Why isn't anesthesia as competitive as radiology?

[RB16]

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Why isn't anesthesia as competitive as radiology? Is it work hours? earning potential? malpractice insurance cost? Lack of respect? CRNA? Number of available residency spots? Am I missing something? Someone please enlighten me as I considered both, but think anesthesia will be a better fit for me? And I realize that this question has been asked once before, but I'm sure things have changed in the last 5 years.

 

[YouISee]

Anesthesia

More spots I believe. That is a big factor.

Radiology

Less spots
Up until recently, much more lucrative; still more money than anesthesia though
Supposedly more secure because no midlevels


In the end, all the specialties gonna see even salaries over time. So look at least 5 years into the future and see if that particular field is at least tolerable on a daily basis.

 

[Mman]

I have no idea why one would be more or less competitive than the other at any given time, however there should be essentially no overlap with people choosing one or the other since they are extremely different fields and if somebody was considering both it definitely isn't for the right reasons.

 

[maceo]

Why isn't anesthesia as competitive as radiology? Is it work hours? earning potential? malpractice insurance cost? Lack of respect? CRNA? Number of available residency spots? Am I missing something? Someone please enlighten me as I considered both, but think anesthesia will be a better fit for me? And I realize that this question has been asked once before, but I'm sure things have changed in the last 5 years.

one can be done from home in pajamas and hours flexible the other you have to go into hospital early and be prepared to resuscitatae someone who wasnt supposed to die that day.. and deal with backstabbing partners and nurses and of course midlevels.

does that answer your question??.. aside from one offers a higher salary.

 

[gasaddict54]

one can be done from home in pajamas and hours flexible the other you have to go into hospital early and be prepared to resuscitatae someone who wasnt supposed to die that day.. and deal with backstabbing partners and nurses and of course midlevels.

does that answer your question??.. aside from one offers a higher salary.

this^

 

[Sdp]

Agreed.

1. Fewer spots
2. Lower work hours
3. Higher pay
4. No midlevel threat
5. Independence

I'm pretty sure both are underappreciated and don't get deserving respect. Have never heard a kid say "when I grow up, I want to be a Radiologist!" I don't think anyone envisions going through 20+ years of schooling so they can spend the rest of their life in a dark room looking at shadows.

 

[panetrain]

Ability to invest in imaging facilities (passive income ventures).
More lucrative fellowship options.
More political power and strength towards hospital administrators (interventional procedures bring hospital $$$$, administrators see our services as a financial loss).
And as stated above, much more stable for the long term. Budget cuts are forcing hospitals to convert to anesthesia care provider models 4:1 CRNS:MD/DO. I see the need for MD/DO anesthesiologist falling off the face of the earth in the next couple of years.
CRNA's have already gained ground on practicing interventional pain unsupervised.
All they have to do is read a book, take a course, run a camera down 100 or so patients and pass a test and they are magically TEE certified!!!

 

[AnesFuture]

According to Charting Outcomes

Rads: 1477 applicants 1095 spots
Anes: 1729 applicants 1374 spots

I also don't understand the argument "administrators see our services as a financial loss" when a lot of places like Michigan directly said they are financially very solvent and make the hospital the most profit of any department.

 

[AegriSomnia]

Agreed.

1. Fewer spots
2. Lower work hours
3. Higher pay
4. No midlevel threat
5. Independence

I'm pretty sure both are underappreciated and don't get deserving respect. Have never heard a kid say "when I grow up, I want to be a Radiologist!" I don't think anyone envisions going through 20+ years of schooling so they can spend the rest of their life in a dark room looking at shadows.

Actually, there is a newish midlevel called the radiologist assistant and there are already a dozen programs for them.

 

[Jeff05]

our services are ABSOLUTELY NOT A LOSS. a well run anesthesia department that runs ORs smoothly and bills efficiently - not only covers its own cost, but can make a lot of cash for the institution.

our services may be a loss at a very small hospital with insignificant surgical volume who have to have a nominal anesthesia provider.

