What Job offers are current residents getting?

[Carbocation1]

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[Hoya11]

At this point, is there any reason to go into anesthesiology? Can any argument even be made to justify going into the field? It just looks completely pointless. I was going to pretend to overlook the fact that no one respects you and that you have an army of insubordinate people with IQs of 80 undermining and making a mockery of your profession. However, I think these issues of CRNAs being allowed to do whatever they want when they want just can't be ignored anymore. These hospitals, insurance companies, and ultimately the government have made it clear what their intentions are and what the proverbial writing on the wall is. How much longer can anesthesiologists, residents, and medical students pretend like everything will be okay? We have ZERO leverage and it looks like checkmate seven ways from Sunday. Am I missing something?

your missing that you make 300k+ for 50-60hrs of work with little to no business side of medicine crap to worry about as in other fields, and do cool stuff like save lives and take care of people at their most vulnerable times. want to go to a marketing dinner from 8-10? want to deal with fatties in clinic writing abx for colds ? want to have your personal phone going off at home all the time? im very happy in anesthesia and left a private practice pain job to return to the OR and have never been happier. work in bulk, off in bulk. in most of medicine, aside from a few surg specialties, your not going to pull in >500k anymore, get over it, be grateful for what you have.

 

[Lurch]

Dude, are you rapid cycling? Your posts over the last several weeks are pathognomonic.

 

[Hoya11]

The question is will any of that even exist in 5 years? When was the last time you saw an anesthesiologist doing their own case? With the way things are going, am I going to be grateful to even have a job in 5 years for over 200k? The field is trending downward and with good reason... the CRNAs are winning the political battle and going completely unchecked. They are practicing independently, doing hearts, etc and have the hospitals, insurance companies, and government on their side. Everything is about the bottom line, and the bottom line is anesthesiologists make too much money for what anyone is willing to pay.

i dont think you have a good grip on the reality of what crnas actually do. its mostly charting and overseeing the maintenance phase. every day i assist with airway difficulties, determine management plans, bail outs, arrythmia management, do all blocks and lines, etc. i think you need more real life experience

 

[repititionition]

i dont think you have a good grip on the reality of what crnas actually do. its mostly charting and overseeing the maintenance phase. every day i assist with airway difficulties, determine management plans, bail outs, arrythmia management, do all blocks and lines, etc. i think you need more real life experience

He has NONE, so any would be "more real life experience"

 

[Hoya11]

I know what CRNAs are supposed to do and what they actually do. They are supposed to be a technical drone doing charting, scutwork, and keeping the stool warm during the autopilot/maintenance phase. What they actually do (in my area) are epidurals, lines, induction, maintenance, emergence and often times have no MD oversight even when they are supposed to... not to mention the various states where there is no doctor present. There are CRNAs practicing independently providing anesthesia to private practice plastic surgeons, ENTs, etc. I want to know where you are practicing so I know where to look for some last ditch job security.

in the other 99.9% of the country dude

 

[IlDestriero]

The question is will any of that even exist in 5 years? When was the last time you saw an anesthesiologist doing their own case? With the way things are going, am I going to be grateful to even have a job in 5 years for over 200k? The field is trending downward and with good reason... the CRNAs are winning the political battle and going completely unchecked. They are practicing independently, doing hearts, etc and have the hospitals, insurance companies, and government on their side. Everything is about the bottom line, and the bottom line is anesthesiologists make too much money for what anyone is willing to pay.

I do my own cases all the time.
Even with a significant pay cut, I'd make 300k with good benefits for ~50 hrs.
They won't practice independently in my shop in my lifetime, or ever.
If you work at an outpatient clinic, Podunk hospital, etc. well, you probably should worry.

