Why choose anything other than anesthesia?

[George85]

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I was shocked when I recently found out the salaries of anesthesiologists and CRNA's. After just an extra year of residency compared to FP, IM, the average graduating anesthesiologist will be making $100k a year more than FP, IM, peds, and in many cases ob/gyn. More than many specialists who have taken 3 year fellowships. CRNA'a where I work (40 of them) start at 120 - 130. About what I'll make in FP. It doesn't make sense.

People here have suggested it's suppy and demand. That doesn't seem to apply within medicine otherwise nurses would be making a lot more. (I use the term medicine in a generic sense). Also, payment is determined by insurance companies. If they halfed anesthesiologists pay tomorrow there would still be anesthesiologists turning up to work - so, why do they continue to pay so much? This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

ADDENDUM. Have just read a couple of other threads and see this subject has been well covered. But I still don't understand why the insurance co's pay up. It's not just about procedures. Payment is for units. Where I'm at the guys that work the hardest are in critical care and get payed less than their buddies in the OR.

 

[svaefinga]

Well, life is not only about money. You spend a lot of time working thus liking or even loving what you do is always an advantage. 😉

 

[MTGas2B]

I was shocked when I recently found out the salaries of anesthesiologists and CRNA's. After just an extra year of residency compared to FP, IM, the average graduating anesthesiologist will be making $100k a year more than FP, IM, peds, and in many cases ob/gyn. More than many specialists who have taken 3 year fellowships. CRNA'a where I work (40 of them) start at 120 - 130. About what I'll make in FP. It doesn't make sense.

People here have suggested it's suppy and demand. That doesn't seem to apply within medicine otherwise nurses would be making a lot more. (I use the term medicine in a generic sense). Also, payment is determined by insurance companies. If they halfed anesthesiologists pay tomorrow there would still be anesthesiologists turning up to work - so, why do they continue to pay so much? This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

That 100k a year equals 1Mill in 10 years. Enough to pay off all loans and provide a very tidy pension fund in 10 short years. So, my question is, why would anyone choose anything other than anesthesia given these numbers? Not to mention lifestyle.

'Cause its not all about the $

 

[jetproppilot]

I was shocked when I recently found out the salaries of anesthesiologists and CRNA's. After just an extra year of residency compared to FP, IM, the average graduating anesthesiologist will be making $100k a year more than FP, IM, peds, and in many cases ob/gyn. More than many specialists who have taken 3 year fellowships. CRNA'a where I work (40 of them) start at 120 - 130. About what I'll make in FP. It doesn't make sense.

People here have suggested it's suppy and demand. That doesn't seem to apply within medicine otherwise nurses would be making a lot more. (I use the term medicine in a generic sense). Also, payment is determined by insurance companies. If they halfed anesthesiologists pay tomorrow there would still be anesthesiologists turning up to work - so, why do they continue to pay so much? This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

That 100k a year equals 1Mill in 10 years. Enough to pay off all loans and provide a very tidy pension fund in 10 short years. So, my question is, why would anyone choose anything other than anesthesia given these numbers? Not to mention lifestyle.

We'll be signing autographs at The Mirage in Vegas after Medical Rokkstarrs debuts on MTV Wednesday nite.

Bring some Copenhagen and I'll have a dip with you.

 

[RonaldColeman]

I was shocked when I recently found out the salaries of anesthesiologists and CRNA's. After just an extra year of residency compared to FP, IM, the average graduating anesthesiologist will be making $100k a year more than FP, IM, peds, and in many cases ob/gyn. More than many specialists who have taken 3 year fellowships. CRNA'a where I work (40 of them) start at 120 - 130. About what I'll make in FP. It doesn't make sense.

People here have suggested it's suppy and demand. That doesn't seem to apply within medicine otherwise nurses would be making a lot more. (I use the term medicine in a generic sense). Also, payment is determined by insurance companies. If they halfed anesthesiologists pay tomorrow there would still be anesthesiologists turning up to work - so, why do they continue to pay so much? This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

ADDENDUM. Have just read a couple of other threads and see this subject has been well covered. But I still don't understand why the insurance co's pay up. It's not just about procedures. Payment is for units. Where I'm at the guys that work the hardest are in critical care and get payed less than their buddies in the OR.

well, it's called derm, rad onc, radiology, ENT, optho. Don't get me wrong--anesthesiology is a sweet gig. It's just that some of those listed above are even sweeter.