 

[Coastie]

our services are ABSOLUTELY NOT A LOSS. a well run anesthesia department that runs ORs smoothly and bills efficiently - not only covers its own cost, but can make a lot of cash for the institution.

our services may be a loss at a very small hospital with insignificant surgical volume who have to have a nominal anesthesia provider.

QFT. Anesthesiology dept's and ORs make tons of coin for the hospital.

 

[Camel]

In my current town, one of the major hospitals dropped the entire radiology department in favor of a remote service provider. Interventional is more secure, though.

 

[sevo85288]

Interventional is getting killed with reimbursement cuts and hospital facility fee cuts. Wherever there is money, there will be cuts... Anesthesia makes tons of money for the hospital as cranking out cases, without large number of complications, still brings the MOST amount of $ for hospitals. The mgma survey shows anesthesia/rads neck to neck with earnings last year. I agree, they are completely different fields and no one should be considering both; if they are honest with themselves. Also, IR, is not a life long career. Most IR guys don't want to get radiated for 30yrs.

 

[RB16]

Interventional is getting killed with reimbursement cuts and hospital facility fee cuts. Wherever there is money, there will be cuts... Anesthesia makes tons of money for the hospital as cranking out cases, without large number of complications, still brings the MOST amount of $ for hospitals. The mgma survey shows anesthesia/rads neck to neck with earnings last year. I agree, they are completely different fields and no one should be considering both; if they are honest with themselves. Also, IR, is not a life long career. Most IR guys don't want to get radiated for 30yrs.

Agree, I should've chosen my words more carefully. As an MS3 with decent scores, for the last couple of weeks, I have been taking a hard look at the different aspects of all specialties, including radiology and anesthesiology. I realize that ultimately you have to choose what you love to do as you will be doing it for the rest of your life. That is why I am leaning towards anesthesia. To me anesthesia is an extremely appealing specialty. Short but meaningful patient encounters, lots of procedures, fair compensation, knowledge base of an internist. So I was just wondering why it is not more appealing than it is.

 

[RB16]

Ability to invest in imaging facilities (passive income ventures).
More lucrative fellowship options.
More political power and strength towards hospital administrators (interventional procedures bring hospital $$$$, administrators see our services as a financial loss).
And as stated above, much more stable for the long term. Budget cuts are forcing hospitals to convert to anesthesia care provider models 4:1 CRNS:MD/DO. I see the need for MD/DO anesthesiologist falling off the face of the earth in the next couple of years.
CRNA's have already gained ground on practicing interventional pain unsupervised.
All they have to do is read a book, take a course, run a camera down 100 or so patients and pass a test and they are magically TEE certified!!!

Thats a scary thought for someone considering getting into the field. Can someone please elaborate on that?

 

[sevo85288]

"I see the need for MD/DO anesthesiologist falling off the face of the earth in the next couple of years."

Pure nonsense. The surgical volume is going up. Babyboomers.
There are not enough anesthesia "providers" to meet the demand.
Large numbers of M.D and CRNA retiring in next 10 yrs. This may accelerate with nationalized healthcare.

 

[maceo]

Thats a scary thought for someone considering getting into the field. Can someone please elaborate on that?

1. more spots
2. Longer work hours
3. lower pay
4.a midlevel threat
5. less Independence no autonomy

 

[Jeff05]

competitiveness is directly related to future compensation/"work" ratio. the higher this number - the more competitive the specialty. you can relate it to a number of factors, but this is the one that matters most.

radiology may make similar salaries, but with much less physical work/stress. so the ratio is higher.

when you chose the specialty: make sure you still can do it (you enjoy it) even if they cut your salary in half - because as much as everyone talks about getting out of medicine if reimbursement drops, the truth is - there isn't anywhere to go (and make more money) for the vast majority of us.

 

[igottaquestion]

because as much as everyone talks about getting out of medicine if reimbursement drops, the truth is - there isn't anywhere to go (and make more money) for the vast majority of us.

shhh . . . they're listening . . .