 

[IlDestriero]

I work at a large specialty referral hospital. They will be the last to fall, assuming they are financially solvent. If you are really worried, go get a job there. They will also be the systems that spin off as private in the future 2 tier system if you're worried about that as well.
I'm not sure why you added the "unfounded" sarcasm at the end. If CRNAs took call and worked 50+ hours a week, they'd make 300 as well. That's the current realistic bottom in my opinion. Why people take shady low paying jobs is something I don't understand. Go find a better job and be happy, or accept being paid less and be happy with what you have.
If a 36 or 40 hr a week CRNA makes ~180, 30% more hours and another 50k or so for call compensation would put them up close to 300.

 

[Man o War]

I second everything IlDestriero said. CRNAs doing hearts independently? Where is this? CRNAs aren't even allowed in the heart rooms at any of the hospitals around here except one, and they are one to one with an attending there. I'm in the same type of practice as he/she is^^^and there is no possible way they will work independently at any of the dozen larger hospitals in my area. It just won't happen. Politics, surgeons, hospital administration would never allow it. BFE? Yes. A few local plastic surgery offices for sedation? Yes. That's been going on for years though, this is nothing new. The surgeon owned surgery centers here don't even have independent CRNAs, and they're as penny pinching/cost conscious as they come.

 

[chocomorsel]

ILDestrierio,what is a " shady low paying job" in your opinion? We are talking anything outside Cali and the West Coast. At my last job my total benefit package came at 375-380K. I thought that was good. I was at 300 W2 base. But reading this forum makes me think otherwise. In a little podunk town that is.

 

[Man o War]

Hinsdale is a supervision model. CRNAs will never do hearts independently without supervision on a wide scale in my opinion.

 

[deleted171991]

LegitBoss4Life, this is the list of optout states: http://www.aana.com/advocacy/stateg...ral-Supervision-Rule-Opt-Out-Information.aspx .

The part of anesthesia that independent CRNAs will end up taking over is anything that is low-risk (patient or procedure), +/- intermediate-risk patients and procedures. The question is not if, it's when (and how many of them). Everything that is high-risk will stay under anesthesiologist care/supervision, for liability (and competency) reasons. (We are talking decades here, it won't just happen overnight.)

The market is not favorable to anesthesiology residency graduates as it is. If more CRNAs become independent, a bunch of anesthesiologists will end up working at lower salaries or not at all. If you can go the extra mile for the same money as a CRNA, you will always have a job. If you provide care for sick patients or high-risk procedures, you will always have a job. Anything in-between is a matter of luck and guesswork.

Generally, any anesthesia activity that can be reduced to a protocol, and is easy to learn, is at risk for midlevel takeover (but that also applies to the rest of medicine, except that midlevels in some other specialties are decades behind CRNAs). That could include a part of regional, OB, neuro, even pain, healthy peds. The more competent you are as a doctor and the more your competency level is actually needed for your daily work (e.g. critical care, cardiac, sick peds, advanced regional, high-risk OB etc.), the safer you'll be.

 

[Wolverines83]

Why would it matter what type of hospital you are at? All hospitals operate the same... which is to make money, increase profits, and find ways to cut overhead. I'm going to be completely honest with you.. if I was the CEO of a hospital I would stop hiring anesthesiologists and employ CRNAs instead to increase profits. Why not? Anesthesia has become so safe in the 21st century that 90-95% of the time it doesn't really matter who is behind the curtain. The 5% of the time where a competent physician would make a difference is not enough to justify paying you 3x more when I can just attribute any less than ideal outcome to just a possible complication. The general public wouldn't know the difference anyway. At the end of the day, medicine is a business. The quality may not be the same with a midlevel provider, but as long as they get the job done no corporate executive is going to care. These CRNAs can practice independently in 17 states already and I'm sure it will continue to grow and expand as they fight to "practice to the full extent of their training". I don't even understand how you don't see a problem with a nurse making the same amount of money as a physician assuming they worked the same amount of hours. Under no circumstances should a nurse make anywhere close to what a physican makes regardless of anything. Are you in academic medicine? The big issue I hear from practicing anesthesiologists is that academic anesthesiologists don't truly understand what is going on in private practice and how much of an issue the CRNAs really are so the ASA is not unified in addressing this problem.

