impressions are:

1) A lot of it is hype and people complaining for the sake of complaining. In the environments I've been in, MDs and CRNAs have gotten along just fine.

2) I have found that especially in academic centers the CRNAs are often there to relieve the anesthesiologists so they can have decent hours. Even during residency, the hours aren't nearly as bad for anesthesia as they are for, say, surgery (and remember, you need one anesthesiologist per surgery!). This is in part thanks to CRNAs taking over the basic, not-too-challenging procedures that just take time.

3) At least here, the CRNAs allow the residents to be in the good "teaching cases"- the more complex, elaborate surgeries. Meanwhile, CRNAs can take the bread and butter stuff.

4) There are PLENTY of things CRNAs can't do, and if you're at a decent hospital, they won't be allowed to do them. MD anesthesiologists won't lose their jobs because we're still better qualified to do, say, a complex transplant case or a very difficult trauma case.

5) Let's not forget that you can also subspecialize in stuff like critical care (running the SICU), pain medicine, peds, etc. Correct me if I'm wrong, but CRNAs can't do these things.

So, take this with a grain of salt because I'm getting this as a third party, but in my experience it has seemed to be a positive (or at least not super negative) phenomenon. Of course, I've only been in big academic hospital settings- I'm sure the CRNA thing is a much bigger problem at smaller community hospitals and private practices, where the big complicated MD-only cases aren't really done. But anesthesiology as a field can't and won't die. It may be moved farther and farther away from the smaller practice settings and into the bigger hospitals, but we'll see if that happens.

And as always, OP, consider what you see on SDN carefully. People enjoy the anonymity of the internet not in small part because they get to complain and whine without retribution or (personal) judgment, so there's a great deal of negativity here. When I was applying to med school, there was a lot of negativity about the application process- but it wasn't nearly as painful as people said it would be, just tedious. Then I read tons of posts about how horrible and miserable and soul-draining med school is, and while I certainly have my bad days, I have still found med school to be really, really cool. And of course, let's not forget the "medicine is going to hell" posts written by people "wanting to give advice so we don't make the same mistake" but really just wanting to vent their frustrations. So if you see a forum and the general mood seems to be negative, assume it's because of some herd behavior type of situation and ask REAL anesthesiologists around you who work in a practice setting you're interested in how they are doing with the CRNA thing.

Dont forget about the fact that many patients will absolutely not let a midlevel anesthesia provider touch them. Many patients dont know CRNAs exist...but I can almost guarantee that if you polled a select population of patients pre op and told them that a nurse, not a doctor, would be running their anesthetic a good amount would be pretty put off by that. Me being one of them. Anesthesia is serious business. If you **** that up, someone is going to be in serious trouble. I have worked with enough nurses in my career, plenty of who are "getting clinicals in to apply to CRNA programs," and they just dont possess the educational background...no offense...but they dont. They know about NURSING. They werent bio majors, they didnt take premed prereqs, they didnt go through medical school and pass many board steps.... they dont know the intricacies of how the body works. They are procedure followers. I am a blood bank technologist and I can only remember like once or twice that a nurse actually knew the ins and outs of transfusion. If I tried to explain why AB pos FFP is universally receivable they just didnt get it. They just know like blood types go together. They dont realize that FFP doesnt contain any antigens for the patients immune system to attack. Most MDs know this stuff intimately. Examples like this (and other issues) were common place in my every day work life in blood bank.

Anesthesiologists are able to pull from that huge knowledge base when things go wrong, nurses just cant because they dont have the training. No offense to nurses because there are plenty of great nurses out there. There are also plenty of things you absolutely want nsg handling. The delivery of anesthesia is absolutely not one of them.

 

[Hoody]

Dont forget about the fact that many patients will absolutely not let a midlevel anesthesia provider touch them.

source please.

Many patients dont know CRNAs exist...

Incorrect. Patients are told before who is handling them. I have yet to see a patient object, or a CRNA try to fake or mislead being a doctor. And I work wayyyyyy closer to a PACU/OR than you.

Anesthesia is serious business.

Indeed. Do you have any sources that say CRNAs are killing off people right and left?