 

[deleted126335]

our services are ABSOLUTELY NOT A LOSS. a well run anesthesia department that runs ORs smoothly and bills efficiently - not only covers its own cost, but can make a lot of cash for the institution.

our services may be a loss at a very small hospital with insignificant surgical volume who have to have a nominal anesthesia provider.

If true why are so many anesthesia practices subsidized?

 

[karizma098]

Ability to invest in imaging facilities (passive income ventures).
More lucrative fellowship options.
More political power and strength towards hospital administrators (interventional procedures bring hospital $$$$, administrators see our services as a financial loss).
And as stated above, much more stable for the long term. Budget cuts are forcing hospitals to convert to anesthesia care provider models 4:1 CRNS:MD/DO. I see the need for MD/DO anesthesiologist falling off the face of the earth in the next couple of years.
CRNA's have already gained ground on practicing interventional pain unsupervised.
All they have to do is read a book, take a course, run a camera down 100 or so patients and pass a test and they are magically TEE certified!!!

well, if that happens we could always take salary cuts. CRNA's that work anesthesiologist hours usually rake in 200k+....it would be pretty hard to turn down an MD willing to do that job for 250, wouldn't it? worst case, for 230?

all i'm saying is....if crna's are such a huge level of cost reduction, they either need to reduce their salaries, or reduce the MD's salary. right now, its usually 200 vs 350 for crna vs MD.( once again, if theyre working md hours, and usually aren't taking call either ).

worst case , in the future we take a bit of a salary cut and life goes on. I see this as a worst case scenario to cutting CRNA's out of 'taking jobs' per say...but then again, i really doubt that will happen. hospitals will indeed cut costs by hiring more CRNA's, and there will probably be less jobs for MD's in metro areas, but this is the case in pretty much every specialty. with a growing and aging population, we will always need "MDA's"

 

[Taurus]

Actually, there is a newish midlevel called the radiologist assistant and there are already a dozen programs for them.

Actually, the radiologist assistants or RA's were created with the input of radiologists to directly compete with another radiology midlevel group called the radiology practitioner assistants or RPA's which were created and defined without official radiology approval. The scope the RPA's created for themselves was to be able to interpret images and do procedures with little or no radiologist supervision. Sound familiar? The radiologists aggressively responded to this threat by creating and promoting the RA's which they can define the scope more appropriately. I believe that the radiologists have handled the threat of the RPA's very effectively. They have contained the problem by moving quickly and aggressively. Only one school produces RPA's and it now has both RPA and RA programs. It's just a matter of time before the RPA program shuts down. Many medical fields can learn from this.

Other few points. First, unlike anesthesiology, radiology has not embraced midlevels to interpret images. So there won't be much penetration of RA's or RPA's. Second, radiology as well as much of medicine has learned the lessons from the debacle of CRNA's in anesthesiology. Radiologists aren't going to be foolish enough to sell out their profession to RA's or RPA's. Third, if you already have a massive infrastructure in place to train CRNA's, you can't ignore them. Your best response is to create competition for CRNA's in the form of AA's.

 

[kazuma]

well, if that happens we could always take salary cuts. CRNA's that work anesthesiologist hours usually rake in 200k+....it would be pretty hard to turn down an MD willing to do that job for 250, wouldn't it? worst case, for 230?

all i'm saying is....if crna's are such a huge level of cost reduction, they either need to reduce their salaries, or reduce the MD's salary. right now, its usually 200 vs 350 for crna vs MD.( once again, if theyre working md hours, and usually aren't taking call either ).

worst case , in the future we take a bit of a salary cut and life goes on. I see this as a worst case scenario to cutting CRNA's out of 'taking jobs' per say...but then again, i really doubt that will happen. hospitals will indeed cut costs by hiring more CRNA's, and there will probably be less jobs for MD's in metro areas, but this is the case in pretty much every specialty. with a growing and aging population, we will always need "MDA's"

These are my thoughts as well. Anesthesia residency spots will definitely become less competitive in the future if/when the drastic pay cuts occur (just like in the 90's). However, as long as there is a supply of MD/DO Anesthesia providers that are willing to work for $200K, I have a hard time believing that hospitals would turn them down for CRNA's with significantly less training.