5% is one out twenty cases. How many cases are done in a day? Let's play SUPER conservative and call it 20. That means every day there's one case requiring the anesthesiologist. If one patient per day had a bad outcome because of anesthesia.....yeah....your hospital would be lined up for demolition in about a week. Please don't be a CEO.

But in all seriousness....go workout or something. Take a jog, drink a beer, whatever. I'm stressed just reading your posts. I can't imagine how you feel writing them

 

[IlDestriero]

Why would it matter what type of hospital you are at? All hospitals operate the same... which is to make money, increase profits, and find ways to cut overhead. I'm going to be completely honest with you.. if I was the CEO of a hospital I would stop hiring anesthesiologists and employ CRNAs instead to increase profits. Why not? Anesthesia has become so safe in the 21st century that 90-95% of the time it doesn't really matter who is behind the curtain. The 5% of the time where a competent physician would make a difference is not enough to justify paying you 3x more when I can just attribute any less than ideal outcome to just a possible complication. The general public wouldn't know the difference anyway. At the end of the day, medicine is a business. The quality may not be the same with a midlevel provider, but as long as they get the job done no corporate executive is going to care. These CRNAs can practice independently in 17 states already and I'm sure it will continue to grow and expand as they fight to "practice to the full extent of their training". I don't even understand how you don't see a problem with a nurse making the same amount of money as a physician assuming they worked the same amount of hours. Under no circumstances should a nurse make anywhere close to what a physican makes regardless of anything. Are you in academic medicine? The big issue I hear from practicing anesthesiologists is that academic anesthesiologists don't truly understand what is going on in private practice and how much of an issue the CRNAs really are so the ASA is not unified in addressing this problem.

I've practiced at a few different locations from really rural to the ivoriest tower. The reason that the type of hospital matters is because the acuity of patients and types of surgeries at the major quaternary care centers is an order of magnitude higher than most hospitals which are an order of magnitude higher than ambulatory centers and office based practices. CRNAs will potentially take the low hanging fruit and smaller practices. Getting a job threatening foothold in a huge high acuity hospital system is not a realistic fear. They simply do not have the training to practice at that level. It would also require the abandonment of significant academic productivity, one of the 3 pillars of academic medicine, as the number of CRNAs engaged in real research or with PhDs is very low.
As an example. I trained at a well known major university referral hospital, and I practiced at the Navy's referral hospital in San Diego as well, the Starship of Navy Medicine, NMCSD. It was essentially a full service hospital doing some peds, had a NICU, heads, hearts, vascular, etc. (at least while I was there) but it didn't do trauma or transplant, sick kids, etc. Excluding some ruptured AAAs, unusual disasters, etc. the average acuity and complexity of cases at the university hospital were not at all comparable to what I did at NMCSD. That's the reality. When things get complex and required uncommon procedures and experienced teams, they were referred out to the big university hospitals.
That's not to say there aren't sick patients and good surgeons at many non university hospitals, but specialty referral hospitals exist for a reason. There are pediatric specialists and a NICU at my local suburban hospital, but they wouldn't touch many of the patients/procedures that I do all the time at the children's hospital. The push is actually to expand these critical services and sub specialty centers of excellence and we expand the practice every year. Even our own hand picked CRNAs that we train on the job cannot do these cases alone, and they sure as hell wouldn't want to.
As for what CRNAs make, that's market driven, and I don't set the rates. We pay below the national average and have no shortage of applicants. But they don't work over 40 hours or take call, so they have to take that into account when comparing offers. Lots of people would be pretty happy working 36-40 hours a week in a supervised setting with limited liability and no call for ~150k.

 

[IlDestriero]

ILDestrierio,what is a " shady low paying job" in your opinion? We are talking anything outside Cali and the West Coast. At my last job my total benefit package came at 375-380K. I thought that was good. I was at 300 W2 base. But reading this forum makes me think otherwise. In a little podunk town that is.

It is impossible to quote any number without taking into account how much you are working, how many hours, and how much call.
300k sounds ok doing your own cases. Make that supervising 4:1 working 7-5+ every day and taking 1/6 call and its pretty freaking bad. That should be a >95th percentile job not a less than 50th percentile job. I've seen 300 for no late/no call mommy track jobs.