 

[sevoflurane]

well, it's called derm, rad onc, radiology, ENT, optho. Don't get me wrong--anesthesiology is a sweet gig. It's just that some of those listed above are even sweeter.

Maybe to your tongue....

 

[Carm]

This was the question I could not find an answer to. Which is why I am doing anesthesia. Gotta love it man.

 

[George85]

You're right, it shouldn't be about money. But, when the differential is so large then money does become a very important factor. Extrapolate that differential over 20 or 25 years instead of 10 and it makes a huge difference to your life.

I thought there was a shortage of primary care docs. If so, where's the supply and demand theory there? You can argue that NP's and PA's can do 90% of what a family doc does, but the same holds true of CRNA's. But instead of bringing the docs pay levels down the CRNA's get paid almost as much as a primary care doc.

I still don't understand about the pay. Many docs, including surgeons, are complaining of declining reimbursement from places such as medicare. Why doesn't this seem to be affecting anesthesia?

And, quite frankly, approaching the end of my intern year, the option of not dealing with demanding, whinning, non-compliant patients on a continuity basis seems like a huge plus.

I think there really is a need for bringing back the rotating internship before deciding on your career based on a few months of med school clinicals. As for fam med, it really doesn't exist. Most places don't do ob, don't do peds. Might as well let the PA's and NP's do all the GP work and ensure that med school grads practice medicine instead of writing out scripts all day and sending everyone for consults.

Regarding the patients acceptance of CRNA's - where I'm at they're never really aware of who does their anesthesia. CRNA is in the OR and most times the MD never comes in. Pt never knows that a nurse did their anesthesia. In fact, CRNA's do the heart and liver transplants.

 

[lvspro]

You're right, it shouldn't be about money. But, when the differential is so large then money does become a very important factor. Extrapolate that differential over 20 or 25 years instead of 10 and it makes a huge difference to your life.

I thought there was a shortage of primary care docs. If so, where's the supply and demand theory there? You can argue that NP's and PA's can do 90% of what a family doc does, but the same holds true of CRNA's. But instead of bringing the docs pay levels down the CRNA's get paid almost as much as a primary care doc.

And, quite frankly, approaching the end of my intern year, the option of not dealing with demanding, whinning, non-compliant patients on a continuity basis seems like a huge plus.

I think there really is a need for bringing back the rotating internship before deciding on your career based on a few months of med school clinicals. As for fam med, it really doesn't exist. Most places don't do ob, don't do peds. Might as well let the PA's and NP's do all the GP work and ensure that med school grads practice medicine instead of writing out scripts all day and sending everyone for consults.

We make our money in different places. FP makes their $$ in the daily grind of seeing OP's, and doing minor procedures, which I will touch on momentarily, and Anesthesiologists make their $$ from knowing what to do when it hits the fan. Of course, a well prepared anesthesiologist has less of these events, but most anesthesiologists know how to save a patient that's circling the drain, and are able to do it at the drop of a hat.
Now, about $$ in FP. If your a particularly sharp person, which I assume you are since you've made it this far, then you can easily make a ton of money in FP. You can see all the run of the mill pathology that seems to turn on most FP's, and you can also reserve a day or two/wk for cosmetic procedures. Said procedures can very easily generate an income equal to, or much greater than, your base FP pay (130 give or take 30 grand) if your efficient.
Back to your decision: if you decide Anesthesia, do so because you find it intellectually stimulating. Whatever your reason for turning to anesthesia, please make sure it's one you can live with, because otherwise you may find yourself cursing the day you chose it when you're rudely paged at 4:15 AM to help resuscitate the victims of a gunfight between rival gangs of which you have no affiliation... I hope. Money, and lifestyle can be had in any specialty, as long as you play your cards right.
Either way, good luck with your decision.
btw, I would slit my own wrists if I had to spend my time in OP clinic.