I have worked with enough nurses in my career, plenty of who are "getting clinicals in to apply to CRNA programs," and they just dont possess the educational background...no offense...but they dont. They know about NURSING. They werent bio majors, they didnt take premed prereqs, they didnt go through medical school and pass many board steps.... they dont know the intricacies of how the body works. They are procedure followers. I am a blood bank technologist and I can only remember like once or twice that a nurse actually knew the ins and outs of transfusion. If I tried to explain why AB pos FFP is universally receivable they just didnt get it. They just know like blood types go together. They dont realize that FFP doesnt contain any antigens for the patients immune system to attack. Most MDs know this stuff intimately. Examples like this (and other issues) were common place in my every day work life in blood bank.

Cool story bro.

No offense to nurses because there are plenty of great nurses out there.

Gee. Why would any nurse take offense from your post. errr rant.

 

[willen101383]

source please.

Incorrect. Patients are told before who is handling them. I have yet to see a patient object, or a CRNA try to fake or mislead being a doctor. And I work wayyyyyy closer to a PACU/OR than you.

I have seen my own mother object to having her anesthesia administered by a CRNA on multiple occasions, being that she went through breast ca, bilateral mastectomy, i dont know how many reconstructive surgeries after that. I had a retinal detachment repair last year and found out a CRNA was going to be administering my anesthesia. I am asthmatic who has sometimes severe reactive airway situations go on out of the blue, absolutely not. I had no qualms about asking that an anesthesiologist take care of me during surgery. While this is n=2 and purely anecdotal, I just know from personal conversations/interactions with patients that plenty of people have issues with CRNAs.

You are right that you work closer to the pacu/or than me. Still doesnt change the fact that ive been doing this for a long time, and although I may work further away, I still know what goes on in the hospital. There is a post right in the anesthesia forum about a CRNA misleading patients by calling himself a doctor, and posting his name as Dr. X on the OR schedule board because he has a DNP.

Indeed. Do you have any sources that say CRNAs are killing off people right and left?

http://www.anesthesiologynews.com/index.asp?section_id=1&show=dept&issue_id=181&article_id=5472

http://www.ncbi.nlm.nih.gov/pubmed/10861159?dopt=abstractplus

a two second internet search provided those two links. Look around on the anes forum....ive seen plenty of stories there.

As for CRNAs killing patients off left and right, that obviously isnt the case. However when things go awry in the OR I sure as hell wouldnt trust a CRNA to handle the situation as well as an anesthesiologist.

Cool story bro.

Gee. Why would any nurse take offense from your post. errr rant.

Most nurses know their limitations hoody, I suspect you are one. You are obviously applying to medical school so that you can practice medicine and care for your patients at a higher level. I have worked with many great nurses who know when things are getting out of their control and they need an attending. I also have worked with plenty of nurses who really dont realize their limitations/have inferiority complexes about nsg/think they could do the doctors job.

Nurses are absolutely a vital link in the delivery of healthcare. I am not arguing that. Nurses are experts in the front line care of patients/managing patients between attending visits/emotional support/psychosocial intervention/preventive care/meds, etc. Doctors would have a very difficult time practicing medicine without nursing. The problem lies in the fact that some nurses are pushing for more and more responsibility that they simply dont have the training to handle. If you wanted to practice medicine it is my firm belief that you should have gone to medical school. There are plenty of places for midlevels....anesthesia is not one of them. Anyways, I am done arguing for tonight.

 

[jdh71]

I've been periodically viewing the Anesthesiology forum and I've noticed that it is really depressing. It seems like all they talk about is the eminent death of their specialty to NPs and healthcare reform. I was actually considering Anesthesiology as a future specialty for myself, but now I'm not so sure.
Has anyone else read some of the threads on Anesthesiology? What are your thoughts?

Well it does suck when someone moves in on your territory, and does it with the temerity of proclamations that they are just as good as you. It's asinine.

Healthcare reform sucks. But those guys probably have the MOST to bitch about because out of all specialties their salaries have nowhere to go but down. Let's say, just for the thought experiement, with the health reform salaries got to a parity between all specialties of 200K, give or take a couple 10 grand either way . . . most of these guys are looking at a cut in HALF of their pay to that level (while the FP guy is looking to pad his pay) . . . context . . .