 

[deleted171991]

I've seen 300 for no late/no call mommy track jobs.

In peds, or general anesthesiology?

 

[IlDestriero]

General. They pay that at a local hospital. I know someone that does it. 7-3 M-F. The private group at the military hospital made more than that as well, though they got limited benefits.

 

[Twiggidy]

Why would it matter what type of hospital you are at? All hospitals operate the same... which is to make money, increase profits, and find ways to cut overhead. I'm going to be completely honest with you.. if I was the CEO of a hospital I would stop hiring anesthesiologists and employ CRNAs instead to increase profits. Why not? Anesthesia has become so safe in the 21st century that 90-95% of the time it doesn't really matter who is behind the curtain. The 5% of the time where a competent physician would make a difference is not enough to justify paying you 3x more when I can just attribute any less than ideal outcome to just a possible complication. The general public wouldn't know the difference anyway. At the end of the day, medicine is a business. The quality may not be the same with a midlevel provider, but as long as they get the job done no corporate executive is going to care. These CRNAs can practice independently in 17 states already and I'm sure it will continue to grow and expand as they fight to "practice to the full extent of their training". I don't even understand how you don't see a problem with a nurse making the same amount of money as a physician assuming they worked the same amount of hours. Under no circumstances should a nurse make anywhere close to what a physican makes regardless of anything. Are you in academic medicine? The big issue I hear from practicing anesthesiologists is that academic anesthesiologists don't truly understand what is going on in private practice and how much of an issue the CRNAs really are so the ASA is not unified in addressing this problem.

1. Public perception matters. A major problem is our surgeons who we do good work for don't advocate for us. That's a major problem. (We also don't advocate for ourselves out of fear of losing jobs, contracts, etc)

2. As I've posted earlier, a CRNA can never do what I can do. I don't care where they've worked or where they've trained. I'm a board certified, cardiac fellowshipped, echo certified anesthesiologist. If a heart surgeon wants to focus on fixing the heart, he'll be better off with me. If he wants to fix the heart, babysit vitals, look over the screen at the echo, possibly help with difficult line placement, fine, take the CRNA and make life more difficult for he and the patient. (Goes back to #1, the surgeons need to advocate for the skilled people they work with)

3. If you're worried about CRNA takeover, then do a fellowship. When I was considering a fellowship one of my attendings told me something that has stuck with me since, "when the chopping block comes, the people with more education and more certifications are usually the last to go" (this probably applies to academics more than private). CRNAs will never RUN an ICU, never be solo on difficult peds cases, never RUN a pain clinic, and never control a division of cardiac anesthesia. (These same attendings also pledged to never teach CRNAs lines, blocks, fiberoptics, etc for that same reason. They would bring residents to those cases)

So while things may seem grim if you're practicing in the boonies because they let nurses do everything because MDs want to live nears cities and suburbs, the reality is, Anesthesiologist will NEVER become extinct because we'll be needed for reasons outlined in #3. It may take some work on our part (more education, more science work, a little political lobbying) but we aren't going anywhere.

 

[Twiggidy]

Yet as I browse Gasworks.....yes, the salaries are going down (alot of 250-300k jobs) but I don't think it's just anesthesiology. A lot of fields are in financial decline. If you're driven by money, medicine is no longer the field to go into. It's a very secure field and you'll make more money than 90-95% of the population, but if you want to be RICH become a venture capitalist.

 

[pgg]

At this point, is there any reason to go into anesthesiology? [snip]

No, you should go into neurosurgery. You'd deserve them and they'd deserve you.

 

[Mad Jack]

I dunno man. Lots of those comments were pro MD. Probably as many if not more as were anti MD. And that's in the NY Times.

My favorite comment was this one:

"It's funny that this article makes Ainsworth, Nebraska look like a town with no doctor and substandard medical care, with only a frightened nurse practitioner and a doctor who stops in once a month from another state.