 

[Laryngospasm]

This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

ADDENDUM. Have just read a couple of other threads and see this subject has been well covered. But I still don't understand why the insurance co's pay up. It's not just about procedures. Payment is for units. Where I'm at the guys that work the hardest are in critical care and get payed less than their buddies in the OR.

First, surgeons do clinic for a large part of the week, this brings their pay down, if all they did was surgical procedures you can bet your a s s that they would make much more than anesthesiologists. We dont have clinic, and this reduces our overhead substantially. Second we are performing procedures also, not just the surgeon, the anesthetic itself can be thought of as a procedure and this entails risk, and with risk comes liability, and higher pay.

 

[sevoflurane]

btw, I would slit my own wrists if I had to spend my time in OP clinic.

I'd rather get in the octegon with matt hughes, gracie, shamrock and tito and mention some rude comment about their mothers. I find a lot more pleasure in treating BP's in a matter of seconds/minutes rather than weeks/months. My own 2 cents.

 

[burntcrispy]

My fiancee worked with a FP in Dallas who made about 300K. Now he's about to start doing a little Botox and whatnot on the side so he'll probably bring in more. I've got a friend who's a hospitalist (IM) in Dallas bringing in serious bank also. As any kind of physician you can rake it in if you know how to do it.

As far as Anesthesia pay, it's probably a combination of things such as procedures, billable time, etc. There's no point trying to rationalize why one specialty will make more than another. Many derm guys make upwards of 750K and from what I've seen it seems to be a fairly laid back job. Are they worth that much, who knows?

You should just find a job that you like and go with it. The money will come later and if not, at least you will be happy. You can always apply for a CA1 spot somewhere if you are dissatisfied with your decision.

 

[InductionAgent]

ADDENDUM. Have just read a couple of other threads and see this subject has been well covered. But I still don't understand why the insurance co's pay up. It's not just about procedures. Payment is for units. Where I'm at the guys that work the hardest are in critical care and get payed less than their buddies in the OR.

From what I've read, a lot of the money anesthesiologists makes comes from premiums that hospitals pay above what the anesthesiologists are getting reimbursed from insurance, in order to have anesthesiologists on staff. This is still true for anesthesia groups in which the groups contract with the hospital for said premium. This is a function of supply and demand, and might diminish in the coming as years as eventually the supply of anesthesiologists currently being churned out fills some of the void.

 

[sevoflurane]

From what I've read, a lot of the money anesthesiologists makes comes from premiums that hospitals pay above what the anesthesiologists are getting reimbursed from insurance, in order to have anesthesiologists on staff. This is still true for anesthesia groups in which the groups contract with the hospital for said premium. This is a function of supply and demand, and might diminish in the coming as years as eventually the supply of anesthesiologists currently being churned out fills some of the void.

Babyboomers are getting old and surgeries are going up. 😉

 

[Induc(junc)tion]

Babyboomers are getting old and surgeries are going up. 😉

I also heard lots of gas docs retiring. Also, a large proportion of CRNA's hitting retirement age soon as well.

 

[gasdoc1]

From what I've read, a lot of the money anesthesiologists makes comes from premiums that hospitals pay above what the anesthesiologists are getting reimbursed from insurance, in order to have anesthesiologists on staff. This is still true for anesthesia groups in which the groups contract with the hospital for said premium. This is a function of supply and demand, and might diminish in the coming as years as eventually the supply of anesthesiologists currently being churned out fills some of the void.

Usually, this applies to hospitals that have a lot of medicaid and, to a lesser extent, medicare. Hospitals that have a middle/upper class patient population with good insurance do not pay the premium. At least this is true in my area of the country, where any anesthesia group can be easily replaced. Again, supply and demand.

 

[InductionAgent]

Babyboomers are getting old and surgeries are going up. 😉

Hopefully, this trend will continue. I'm cautiously optimistic about the future. Obviously, the big unknown is whether Internal Medicine subspecialties and IR will continue to progress in the scope of procedures they do sans anesthesia, with only "conscious sedation."

The fact that the ASA is so actively encouraging young anesthesiologists to pursue critical care, perioperative medicine, and pain management is a bit ominous. It seems that the current strategy is to ensure adequate residency graduates to avoid a shortfall that saw CRNAs encroach on OR territory, yet expand the scope of anesthesiologists' practice so that in the event of a glut (or at least cooling of demand) there is no big scare that will reduce residency applications as happened in the mid-90s.