Anyway, it also happens to do with the type of people who go into gas . . . these are guys I like personally - fun to go out with, interesting, well traveled - but are kind of lazy as workers. It's not that they can't, won't, or don't work really hard, but simply they ****ing bitch and moan about it more than any other group I've ever seen. Hell even the eye, radar and rash pre-lims don't act like the ox has been gored like the gas pre-lims.

 

[willen101383]

http://forums.studentdoctor.net/showthread.php?t=732109

Theres a thread I dug up for you.

 

[Hoody]

. . . most of these guys are looking at a cut in HALF of their pay to that level (while the FP guy is looking to pad his pay) . . . context . . .

So you're cool with FPs making 130k a year (or less)? If you cut the salary in half of the upper paying salaries, you'd still be making MORE than the "FP looking to pad his pay."


Let me guess....you're probably okay with random specialties acting as PCPs.

 

[jdh71]

So you're cool with FPs making 130k a year (or less)? If you cut the salary in half of the upper paying salaries, you'd still be making MORE than the "FP looking to pad his pay."


Let me guess....you're probably okay with random specialties acting as PCPs.

Let me guess . . . you beat little children. Oh, oh, oh, you like to tongue the buttholes of beagles. I bet you think it's funny to club baby seals. This is fun!!1!one!!!eleven!

I'm cool with anyone making as much as anyone can. I can't do anything about the disparities within the less than free marketplace. The more distortion to the marketplace the worse it is over all.

All I was saying is this: I can understand why they are bitching. Looking at a large salary pay cut, as in making half of what you used to sucks. I'd bitch about it too.

 

[PremedGunner]

healthcare reform probably doesn't suck, and theres going to be a lot more patients.

just because someone is very educated should not mean that they are entitled to 400k.

anaethsistigiiologogogy (SP????) will not die out because thats ridiculous and they are highly needed

 

[jdh71]

healthcare reform probably doesn't suck, and theres going to be a lot more patients.

just because someone is very educated should not mean that they are entitled to 400k.

anaethsistigiiologogogy (SP????) will not die out because thats ridiculous and they are highly needed

How much is a person "entitled" to make?

 

[Hoody]

All I was saying is this: I can understand why they are bitching. Looking at a large salary pay cut, as in making half of what you used to sucks. I'd bitch about it too.

And all I was saying is that I can understand why the FP guys are bitching.

But you're one mature resident.

 

[loveoforganic]

Great insight

It would be wise to take the strong spirited threads like those in the specialty forums with a grain of salt.

That's asinine. Those people posting in the subspecialty forums are generally residents and attendings in the field. If you're going to take their opinions with a grain of salt, whose aren't you going to?

While the anesthesiology forum here does, in general, swing wayyyyyyy to the right and to the alamarist, they still make some important points worth digging deeper into for yourself.

 

[jdh71]

And all I was saying is that I can understand why the FP guys are bitching.

I get that too, but that's as much my fault as the gas trolls making 400k. I'm just trying to get MINE. It's someone else's world, I just live here.

But you're one mature resident.

Hmmm . . . why do I sense sarcasm? ISWYDT

 

[Hoody]

ISWYDT

 

[HealthHare]

That's asinine. Those people posting in the subspecialty forums are generally residents and attendings in the field. If you're going to take their opinions with a grain of salt, whose aren't you going to?

While the anesthesiology forum here does, in general, swing wayyyyyyy to the right and to the alamarist, they still make some important points worth digging deeper into for yourself.

Taking something with a grain of salt simply means taking a cautious and objective approach to what someone says. I'm sure what some of those guys are saying are realities of the specialty, but I'm also sure there is a lot of BS being said that is more based on fear and frustration than fact. It has become increasingly clear to me that a small group of residents and attendings on SDN do not define an entire specialty.

 

[LawNonTrad]

How much is a person "entitled" to make?