Funny because my dad, Melvin Campbell, has worked as a doctor there for the past 37 years. He speaks highly of his NP, she's very capable -- and the only time she's on her own is when he's on vacation (that is, rarely). Yeah, the hospital has been trying to recruit a doctor since 2012 -- not because they don't have one, but because my dad can't work as the sole physician in the county forever.

In fact, he had a conversation with Ms. Tavernise when she was writing this article, which does shine light on the problem of rural communities with limited healthcare options. But come on. She wanted to make rural Nebraska look isolated, and doctors look like jerks, and the problem look scary for dramatic effect, and she had to ignore a few facts that didn't fit that storyline."

 

[kazuma]

1. Public perception matters. A major problem is our surgeons who we do good work for don't advocate for us. That's a major problem. (We also don't advocate for ourselves out of fear of losing jobs, contracts, etc)


3. If you're worried about CRNA takeover, then do a fellowship. When I was considering a fellowship one of my attendings told me something that has stuck with me since, "when the chopping block comes, the people with more education and more certifications are usually the last to go" (this probably applies to academics more than private). CRNAs will never RUN an ICU, never be solo on difficult peds cases, never RUN a pain clinic, and never control a division of cardiac anesthesia. (These same attendings also pledged to never teach CRNAs lines, blocks, fiberoptics, etc for that same reason. They would bring residents to those cases)

So while things may seem grim if you're practicing in the boonies because they let nurses do everything because MDs want to live nears cities and suburbs, the reality is, Anesthesiologist will NEVER become extinct because we'll be needed for reasons outlined in #3. It may take some work on our part (more education, more science work, a little political lobbying) but we aren't going anywhere.

While it's true that a CRNA might never run a unit, NP's run units and are sometimes the only in house providers even in high acuity CTICU's at academic centers (surgeon at home and may or may not answer phone based on my experience). I can see the value of CT or Peds fellowships in certain PP situations or in many academic centers, but I have a tough time seeing how more education and specialization will save our field when the trend is heading towards increased scope of practice for far less educated providers including NP's and crna's.

 

[Twiggidy]

And I've said before, I have no problem with CRNAs as there are very useful to a busy practice, but I just don't ever see a day where the field of anesthesiology and the duties that come with it will be fully run by nurses. Sure someday we may all be working for a corporation making 250k but again, that's more the 90% of the country's salary.

 

[aimedicine]

i seriously can't believe highly educated people on this forum with take home pay well over 200k are confused/worried about how to get rich....are doctors business acumen really that bad?...i have family relative that have much less captial (than a doctor can garner) and most of them have successful business both locally and internationally. If you want to be rich you have to stop thinking like a physician and start thinking like a businessmen and use the resources around you...

 

[pgg]

i seriously can't believe highly educated people on this forum with take home pay well over 200k are confused/worried about how to get rich....are doctors business acumen really that bad?...i have family relative that have much less captial (than a doctor can garner) and most of them have successful business both locally and internationally. If you want to be rich you have to stop thinking like a physician and start thinking like a businessmen and use the resources around you...

Ah, more "be brilliant and it'll all work out" advice, that was overdue in this thread.

Assuming one lives within one's means, saves diligently, and doesn't leave a trail of wrecked marriages and alimony / child support payments in one's wake, the difference between $200K and $400K isn't the difference between comfort and poverty. It's the difference between retiring at 50 and retiring at 65. Don't put up the "woe is me I can't be successful on $200K" strawman; no one is arguing that.

 

[aimedicine]

Ah, more "be brilliant and it'll all work out" advice, that was overdue in this thread.

Assuming one lives within one's means, saves diligently, and doesn't leave a trail of wrecked marriages and alimony / child support payments in one's wake, the difference between $200K and $400K isn't the difference between comfort and poverty. It's the difference between retiring at 50 and retiring at 65. Don't put up the "woe is me I can't be successful on $200K" strawman; no one is arguing that.

with 200k and willingness to venture into businesss...you can retire at 50, that's my argument. AND you don't have to be brilliant, you just have to have common sense and the diligence. I know pediatricians and pharmacist who own houses close to 1 million, they sure didn't buy those houses with their physician salary...they all use their salary as capital to build a business that generated second income stream, which turned into third income stream, which....etc. you get my drift.

