What Job offers are current residents getting?

[aneftp]

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.

Blade. It depends how eventful the nights are.

In my practice 3 of MDs are 62, 62 and 66. One MD literally just retired at age 72. 3 more are 55 and older. This is out of 12 MDs. We have 4 of us 38-41. And one other who is 50.

If calls are rough at night than I agree it's gets harder as u get older. Fortunately our calls are pretty light. Appy can wait till the morning if it can't be done by 9pm. I take call roughly 1:5/6. And in 6 months I have been with new group had a total of 3 times I worked at 12am or later. And never past 2am.

But don't think surgery centers Monday through Friday's are any better. Just depends on the surgery center. My friend just left a surgery center paying him around $375-400k no calls no weekends. U would think that's easy money. But he's working 50 hours a week and rarely gets done before 3pm. 2 days a week he's there to around 730pm. So he missed the post call days or the early days you have in hospital based practice to run errands. It's hard to schedule dental appt for 4pm cause you know u would be at surgery center to 3pm at the earliest.

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[aimedicine]

alright bro, if you say so.

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.

LMAO

 

[bashwell]

I prefer this version (light side of the force):



Or (dark side of the force):

 

[aneftp]

If that is in a state with no state tax, I'm sold. Please exist in 5 years.

They do exist. Yes. No income state income taxes.

But surgery center jobs can be unstable. A lot of kissing but. Not canceling too many surgeries. Many patients aren't as optimized as you think.

Remember they are general surgeon owned so surgeons will try to push cases through. Especially those that probably should be done at hospital

 

[deleted162650]

>450k is possible but you gotta move midwest or go to cali and bust your butt

LOL at the Cali part. Yes there are a very select few ulta-lucrative practices here, but those jobs are locked down tighter than Fort Knox (most involve a very busy OB component with patients that are actually privately insured - think Cedars). And I'm not talking residency connections kinda locked down, I'm talking your dad is a founding member of the practice sorta locked down. If you come to Cali, you do it for the lifestyle/weather/beach/and blondes, but certainly not for the $$$. In general NorCal pays better than SoCal, but either way sky high real estate prices will eat up a big portion of your income and don't forget about the state tax up above 10% for the highest brackets plus sales tax, etc. There may be some lucrative BFE jobs in CA, but if you're gonna be BFE then why pay the piper to live in CA?? If you're not living in coastal SoCal then I really see no reason to live in this state at all. State income tax on 400K alone over a 30 year career is gonna approach $1.2mil. The only reason I'm here is bc I grew up here, all my family/wife's family is here (and we have kids), and I've got a bit of a love affair with the Pacific Ocean.

P.S. Don't say "Cali." You sound like a Midwest frat boy. Nobody that lives here actually calls it "Cali"

 

[jthedestroyr]

LOL at the Cali part. Yes there are a very select few ulta-lucrative practices here, but those jobs are locked down tighter than Fort Knox (most involve a very busy OB component with patients that are actually privately insured - think Cedars). And I'm not talking residency connections kinda locked down, I'm talking your dad is a founding member of the practice sorta locked down. If you come to Cali, you do it for the lifestyle/weather/beach/and blondes, but certainly not for the $$$. In general NorCal pays better than SoCal, but either way sky high real estate prices will eat up a big portion of your income and don't forget about the state tax up above 10% for the highest brackets plus sales tax, etc. There may be some lucrative BFE jobs in CA, but if you're gonna be BFE then why pay the piper to live in CA?? If you're not living in coastal SoCal then I really see no reason to live in this state at all. State income tax on 400K alone over a 30 year career is gonna approach $1.2mil. The only reason I'm here is bc I grew up here, all my family/wife's family is here (and we have kids), and I've got a bit of a love affair with the Pacific Ocean.

P.S. Don't say "Cali." You sound like a Midwest frat boy. Nobody that lives here actually calls it "Cali"

The funny thing is, once I left California, you couldn't pay me to move back to live there. I noticed a lot of Midwestern transplants moving to California for the "California dream" to escape the frozen tundra. Yeah, I'll pass on the state income tax >10% + traffic + insane housing costs. If you want to live in the central California AKA arm pit of California you can find reasonable costs, and there are a few MD only groups that do well but you're still going to get hit with those taxes. As Salty mentioned, if you're going to be paying those taxes no need to live anywhere else besides the coastal parts.