I suppose if it gets bad enough, CRNA salaries could plummet to 80-120K and I could see hospitals picking up CRNA's to save 80-100K vs paying MD/DO's 200K. However, I can't see how that would be desirable for a CRNA considering the hours and stress levels when they could probably make almost as much in a lower stress and less time consuming area of nursing.

I'm applying to Anesthesia programs this summer fully aware that I could very well end up earning the same salary as Family Practice physician because I like the field and couldn't imagine myself going into any other area of medicine. I feel bad for any of the recent or near future applicants that expect to be making today's Anesthesia salaries by the time they finish training in 4-8 years.

 

[Jeff05]

If true why are so many anesthesia practices subsidized?

this is a good start:
http://www.hpsllc.com/files/publications/Q1-Newsletter-Final.pdf

essentially, the bottom line is that if you have excellent OR utilization (keep em running), ensure you have excellent staff that keep efficiency high, and make sure the group is billing/collecting effectively your anesthesia group will make money for the hospital. in addition, our relative supply decreased so the resulting demand made anes salaries VERY high. this is correcting itself.

at this time 75% of hospitals offer some subsidy to the anesthesia groups. consequently, 25% are not - and if the group is a part of the institution, make substantial profits from the anesthesia services.

 

[maceo]

Your best response is to create competition for CRNA's in the form of AA's.

Thats what Ive been saying forever now. TRAIN AAs and PAs in anesthesia open them up in every state.

 

[ProRealDoc]

Actually, the radiologist assistants or RA's were created with the input of radiologists to directly compete with another radiology midlevel group called the radiology practitioner assistants or RPA's which were created and defined without official radiology approval. The scope the RPA's created for themselves was to be able to interpret images and do procedures with little or no radiologist supervision. Sound familiar? The radiologists aggressively responded to this threat by creating and promoting the RA's which they can define the scope more appropriately. I believe that the radiologists have handled the threat of the RPA's very effectively. They have contained the problem by moving quickly and aggressively. Only one school produces RPA's and it now has both RPA and RA programs. It's just a matter of time before the RPA program shuts down. Many medical fields can learn from this.

Other few points. First, unlike anesthesiology, radiology has not embraced midlevels to interpret images. So there won't be much penetration of RA's or RPA's. Second, radiology as well as much of medicine has learned the lessons from the debacle of CRNA's in anesthesiology. Radiologists aren't going to be foolish enough to sell out their profession to RA's or RPA's. Third, if you already have a massive infrastructure in place to train CRNA's, you can't ignore them. Your best response is to create competition for CRNA's in the form of AA's.

Not selling out our profession requires serious commitment as in willingness to work hard, support our PACs and not be greedy. Unfortunately anesthesia is full of LAZY, apolitical lifestylers (with more on the way) whose mission is to make the most money while working as little as possible.

 

[Mac4]

Radiology is also a highly stressful speciality. Yes, it is easy to read pre-op X-rays and r/o inflirates. However, it is a different ball game when you have to make the call in the middle of night regarding a head CT/MRI spine/Abd CT/CT-PE etgc etc.

 

[OHMAN0125]

Not selling out our profession requires serious commitment as in willingness to work hard, support our PACs and not be greedy. Unfortunately anesthesia is full of LAZY, apolitical lifestylers (with more on the way) whose mission is to make the most money while working as little as possible.

I dont know if this is true. according to this article anesth is right behind rads for the most contributions to political candidates (among medical professions). this makes sense, otherwise why would gas be so lucrative? it's all about lobbying power. granted i'm sure in both groups there are many individuals who could give more.

http://www.usatoday.com/news/health/2010-02-16-health-care_N.htm

 

[ProRealDoc]

I dont know if this is true. according to this article anesth is right behind rads for the most contributions to political candidates (among medical professions). this makes sense, otherwise why would gas be so lucrative? it's all about lobbying power. granted i'm sure in both groups there are many individuals who could give more.

http://www.usatoday.com/news/health/2010-02-16-health-care_N.htm

So we have 36K plus physicians who command an average salary of 300K and the best we can do is 900K?? That comes out to about 25 bucks per attending anesthesiologist. If we think our future is only worth that much, no wonder we're getting screwed. We should be the # 1 PAC in the nation and should basically have every policitian with a say about our future in our pockets. We should own those cats outright.