 

[repititionition]

While it's true that a CRNA might never run a unit, NP's run units and are sometimes the only in house providers even in high acuity CTICU's at academic centers (surgeon at home and may or may not answer phone based on my experience). I can see the value of CT or Peds fellowships in certain PP situations or in many academic centers, but I have a tough time seeing how more education and specialization will save our field when the trend is heading towards increased scope of practice for far less educated providers including NP's and crna's.

I have a fresh grad PA friend who is looking at jobs in DC where PA's run the f-ing unit. All procedures, solo coverage at night, etc.

 

[amyl]

The surgery pa does all the lines at my hospital. The just hired a pa for the pulmonogist. They want her to do all the lines too. I'm the only person who said "what? No." Have I mentioned I don't like it here and am leaving? ....and can't wait.

 

[nimbus]

The surgery pa does all the lines at my hospital. The just hired a pa for the pulmonogist. They want her to do all the lines too. I'm the only person who said "what? No." Have I mentioned I don't like it here and am leaving? ....and can't wait.

But that surgery PA who does all the lines is probably better than 90% of the existing medical staff. I'm all for adequate training but lines are monkey skills that don't require an MD. Just decent training, experience and common sense.

 

[amyl]

They can't get an airway and thus can't manage the complications of line placement.

 

[deleted171991]

They can't get an airway and thus can't manage the complications of line placement.

Neither can most IM trainees, and yet they put in a ton of lines.

 

[amyl]

Doesn't mean it's a good idea

 

[deleted171991]

Doesn't mean it's a good idea

Monkey see, monkey do.

As long as the person is well-trained and there is readily available support for complications, I don't see why it's a big deal.

 

[sleepallday]

If the PA is employed by the surgeon, guess who bills for all their lines?

That's the only reason why I can see some surgeons insist on it. If I'm doing a case where the line is essential, then I'm putting it in myself.

 

[anbuitachi]

So 25 pages later did any NEW grads post job offers they got? It seemed to me everyone who posted have been in it for few years or more?

 

[aimedicine]

So 25 pages later did any NEW grads post job offers they got? It seemed to me everyone who posted have been in it for few years or more?

lol my sentiment exactly. Some people did PM me. But from everything i've gathered followeiing this thread...the consensus seems to be...without a fellowship a new grad will make 250-300k (AAMC has starting pay for anesthesia at 276k)...and with some experience and/or increase hours 350-450k possible...>450k is possible but you gotta move midwest or go to cali and bust your butt. And last but not least, a fellowship can help in terms of job security/increase pay/yada yada yada

BUT please new grads (and really anyone else with insight).... post some ball park numbers thanks. or PM me if you are uncomfortable posting.

 

[anbuitachi]

lol my sentiment exactly. Some people did PM me. But from everything i've gathered followeiing this thread...the consensus seems to be...without a fellowship a new grad will make 250-300k (AAMC has starting pay for anesthesia at 276k)...and with some experience and/or increase hours 350-450k possible...>450k is possible but you gotta move midwest or go to cali and bust your butt. And last but not least, a fellowship can help in terms of job security/increase pay/yada yada yada

BUT please new grads (and really anyone else with insight).... post some ball park numbers thanks. or PM me if you are uncomfortable posting.

Not looking forward to the job market when I get out in 5 years (if all goes smoothly. ) pretty sure starting will be <200 by then

 

[aimedicine]

Not looking forward to the job market when I get out in 5 years (if all goes smoothly. ) pretty sure starting will be <200 by then

don't worry about the things you can't control...just work your butt off during residency and be as competent as possible so you can put yourself in a position to be successful. Strive for greatness even if it might not get rewarded monetarily (money is important but its not everything)....if anesthesia money isnt great for you in 5 years...take your earnings and use it as capital for business...there are many ways to skin a cat.