I will say I do miss the produce. California has amazingly fresh produce, but I can live without all the other headaches associated with living in California.

 

[GaseousClay]

LOL at the Cali part. Yes there are a very select few ulta-lucrative practices here, but those jobs are locked down tighter than Fort Knox (most involve a very busy OB component with patients that are actually privately insured - think Cedars). And I'm not talking residency connections kinda locked down, I'm talking your dad is a founding member of the practice sorta locked down. If you come to Cali, you do it for the lifestyle/weather/beach/and blondes, but certainly not for the $$$. In general NorCal pays better than SoCal, but either way sky high real estate prices will eat up a big portion of your income and don't forget about the state tax up above 10% for the highest brackets plus sales tax, etc. There may be some lucrative BFE jobs in CA, but if you're gonna be BFE then why pay the piper to live in CA?? If you're not living in coastal SoCal then I really see no reason to live in this state at all. State income tax on 400K alone over a 30 year career is gonna approach $1.2mil. The only reason I'm here is bc I grew up here, all my family/wife's family is here (and we have kids), and I've got a bit of a love affair with the Pacific Ocean.

P.S. Don't say "Cali." You sound like a Midwest frat boy. Nobody that lives here actually calls it "Cali"

Salty what type of unit value are you getting in so. cal? I've heard anywhere from the 30-40s in san diego (which seems really low for a big city) vs 50s in orange county.

 

[aimedicine]

LOL at the Cali part. Yes there are a very select few ulta-lucrative practices here, but those jobs are locked down tighter than Fort Knox (most involve a very busy OB component with patients that are actually privately insured - think Cedars). And I'm not talking residency connections kinda locked down, I'm talking your dad is a founding member of the practice sorta locked down. If you come to Cali, you do it for the lifestyle/weather/beach/and blondes, but certainly not for the $$$. In general NorCal pays better than SoCal, but either way sky high real estate prices will eat up a big portion of your income and don't forget about the state tax up above 10% for the highest brackets plus sales tax, etc. There may be some lucrative BFE jobs in CA, but if you're gonna be BFE then why pay the piper to live in CA?? If you're not living in coastal SoCal then I really see no reason to live in this state at all. State income tax on 400K alone over a 30 year career is gonna approach $1.2mil. The only reason I'm here is bc I grew up here, all my family/wife's family is here (and we have kids), and I've got a bit of a love affair with the Pacific Ocean.

P.S. Don't say "Cali." You sound like a Midwest frat boy. Nobody that lives here actually calls it "Cali"

this guy lol

 

[Ezekiel2517]

I'm pretty sure unit in OC is not 50's and San Diego is not close to 40's

 

[deleted171991]

If that is in a state with no state tax, I'm sold. Please exist in 5 years.

You are looking at it the wrong way.

You should care about 10 things:
1-9. malpractice reform and limits;
10. (your salary plus benefits minus) the total cost of living in that state.

In that order.

State income tax is just one component of the package. For example, NH has zero tax on salaries, but the total cost of living will beat many states with up to 7-8% income tax. On the other hand, you might get a good deal in AK.

 

[aimedicine]

You are looking at it the wrong way.

You should care about 10 things:
1-9. malpractice reform and limits;
10. (your salary plus benefits minus) the total cost of living in that state.

In that order.

State income tax is just one component of the package. For example, NH has zero tax on salaries, but the total cost of living will beat many states with up to 7-8% income tax. On the other hand, you might get a good deal in AK.

i definitely agree with the above...some states have ridiculous sales and property tax .
I know it varies, on average how many times can anesthesiologist expect to get sued over their career and how much money comes out of the anesthesiology pocket/assets? i've heard to expect at least 1 serious lawsuit over your career

 

[deleted171991]

i definitely agree with the above...some states have ridiculous sales and property tax .
I know it varies, on average how many times can anesthesiologist expect to get sued over their career and how much money comes out of the anesthesiology pocket/assets? i've heard to expect at least 1 serious lawsuit over your career

The statistics say that 90+% of American doctors will be sued at least once during their career.