I think you realize that the average anesthesiologist would be making less money if we had a truly free market in health care without prices being driven up by government/health insurance co. involvement. If people were truly free to negotiate the price of every procedure/test/anesthetic procedure with their doctor on a face-to-face level (i.e. a pure free market), there's no way that anesthesiologists would be making 300k a year or radiologists would be making 400k a year.

So I think we can cut the crap about entitlements to higher pay. If you're Tiger Woods and you make 100 million dollars a year from endorsements, you're entitled to it. Supply and demand. And he doesn't earn that money from govt/private company involvement in the golf industry. He earns it because he's just that damned good at golf (or at least he used to be ).

I'll also mention the fact that the professional medical organizations have limited the enrollment at medical schools for years and have kept the supply of doctors artifically low, distorting market forces and driving up the cost of health care. So I don't care about hearing words like "entitlement" when it comes to physician pay.

 

[loveoforganic]

Taking something with a grain of salt simply means taking a cautious and objective approach to what someone says. I'm sure what some of those guys are saying are realities of the specialty, but I'm also sure there is a lot of BS being said that is more based on fear and frustration than fact. It has become increasingly clear to me that a small group of residents and attendings on SDN do not define an entire specialty.

You're right, sorry. I normally hear that expression used incorrectly apparently At any rate, agree with what you wrote.

 

[loveoforganic]

I think you realize that the average anesthesiologist would be making less money if we had a truly free market in health care without prices being driven up by government/health insurance co. involvement. If people were truly free to negotiate the price of every procedure/test/anesthetic procedure with their doctor on a face-to-face level, there's no way that anesthesiologists would be making 300k a year or radiologists would be making 400k a year.

Do you really think medicine could function in any sort of true free market?

 

[morning]

If you can't vent on a forum for your profession, where CAN you vent? I'm sure they don't go through their lives like this.

How much is a person "entitled" to make?

Whatever it is, it isn't because they're highly educated. I got into this in the Topics in Healthcare forum once...there's this prevailing belief that doctors are OWED money because they went to school for a long time and work hard, as if this is a soshulist country where you get paid based on what you feel like you deserve to get paid and not how much you benefit the people who own the company you work for. Anesthesiologists generally work for hospitals. Hospital administration views their work as a business, and in the interests of greed and profit, they will hire those who they can pay less.

I DON'T support passing up physicians for midlevels to maximize profit. I'm just just saying that this is how it is, and that no one is ever going to get paid based on some utopian ideal of "I got a lot of education and I'm very smart, so that means I should make THIS much." Salaried docs will have to contend with the profit margins of admins, and docs who are paid via imbursement have to contend with the profit margins of insurance companies. If at any point either of those bodies can cut costs, they will...(there's no law that says insurance companies have to peg their rates to Medicare, but if they have the opportunity...why wouldn't they?)

 

[LawNonTrad]

Do you really think medicine could function in any sort of true free market?

Loveoforganic, that's not the point. It's irrelevant because what I'm talking about is the current health care infrastructure in our country. It is obviously not a free market so to hear doctors bandy about terms like entitlement when it comes to their salary is rather ridiculous. Even if they aren't directly working in socialized medicine (VA) or corporatized medicine, they're still a cog in that system and their salary is not their true dollar value. Obviously, orthopedists are not 3 times as valuable as family practice doctors, yet they make 3 times as much. That wouldn't happen in a free market system. The only way to have your dollar value accurately measured is in a free, competitive market.

Edit: So you're right that U.S. medicine will likely never be one, and that means that doctors should not attempt to justify their artificially inflated salaries imo.

 

[jdh71]

I think you realize that the average anesthesiologist would be making less money if we had a truly free market in health care without prices being driven up by government/health insurance co. involvement. If people were truly free to negotiate the price of every procedure/test/anesthetic procedure with their doctor on a face-to-face level (i.e. a pure free market), there's no way that anesthesiologists would be making 300k a year or radiologists would be making 400k a year.

So I think we can cut the crap about entitlements to higher pay. If you're Tiger Woods and you make 100 million dollars a year from endorsements, you're entitled to it. Supply and demand. And he doesn't earn that money from govt/private company involvement in the golf industry. He earns it because he's just that damned good at golf (or at least he used to be ).