I see your point but I think we can do much, much better than that.

 

[checkov]

So we have 36K plus physicians who command an average salary of 300K and the best we can do is 900K?? That comes out to about 25 bucks per attending anesthesiologist. If we think our future is only worth that much, no wonder we're getting screwed. We should be the # 1 PAC in the nation and should basically have every policitian with a say about our future in our pockets. We should own those cats outright.

I see your point but I think we can do much, much better than that.

Excellent point. It's interesting to compare the political activity of physicians to lawyers, who have a record of vastly outspending the AMA in lobbying efforts -- per report, in 2008, lawyers and law firms gave almost $234 million to federal campaigns, including almost $127 million to Congressional candidates -- more than any other industry group and significantly more than all health-care-related contributions combined (see graph).

Furthermore, if one looks at political action committees (excluding contributions from individuals, donations, and soft money gifts), the ASAPAC ranks significantly below unions and law firms.

Also interesting to note the the AANA's political action committee [CRNA-PAC] raises over 2 million dollars annually.

 

[gasaddict54]

Thats what Ive been saying forever now. TRAIN AAs and PAs in anesthesia open them up in every state.

guys for the life of me I cant understand this line of thinking. The more anesthesia providers available of any kind OVERALL will drive down the salaries for all levels of the profession IMHO. I dont see how more AAs instead of CRNAs helps me, as i dont see what the difference is when hospitals are going to cut costs by hiring the cheapest personnel period. If hospital administrators see crnas and Anesthesiologists as near equals , then what keeps them from putting AAs in the same category? IMO we need LESS crnas , AAs and MDs. ANY market w saturation of any kind drives down salaries.

 

[YouISee]

"I see the need for MD/DO anesthesiologist falling off the face of the earth in the next couple of years."

Pure nonsense. The surgical volume is going up. Babyboomers.
There are not enough anesthesia "providers" to meet the demand.
Large numbers of M.D and CRNA retiring in next 10 yrs. This may accelerate with nationalized healthcare.

Here is the real deal. Docs aren't gonna make the coin of the golden years. The model of practice will change in all specialties.

The main thing is docs protect their right to manage these lower level ****** incl CRNAS, NPs, etc.

 

[Coastie]

Not selling out our profession requires serious commitment as in willingness to work hard, support our PACs and not be greedy. Unfortunately anesthesia is full of LAZY, apolitical lifestylers (with more on the way) whose mission is to make the most money while working as little as possible.

I think this is primarily due to the FMG influx of the mid 90's.

I see the current residents and upcoming med students in anesthesiology as being anything but lifestylers. There are still a few here and there, but they are frequently called out and generally do poorly in residency.

 

[Taurus]

guys for the life of me I cant understand this line of thinking. The more anesthesia providers available of any kind OVERALL will drive down the salaries for all levels of the profession IMHO. I dont see how more AAs instead of CRNAs helps me, as i dont see what the difference is when hospitals are going to cut costs by hiring the cheapest personnel period. If hospital administrators see crnas and Anesthesiologists as near equals , then what keeps them from putting AAs in the same category? IMO we need LESS crnas , AAs and MDs. ANY market w saturation of any kind drives down salaries.

Ok, I'll bite. The reason why increasing the number of midlevel anesthesia providers is good for anesthesiology because despite the AANA propaganda that CRNA's are just as good as anesthesiologists most hospitals don't see it that way. Do you see hospitals en masse firing their anesthesiologists and replacing them with CRNA's? I don't. Just like I don't see hospitals and groups replacing physicians with NP's en masse. The training of a physician is unparalled. If CRNA's were gaining more market share, then you wouldn't see threads like this from the CRNA's themselves crying about how they're having a hard time finding jobs and they're not getting signing bonuses. Think about it for a second. In a deep recession like this, this would be the perfect opportunity for hospitals to increase their CRNA ranks (since there are more CRNA's available to hire) and thereby decrease their total payroll. Yet, this is not happening. Both anesthesiology and midlevel positions are proportionally being hit. There is no change in market share. Why? The reason is because administrators recognize that there is significant value to hire an anesthesiologist even if it costs more. You can pay more now for a physician or pay a lot more later in a lawsuit. This is why increasing the number of anesthesia midlevel providers is a smart strategic move for anesthesiology. The future of the profession I believe depends on it. Diversify, diversify, diversify the midlevels in your group. This is the ideal we need to all strive for.