There are many stories about how traumatic and PTSD-provoking this experience can be. But at least it shouldn't rob you and your family, just to make some lawyers filthy rich.

 

[aimedicine]

The statistics say that 90+% of American doctors will be sued at least once during their career.

There are many stories about how traumatic and PTSD-provoking this experience can be. But at least it shouldn't rob you and your family, just to make some lawyers filthy rich.

sounds about right

 

[W19]

now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.

I wonder what you think of your psych/FM physician colleagues...

 

[Twiggidy]

LOL at the Cali part. Yes there are a very select few ulta-lucrative practices here, but those jobs are locked down tighter than Fort Knox (most involve a very busy OB component with patients that are actually privately insured - think Cedars). And I'm not talking residency connections kinda locked down, I'm talking your dad is a founding member of the practice sorta locked down. If you come to Cali, you do it for the lifestyle/weather/beach/and blondes, but certainly not for the $$$. In general NorCal pays better than SoCal, but either way sky high real estate prices will eat up a big portion of your income and don't forget about the state tax up above 10% for the highest brackets plus sales tax, etc. There may be some lucrative BFE jobs in CA, but if you're gonna be BFE then why pay the piper to live in CA?? If you're not living in coastal SoCal then I really see no reason to live in this state at all. State income tax on 400K alone over a 30 year career is gonna approach $1.2mil. The only reason I'm here is bc I grew up here, all my family/wife's family is here (and we have kids), and I've got a bit of a love affair with the Pacific Ocean.

P.S. Don't say "Cali." You sound like a Midwest frat boy. Nobody that lives here actually calls it "Cali"

this is true.

 

[Twiggidy]

But don't think surgery centers Monday through Friday's are any better. Just depends on the surgery center. My friend just left a surgery center paying him around $375-400k no calls no weekends. U would think that's easy money. But he's working 50 hours a week and rarely gets done before 3pm. 2 days a week he's there to around 730pm. So he missed the post call days or the early days you have in hospital based practice to run errands. It's hard to schedule dental appt for 4pm cause you know u would be at surgery center to 3pm at the earliest.

It's hard for me to listen to anyone complain about their job if they don't spend at least one night a week and one weekend a month sleeping in the hospital.

The original quote mad a good point, as we get older, sometimes we like to be able to sleep in our own beds and not hear the phone ring all night for BS.

 

[Carbocation1]

http://m.anesthesiologynews.com/Article.aspx?d=Commentary&d_id=449&i=June+2015&i_id=1194&a_id=32585

 

[pjl]

It sucks to make 400k and not be done by 3. I'm crying for that poor soul.

 

[deleted50478]

It sucks to make 400k and not be done by 3. I'm crying for that poor soul.

400k W-2 or 1099?

 

[anbuitachi]

It sucks to make 400k and not be done by 3. I'm crying for that poor soul.

got to make back those 10 years of lost earnings and debt bro

 

[pjl]

I have no problem with guys making mad money doing anesthesia or any other specialty. Whether it is 200k or 1.5 mil, please just dont whine about how tough life is because you are not done by 3. Make your freaking 2x a year dentist appointment on one of your 10 weeks off.
400k 1099 is at worst comparable to 300k w2, which still is a good living for 50 hours a week.
You are being paid to do a job you chose, that, despite what people say, is better than swinging an ax in the salt mines. 50 hours a week is really not that bad, and you are still gonna be able to pay off even the crazy debt people are getting into now.

Reminds me of one of our surgical subspecialties complaining because the only OR time available on a day is during their 1/2 day off per week, then being sad they aren't making more than the average sub-specialist. Yes, I pointed that out to them as well.

Sorry, just hits me wrong. Complain about debt, risk, lack of respect, lack of autonomy, CRNAs, admin, whatever, just dont whine about not getting out by 3 and expect others to respect how hard you have it when you are still earning in the top couple %nationwide income.