 

[pgg]

with 200k and willingness to venture into businesss...you can retire at 50, that's my argument.

I think that's as terrible an argument as the "I coulda been an ibanker" one.

You're grossly underestimating the difficulty of being a successful entrepreneur ... and the risk involved. Risk isn't just a word, it shows up in the business world. Often.

Odds are that $200K seed will soon be $0K for most people. Even special people, like SDN'ers.

 

[aimedicine]

I think that's as terrible an argument as the "I coulda been an ibanker" one.

You're grossly underestimating the difficulty of being a successful entrepreneur ... and the risk involved. Risk isn't just a word, it shows up in the business world. Often.

Odds are that $200K seed will soon be $0K for most people. Even special people, like SDN'ers.

"those who say they can and can't are usually both right" - Henry Ford (i believe)

 

[pgg]

"those who say they can and can't are usually both right" - Henry Ford (i believe)

That's not an argument - that's an accusation. And a rather snide one as well, because the obvious implication is that people who fail at something fail because they just didn't believe in themselves.

Medicine isn't my first stab at life. I ran my own business prior to med school, and was doing fairly well. I sold out and left in large part because I wanted to be a doctor but also because of the risk and volatility.

I don't know what your entrepreneurial experience is. Maybe you've mentioned it previously. I've been there and you're out of your mind if you think all it takes to get rich is $200K and "common sense and the diligence" whatever that vague platitude means. I wish you the best, if you go that way. At least you can fall back on medicine. Most entrepreneurs fail and have a less marketable/employable skill set to turn to.

Medicine is still the surest thing out there where effort and work are very consistently rewarded very well. Especially once you've sunk the cost of tuition and endured the training. You wouldn't think it reading this forum but it's the truth. I read all these posts from anesthesiologists who are wringing their hands about their future and looking for an exit, and all I can do is shake my head in disbelief.

 

[deleted171991]

I read all these posts from anesthesiologists who are wringing their hands about their future and looking for an exit, and all I can do is shake my head in disbelief.

I think some of us, who were late to the party, just want a backup plan, seeing that there are only morsels left on the table, and it might get worse in the future. The perspective depends a lot on one's bank account and income.

 

[aimedicine]

That's not an argument - that's an accusation. And a rather snide one as well, because the obvious implication is that people who fail at something fail because they just didn't believe in themselves.

Medicine isn't my first stab at life. I ran my own business prior to med school, and was doing fairly well. I sold out and left in large part because I wanted to be a doctor but also because of the risk and volatility.

I don't know what your entrepreneurial experience is. Maybe you've mentioned it previously. I've been there and you're out of your mind if you think all it takes to get rich is $200K and "common sense and the diligence" whatever that vague platitude means. I wish you the best, if you go that way. At least you can fall back on medicine. Most entrepreneurs fail and have a less marketable/employable skill set to turn to.

Medicine is still the surest thing out there where effort and work are very consistently rewarded very well. Especially once you've sunk the cost of tuition and endured the training. You wouldn't think it reading this forum but it's the truth. I read all these posts from anesthesiologists who are wringing their hands about their future and looking for an exit, and all I can do is shake my head in disbelief.

alright bro, if you say so.

 

[Laryngophed]

alright bro, if you say so.

Well, that settles it.

/thread

 

[IlDestriero]

There's a big difference between starting a business while being actively engaged in the day to day operations, staying late as needed, taking little income during a downturn, etc. and funneling money into a business as a partner that is minimally engaged in the day to day operations. That's what you will likely have to do as a practicing physician investor. If you find the right partners and the right business that's fine, but you're taking on a much bigger risk of loss and headaches.
If given the opportunity, I would have happily invested £100,000 in the Bruichladdich distillery in 2000. Barring disaster that would have been a no brainier, and with 59 other investors, we could have coughed up another £20-30k as needed to fix a problem. This was as close to a sure thing as there could be. The timing was right and they picked a proven winner to run the show. The worst thing that could have happened is that the whisky didn't age as well as they wanted and they had to delay distribution 2-3 more years and sell some to blenders and independent bottlers who want to age it themselves. There was really no way to lose your investment. In 2014 that share was worth ~£1M when they sold the turned around distillery to Rémy. Not a bad return.
How often do those opportunities present AND how often are they open to you. Not often. I guarantee you people were lined up to get in on that deal.