 

[gasaddict54]

Ok, I'll bite. The reason why increasing the number of midlevel anesthesia providers is good for anesthesiology because despite the AANA propaganda that CRNA's are just as good as anesthesiologists most hospitals don't see it that way. Do you see hospitals en masse firing their anesthesiologists and replacing them with CRNA's? I don't. Just like I don't see hospitals and groups replacing physicians with NP's en masse. The training of a physician is unparalled. If CRNA's were gaining more market share, then you wouldn't see threads like this from the CRNA's themselves crying about how they're having a hard time finding jobs and they're not getting signing bonuses. Think about it for a second. In a deep recession like this, this would be the perfect opportunity for hospitals to increase their CRNA ranks (since there are more CRNA's available to hire) and thereby decrease their total payroll. Yet, this is not happening. Both anesthesiology and midlevel positions are proportionally being hit. There is no change in market share. Why? The reason is because administrators recognize that there is significant value to hire an anesthesiologist even if it costs more. You can pay more now for a physician or pay a lot more later in a lawsuit. This is why increasing the number of anesthesia midlevel providers is a smart strategic move for anesthesiology. The future of the profession I believe depends on it. Diversify, diversify, diversify the midlevels in your group. This is the ideal we need to all strive for.

there are some good points but still the oversupply of any type of market with top, mid or lower level positions isnt generally good for that particular profession. You have far more confidence in the intelligence of administration than I

 

[Taurus]

there are some good points but still the oversupply of any type of market with top, mid or lower level positions isnt generally good for that particular profession. You have far more confidence in the intelligence of administration than I

You have to choose your poison.

Do you want to undercut the CRNA's and protect the future of your profession? Or do you want to line your pockets now and pass the buck on to future generations of anesthesiologists to worry about?

The latter is how anesthesiology got into this mess in the first place. Your predecessor anesthesiologists sold out your profession long ago and now you're paying the price for it. You can keep ignoring the problem or make some painful fixes. If there is no real leadership in anesthesiology, then anesthesiology as a medical profession may not exist by the time you're ready to retire. As they say, sometimes you can't have your cake and eat it too. The only viable solution is the AA's. Create a competitor. The model works and it has been used successfully again and again. The whole RA vs. RPA was very effective. One group knows that if they're too aggressive then it will give their competitor a hiring advantage. Think about it. If there were more AA's right now, how many here would not try to hire one? There's a huge pent up demand by pissed off anesthesiologists out there.

 

[gasaddict54]

You have to choose your poison.

Do you want to undercut the CRNA's and protect the future of your profession? Or do you want to line your pockets now and pass the buck on to future generations of anesthesiologists to worry about?

The latter is how anesthesiology got into this mess in the first place. Your predecessor anesthesiologists sold out your profession long ago and now you're paying the price for it. You can keep ignoring the problem or make some painful fixes. If there is no real leadership in anesthesiology, then anesthesiology as a medical profession may not exist by the time you're ready to retire. As they say, sometimes you can't have your cake and eat it too. The only viable solution is the AA's. Create a competitor. The model works and it has been used successfully again and again. The whole RA vs. RPA was very effective. One group knows that if they're too aggressive then it will give their competitor a hiring advantage. Think about it. If there were more AA's right now, how many here would not try to hire one? There's a huge pent up demand by pissed off anesthesiologists out there.

but my point is what will keep AAs from being the exact same problem? But anyway maybe i am being quite selfish, but going into this thinking upon finishing that I would make 350K plus, w 250K of debt to pay wasnt so bad , but making 200K w 250K of debt makes me want to puke😱

 

[staup]

Radiology is also a highly stressful speciality. Yes, it is easy to read pre-op X-rays and r/o inflirates. However, it is a different ball game when you have to make the call in the middle of night regarding a head CT/MRI spine/Abd CT/CT-PE etgc etc.