 

[InductionAgent]

Usually, this applies to hospitals that have a lot of medicaid and, to a lesser extent, medicare. Hospitals that have a middle/upper class patient population with good insurance do not pay the premium. At least this is true in my area of the country, where any anesthesia group can be easily replaced. Again, supply and demand.

Interesting. I guess when it could get really nasty is if/when there are enough anesthesia groups that the Medicaid hospitals no longer have to pay premiums to have staff!

 

[stephend7799]

its not a premium

its a stipend for 24 hour coverage of the hospital.. if they didnt give a stipend every anesthesiologist would leave at 3 pm and there would be noone working after 3

 

[MedicinePowder]

I was shocked when I recently found out the salaries of anesthesiologists and CRNA's. After just an extra year of residency compared to FP, IM, the average graduating anesthesiologist will be making $100k a year more than FP, IM, peds, and in many cases ob/gyn. More than many specialists who have taken 3 year fellowships. CRNA'a where I work (40 of them) start at 120 - 130. About what I'll make in FP. It doesn't make sense.

People here have suggested it's suppy and demand. That doesn't seem to apply within medicine otherwise nurses would be making a lot more. (I use the term medicine in a generic sense). Also, payment is determined by insurance companies. If they halfed anesthesiologists pay tomorrow there would still be anesthesiologists turning up to work - so, why do they continue to pay so much? This seems to mean that the anesthesiologist is making more per procedure than the surgeon carrying out the procedure. Again, that doesn't make sense.

ADDENDUM. Have just read a couple of other threads and see this subject has been well covered. But I still don't understand why the insurance co's pay up. It's not just about procedures. Payment is for units. Where I'm at the guys that work the hardest are in critical care and get payed less than their buddies in the OR.

not everyone shares enthusiasm for anesthesiology. for some, no amount of money would bring them to do anesthesiology for various reasons. some reasons may be unfounded. one that would come up from fellow students was that they would be subordinate to surgeons. alot of ego in those that get into medical school.

 

[CambieMD]

We make our money in different places. FP makes their $$ in the daily grind of seeing OP's, and doing minor procedures, which I will touch on momentarily, and Anesthesiologists make their $$ from knowing what to do when it hits the fan. Of course, a well prepared anesthesiologist has less of these events, but most anesthesiologists know how to save a patient that's circling the drain, and are able to do it at the drop of a hat.
Now, about $$ in FP. If your a particularly sharp person, which I assume you are since you've made it this far, then you can easily make a ton of money in FP. You can see all the run of the mill pathology that seems to turn on most FP's, and you can also reserve a day or two/wk for cosmetic procedures. Said procedures can very easily generate an income equal to, or much greater than, your base FP pay (130 give or take 30 grand) if your efficient.
Back to your decision: if you decide Anesthesia, do so because you find it intellectually stimulating. Whatever your reason for turning to anesthesia, please make sure it's one you can live with, because otherwise you may find yourself cursing the day you chose it when you're rudely paged at 4:15 AM to help resuscitate the victims of a gunfight between rival gangs of which you have no affiliation... I hope. Money, and lifestyle can be had in any specialty, as long as you play your cards right.
Either way, good luck with your decision.
btw, I would slit my own wrists if I had to spend my time in OP clinic.

Primary care physicians are very important to our health care system. The problem is that they are treated like ugly step-children in many regards.
I enjoyed many aspects of FP but it became obvious to me that the insurance companies were sucking me dry. I did not leave for income alone .I always enjoyed pharmacology and enjoy critical and doing procedures.
I am working hard right now. I am on my trauma rotation which involves working 7pm - 7am. I am up all night long doing cases. Aside from being exhusted I am enjoying what I am doing. Every case is different and comes with its own challenges.
I have not missed FP al all. I am happy with my decision to leave.
I think that one should enjoy their work.
Anesthesia is not for everyone. Some people find it too stressful and others want more patient contact.
Do not choose a specialty based on lifestyle and money. You must enjoy what you are doing for a living. Why go into debt to be bored and frustrated.
I am off to work now.

Cambie