 

[pjl]

Wow, Im an ass, sorry. Not changing it though

 

[anbuitachi]

I have no problem with guys making mad money doing anesthesia or any other specialty. Whether it is 200k or 1.5 mil, please just dont whine about how tough life is because you are not done by 3. Make your freaking 2x a year dentist appointment on one of your 10 weeks off.
400k 1099 is at worst comparable to 300k w2, which still is a good living for 50 hours a week.
You are being paid to do a job you chose, that, despite what people say, is better than swinging an ax in the salt mines. 50 hours a week is really not that bad, and you are still gonna be able to pay off even the crazy debt people are getting into now.

Reminds me of one of our surgical subspecialties complaining because the only OR time available on a day is during their 1/2 day off per week, then being sad they aren't making more than the average sub-specialist. Yes, I pointed that out to them as well.

Sorry, just hits me wrong. Complain about debt, risk, lack of respect, lack of autonomy, CRNAs, admin, whatever, just dont whine about not getting out by 3 and expect others to respect how hard you have it when you are still earning in the top couple %nationwide income.

Idk.. It kinda depends on when the starting time is.. 12am to 3pm is already 15 Hrs..

 

[pjl]

That is one heck of a surgery center.

 

[Hoya11]

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.

local AMC place 350k to start (if BC), 5 calls/month, work sometimes post call (@200k/hr beyond 8am pc day) no opportunity for partnership. (not bad overall)
2 local places not yet taken over by AMC (and part of a larger network resisting this particular AMC) 275k to - 300k over 3-4yr partnership track. Once partner ~500k. 2-3 calls/month.

 

[turnupthegas]

What state/region is this?

 

[criticalelement]

you re not going to find people working hard past 3 pm for 300k. Just sayin....

300k is a 40 hour per week job. anything over that should be at 200 per hour

 

[BLADEMDA]

you re not going to find people working hard past 3 pm for 300k. Just sayin....

300k is a 40 hour per week job. anything over that should be at 200 per hour

5 years ago that same job was paying over $350K. What do you think it will pay circa 2020? My guess is $250K or less as market forces drive salaries down.

 

[JLarry8900]

local AMC place 350k to start (if BC), 5 calls/month, work sometimes post call (@200k/hr beyond 8am pc day) no opportunity for partnership. (not bad overall)
2 local places not yet taken over by AMC (and part of a larger network resisting this particular AMC) 275k to - 300k over 3-4yr partnership track. Once partner ~500k. 2-3 calls/month.

What are the hours like for the AMC job?

 

[aneftp]

5 years ago that same job was paying over $350K. What do you think it will pay circa 2020? My guess is $250K or less as market forces drive salaries down.

It hard to predict.

250k. But 250k 40-45 hours more likely.

VA already pays 250-285k most places. Kaiser (basically like VA but private) pays $300-325k in mid Atlantic. West coast (Southern California slight less, Bay Area more than southern).

Those are close to 40 hour work weeks.

Hard to see someone working more than 40 hours for less than the government. And it's not like government is going to force pay cuts on VA docs.

 

[anbuitachi]

5 years ago that same job was paying over $350K. What do you think it will pay circa 2020? My guess is $250K or less as market forces drive salaries down.

I need to stop reading sdn. <250k when I'm done w residency?? No wonder 15% of the class is doing EM

 

[BLADEMDA]

I need to stop reading sdn. <250k when I'm done w residency?? No wonder 15% of the class is doing EM

No. What I posted was $250K for a 40 hour per week job. The typical job with Call, weekends, nights, etc. will stay pay over $300 with many in the $350K range.

 

[Pooh & Annie]

People, I IMPLORE you. Stop telling everyone what they'll be earning. You should be smart enough to know what you don't know.

 

[Carbocation1]

No. What I posted was $250K for a 40 hour per week job. The typical job with Call, weekends, nights, etc. will stay pay over $300 with many in the $350K range.

Location? BFE or major metro?

 

[anbuitachi]

Location? BFE or major metro?

BFE. the going rate in major metro where I am is like 225-275 for 50+ hrs a week right now

 

[IlDestriero]

BFE. the going rate in major metro where I am is like 225-275 for 50+ hrs a week right now

You can make more than that in academics in major metro desirable areas. And get a great benefit package.

 

[Carbocation1]

Any new employers looking to hire Anesthesiologists with expertise in Perioperative Medical Managament, or is this still limited to academia for now?