Radiologists always bring this up, but IMHO I think Gas is much more stressful than Rads. It's true Rads has a lot of work to do and at times have to make crucial calls, but honestly, if it's not clear, they say "not clear and rely on clinical reasoning." Also, when I'm on the phone with a radiologist the experienced ones make these calls in under a minute of reading it. Come on? That's overwhelming stress? My brother has a 9-5 computer job and when he occassionally works to 8 or 9PM he calls that "overwhelmingly stressfull" because he isn't used to it. I think it is similar with Rads, they aren't used to super stress that clinical medicine can sometimes offer. There is nothing like having a patient crash in front of your face, which Gas can experience multiple times a day at some places. Whether medical students realize this and it effects their decision, I don't know, I know I didn't realize it in medical school.

That being said, I definitely think Rads is an important, needed specialty, obviously.

As far as competiveness, it's difficult to use the number of applicants argument because that has an automatic selection bias, a quarter to half of the Gas applicants wouldn't match or get interviews in Rads so they don't apply to Rads.

And by the way, I'm a medicine resident.

 

[Southpaw]

a quarter to half of the Gas applicants wouldn't match or get interviews in Rads so they don't apply to Rads.

And by the way, I'm a medicine resident.

This is overstating it, in many ways. Gas applicants don't apply to rads not because they wouldn't get an interview, but mostly because they're two extremely different fields and if you're applying to one you've excluded the other as a career possibility.

Using your reasoning, you'd expect to see a lot more 'cream of the crop' applicants who've applied to Anesthesiology who've also applied for other specialties (perceived 'more competitive' specialties). The match statistics don't support this argument.

I don't think you intended it this way, but your statement, to me, implied that people apply to anesthesiology because that's all they can match into. This is the belief of outsiders who know nothing about the match process (CRNAs have used this argument). Anesthesiology has gotten quite competitive, especially at the top tier programs, over the past decade. It's in the middle competitiveness-wise, with EM and GS.

 

[staup]

I don't think you intended it this way, but your statement, to me, implied that people apply to anesthesiology because that's all they can match into. QUOTE]

I didn't mean or implay that at all. All I am saying is that traditionally the scores and grades one needs to match into Radiology rather than Gas are higher. I am not saying there are not Gas candidates that could match into Rads, because obviously there are, what I am saying is that some of the people that barely match into Gas would not match into Rads and hence often would not even apply. So Rads is a little more competitive. The average board scores don't lie.

I am by no means putting down Gas or any other specialty, I am just stating a fact that traditionally you need better stats to match into Rads. Hence, people who has 215 board scores don't apply to Rads often because they know they won't match. Are there people who still try and occasionally match with those stats, yes, but the average student would not with those scores.

So my point was that comparing a percentage of people who try and match into each specialty is not the entire story of competitiveness because the applicant pools are different. It may be more indicative of where things are heading in the future.

 

[DoctorGo]

competitiveness is directly related to future compensation/"work" ratio. the higher this number - the more competitive the specialty. you can relate it to a number of factors, but this is the one that matters most.

radiology may make similar salaries, but with much less physical work/stress. so the ratio is higher.

when you chose the specialty: make sure you still can do it (you enjoy it) even if they cut your salary in half - because as much as everyone talks about getting out of medicine if reimbursement drops, the truth is - there isn't anywhere to go (and make more money) for the vast majority of us.

Increased demand and greed has made radiology high stress due to high volume requirements with the lawyers and administrators watching your every move. With the advent of PACS, Admins can monitor you productivity closely, including know when you are there, when you take breaks, etc.

 

[cfdavid]

As a general rule, it seems that any field which doesn't require your physical prescence at a certain location in order to do the job will be at increased risk of outsourcing.