I'll also mention the fact that the professional medical organizations have limited the enrollment at medical schools for years and have kept the supply of doctors artifically low, distorting market forces and driving up the cost of health care. So I don't care about hearing words like "entitlement" when it comes to physician pay.

That was one of the biggest, steaming piles of strawman I've ever seen in here. That's was impressive work son.

I didn't bring up "entitlements" anywhere. So maybe you can cut the crap instead?

 

[jdh71]

Do you really think medicine could function in any sort of true free market?

Yes

 

[morning]

Loveoforganic, that's not the point. It's irrelevant because what I'm talking about is the current health care infrastructure in our country. It is obviously not a free market so to hear doctors bandy about terms like entitlement when it comes to their salary is rather ridiculous. Even if they aren't directly working in socialized medicine (VA) or corporatized medicine, they're still a cog in that system and their salary is not their true dollar value. Obviously, orthopedists are not 3 times as valuable as family practice doctors, yet they make 3 times as much. That wouldn't happen in a free market system. The only way to have your dollar value accurately measured is in a free market.

I'm honestly not sure about whether salaries could survive the free market. Cash only primary care is obviously viable, but I can't see anyone being able to pay for specialized treatments out of pocket, so cash only HOSPITALS could never be viable. That's why even insurance relies on having healthy people to subsidize the unhealthy people (yes, even in your insurance, you will be paying for someone else's healthcare...) because no one person could handle the cost of, say, cancer treatment or a prolonged hospital stay.

The main problem doctors deal with, money-wise, is that it IS a free market...for everyone but the physician. It's a very unusual situation. Hospitals maximize their profits. Medical schools maximize their profits. Nurses of all stripes and education levels maximize their profits. Lawyers, obviously, are a big piece of the puzzle. All these people and organizations are allowed to dig their heels in and be as capitalist as they want to be, but doctors are not.

 

[LawNonTrad]

That was one of the biggest, steaming piles of strawman I've ever seen in here. That's was impressive work son.

I didn't bring up "entitlements" anywhere. So maybe you can cut the crap instead?

WTH?

I was agreeing with you and disagreeing with PremedGunner!

That's why I used the word "entitle" in its various forms, because he did! I saw you mention the distortions in our less than free market and I quoted you because I was agreeing with you.

Basically I was lending support to what I thought was your argument that it's really impossible to measure anyone's value in our distorted non-free market health care system, so I don't have a problem with physicians getting all they can get while the getting is good.

 

[jdh71]

Whatever it is, it isn't because they're highly educated. I got into this in the Topics in Healthcare forum once...there's this prevailing belief that doctors are OWED money because they went to school for a long time and work hard, as if this is a soshulist country where you get paid based on what you feel like you deserve to get paid and not how much you benefit the people who own the company you work for. Anesthesiologists generally work for hospitals. Hospital administration views their work as a business, and in the interests of greed and profit, they will hire those who they can pay less.

I DON'T support passing up physicians for midlevels to maximize profit. I'm just just saying that this is how it is, and that no one is ever going to get paid based on some utopian ideal of "I got a lot of education and I'm very smart, so that means I should make THIS much." Salaried docs will have to contend with the profit margins of admins, and docs who are paid via imbursement have to contend with the profit margins of insurance companies. If at any point either of those bodies can cut costs, they will...(there's no law that says insurance companies have to peg their rates to Medicare, but if they have the opportunity...why wouldn't they?)

What I hear you saying is that no one is "entitled" to make any amount of money. Which is the correct assessment. However, I am "entitled", as in: "it is my natural right," to make what I can make. The entitled argument about what is "owed" because of such and such is complete and utter nonsense. I'm not owed anything more than someone is willing to pay me. You may complain out the rigged system that allows the gas trolls to make 400K/yr, but its NOT their fault they get paid that much. What are they supposed to say, "Heeeeeeyyyyy, guy, this is too much money. I'm not taking it!"

???

 

[jdh71]

WTH?

I was agreeing with you and disagreeing with PremedGunner!

That's why I used the word "entitle" in its various forms, because he did! I saw you mention the distortions in our less than free market and I quoted you because I was agreeing with you.

Well, this makes more sense now.