 

[repititionition]

Should we all be so lucky as to get in as early investors on a sure bet in the luxury goods market...

Yet there are relatively safe opportunities out there even within areas of medicine, some of those peripheral to the practice of anesthesiology, and I know of very few doctors who take advantage.

Yes, they all take extra work (and most doctors prefer to be pure capitalists, not entrepreneurs), but it is staggering to me how many doctors act like a) there are no opportunities and b) don't seek them out. I'll allow one or the other, but not both.

 

[deleted50478]

Should we all be so lucky as to get in as early investors on a sure bet in the luxury goods market...

Yet there are relatively safe opportunities out there even within areas of medicine, some of those peripheral to the practice of anesthesiology, and I know of very few doctors who take advantage.

Yes, they all take extra work (and most doctors prefer to be pure capitalists, not entrepreneurs), but it is staggering to me how many doctors act like a) there are no opportunities and b) don't seek them out. I'll allow one or the other, but not both.

Don't talk about your fantasy of making money investing in 'opportunities'. Come back after you've made your fortune and rub our noses in it. Or come back and tell us about how you lost your shirt putting money into a too-good-to-be-true investment. I hope you make bank and I'll congratulate you even if you come back an arrogant prick. I just feel confident it'll never happen.

 

[repititionition]

Don't talk about your fantasy of making money investing in 'opportunities'. Come back after you've made your fortune and rub our noses in it. Or come back and tell us about how you lost your shirt putting money into a too-good-to-be-true investment. I hope you make bank and I'll congratulate you even if you come back an arrogant prick. I just feel confident it'll never happen.

Hey nola - I don't mean to be confrontational or arrogant.

I speak from personal and current experience (e.g. my money IS where my mouth is) and I'm not trying to rub anyone's nose in it. I want nothing but success -- whatever that looks like -- for every physician here, because I have and continue to learn a ton from this community.

I am a very non-traditional medical student, happy to PM if you want details.

 

[BLADEMDA]

That's not an argument - that's an accusation. And a rather snide one as well, because the obvious implication is that people who fail at something fail because they just didn't believe in themselves.

Medicine isn't my first stab at life. I ran my own business prior to med school, and was doing fairly well. I sold out and left in large part because I wanted to be a doctor but also because of the risk and volatility.

I don't know what your entrepreneurial experience is. Maybe you've mentioned it previously. I've been there and you're out of your mind if you think all it takes to get rich is $200K and "common sense and the diligence" whatever that vague platitude means. I wish you the best, if you go that way. At least you can fall back on medicine. Most entrepreneurs fail and have a less marketable/employable skill set to turn to.

Medicine is still the surest thing out there where effort and work are very consistently rewarded very well. Especially once you've sunk the cost of tuition and endured the training. You wouldn't think it reading this forum but it's the truth. I read all these posts from anesthesiologists who are wringing their hands about their future and looking for an exit, and all I can do is shake my head in disbelief.

I've been at this gig for 20+ years in Private Practice and I"m looking for a change of scenery not an "exit." I enjoy working during daylight hours but the night is a killer as you age. Even weekends are fine during the day just not the night so much.

 

[Ignatius J]

I think that's as terrible an argument as the "I coulda been an ibanker" one.

You're grossly underestimating the difficulty of being a successful entrepreneur ... and the risk involved. Risk isn't just a word, it shows up in the business world. Often.

Odds are that $200K seed will soon be $0K for most people. Even special people, like SDN'ers.

I love how we easily accept the hypothetical that he will make less than 200K but then readily reject the hypothetical of him being successful in his own business. Oh, studentdoctor, you never fail to amuse me.