 

[badasshairday]

As a general rule, it seems that any field which doesn't require your physical prescence at a certain location in order to do the job will be at increased risk of outsourcing.

Not enough radiologists in the world for that to happen. Can't outsource a high skilled job, like you can a factor job.

 

[Monty Python]

Not enough radiologists in the world for that to happen. Can't outsource a high skilled job, like you can a factor job.

My hospital digitally sends our images to Australia. The reading is faxed back on Australian radiologist group letterhead within 15 minutes.

 

[PercAVR]

Anesthesia is a job that can be done by a Nurse (CRNA) under supervision of a Surgeon. It does not need a doctoral degree. And that's the way it's going to be in 10-15 years.

 

[hivoltage]

Anesthesia is a job that can be done by a Nurse (CRNA) under supervision of a Surgeon. It does not need a doctoral degree. And that's the way it's going to be in 10-15 years.

Anesthesia can be done by CRNAs... They do it all the time. I see it. They cant medically evaluate the patient.. thats our jobs. BUt in the OR. save for the hardest cases they do it all. So you will be competing with that your whole career. They view you( hospital administrators) as an escape valve. so you are just their to keep the malpractice attorneys happy. so be careful when going into this field. do diligent research because the last thing you wanna do is have only a few choices and have to go to BFE to work and your wife/husband will not be happy and you will get divorced and have to work to pay the child support/alimony.

 

[badasshairday]

My hospital digitally sends our images to Australia. The reading is faxed back on Australian radiologist group letterhead within 15 minutes.

Which is then viewed by an American Radiologist in the morning, as somebody needs to assume the liability. Nothing is worse than having a patient find out their image was not read by an American board certified Radiologist when it is realized a finding was missed. Nighthawks can be domestic or international, and are useful for groups who don't want to take night call. It is not a way for hospitals to save money, an Australian radiology group is making GOOD money off of this. Other groups do night call and have a radiologist in house... they don't rely on these services. And the most recent trends are to have someone in-house 24/7.

 

[WholeLottaGame7]

Anesthesia is a job that can be done by a Nurse (CRNA) under supervision of a Surgeon. It does not need a doctoral degree. And that's the way it's going to be in 10-15 years.

Hahahaha. Yes, because surgeons are SOOO interested in the perioperative management of their patient's medical problems. If anything, I see more and more surgical specialties (and even some general surgeons) moving towards being a consult service only. I can't tell you how many times in the past 6 weeks on GenMed I've seen the ED consult surgery for an admission, only to have the surgeon come back with "admit to gen med and we'll consult on them." And they're supposed to be directing the medical care of a patient while simultaneously operating? Not happening. If anything, you're describing life back in the 1950s.

I don't think any specialty is truly immune to mid-level encroachment. If anything, I think diagnostic rads is safer than IR, where you have mid-levels doing PICCs, dialysis access, other fluoro procedures. It is what it is: there are too few providers for the amount of health care we're trying to provide as a country.

 

[Monty Python]

Which is then viewed by an American Radiologist in the morning, as somebody needs to assume the liability. Nothing is worse than having a patient find out their image was not read by an American board certified Radiologist when it is realized a finding was missed. Nighthawks can be domestic or international, and are useful for groups who don't want to take night call. It is not a way for hospitals to save money, an Australian radiology group is making GOOD money off of this. Other groups do night call and have a radiologist in house... they don't rely on these services. And the most recent trends are to have someone in-house 24/7.

Wish it were so ... my hospital sometimes has one radiologist. Sometimes. With banker's hours. Other times, depending on local interest and contract legalities our films are read by the next hospital down the road and their locums radiologists. Other other times the images get zapped to Oz. It is very annoying to not have consistent radiologist availability at the same phone number. And inhouse 24/7 is beyond our wildest pipe-dream, unfortunately.

 

[Stank811]

Anesthesia is a job that can be done by a Nurse (CRNA) under supervision of a Surgeon. It does not need a doctoral degree. And that's the way it's going to be in 10-15 years.


...ridiculous