 

[deleted171991]

Any new employers looking to hire Anesthesiologists with expertise in Perioperative Medical Managament, or is this still limited to academia for now?

Not even academia cares about that. As in nobody will pay you extra for that expertise.

 

[Carbocation1]

Not even academia cares about that. As in nobody will pay you extra for that expertise.

I understand how this wouldn't be valued in a FFS system. But wouldn't this save money and thus provide value in the future bundled-payments scheme? A physician anesthesiologist with expertise in perioperative medical management will consult cardiologists/pulmonologists/hospitalists at a lower frequency, therefore saving money. Please let me know if I am not understanding something correctly.

 

[Wiscoblue]

Ideally, yes. But then the anesthesiologist starts to consult ppl just to cover his &$$.

 

[pgg]

I understand how this wouldn't be valued in a FFS system. But wouldn't this save money and thus provide value in the future bundled-payments scheme? A physician anesthesiologist with expertise in perioperative medical management will consult cardiologists/pulmonologists/hospitalists at a lower frequency, therefore saving money. Please let me know if I am not understanding something correctly.

Are you talking about the perioperative surgical home none of us want anything to do with?

 

[kaioukenx]

You can make more than that in academics in major metro desirable areas. And get a great benefit package.

A major metro academic job that starts you off at >275k before benefits for a board eligible new grad seems 1-2 SD above average. So while you CAN do so, it certainly isn't likely. Am I way off here?

 

[nimbus]

Any new employers looking to hire Anesthesiologists with expertise in Perioperative Medical Managament, or is this still limited to academia for now?

We hire people to cover the rooms/cases.

We don't get paid for "perioperative medical management". Hospitalists do. Maybe things will change going forward but that's the current reality. Frankly I'm so busy in the OR that I have no desire to admit, round on, field calls, and discharge a large list of inpatients. I sincerely hate that stuff. That's why I went into anesthesia.

 

[RedAnesthesia]

We hire people to cover the rooms/cases.

We don't get paid for "perioperative medical management". Hospitalists do. Maybe things will change going forward but that's the current reality. Frankly I'm so busy in the OR that I have no desire to admit, round on, field calls, and discharge a large list of inpatients. I sincerely hate that stuff. That's why I went into anesthesia.

I am really not sure how that model of care will translate for the vast majority of anesthesiologists. Only certain amount of hours in a day to do the work.

 

[Silent Cool]

Are you talking about the perioperative surgical home none of us want anything to do with?

@pgg ,
Would you briefly describe the perioperative surgical home and why it is so despised by anesthesiologists? I have heard similar sentiments from others in your field but I don't fully understand why.

thanx

 

[Baller MD]

@pgg ,
Would you briefly describe the perioperative surgical home and why it is so despised by anesthesiologists? I have heard similar sentiments from others in your field but I don't fully understand why.

thanx

Sounds like hospitalist type work.

 

[amyl]

Academic jobs I know are 290 some call big center. 265 base plus plus for call work late etc. both have good benefits

 

[jw3600]

alright bro, if you say so.

Maybe the reason you aren't getting the results with this thread that you would like is because you're kind of a dick?

 

[deleted162650]

We don't get paid for "perioperative medical management". Hospitalists do.

Are you sure about that? What's to stop us from billing those same CPT codes that hospitalists do. I don't think that CMS or insurers look into your residency training as long as you're a licensed physician. I could be wrong so someone please educate me on this.

My understanding is that that type of work just pays significantly less than OR time so it's not worth our time, not that we literally can't get paid for doing it???

 

[Twiggidy]

@pgg ,
Would you briefly describe the perioperative surgical home and why it is so despised by anesthesiologists? I have heard similar sentiments from others in your field but I don't fully understand why.

thanx

Because in a nutshell someone wants anesthesiologists to preop, admit, provide anesthesia, and provide extended postoperative care for surgical patients (meaning beyond the PACU and likely all the way to discharge). Basically doing the job surgeons or their PAs have done for years. Now the surgeon can "just operate" and not have to worry about labs, consults, rounding, etc. Basically increased work for anesthesiologist and likely little to no (or even DECREASE) pay. That's the nutshell .