Why was anesthesia fairly unpopular 10 years ago?

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Ruban

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So it's true that all specialties wax and wane in their popularity. But some do so far less. For example, anesthesia was fairly unpopular 10 years ago, but is very popular today. But other fields, such as ortho and derm, have always had high numbers of applicants.

My question: did anything change regarding the relative desirability of anesthesia in the past 10-15 years that has now made it one of the more popular specialties, whereas before it was not particularly popular? It seems that the work of an anesthesiologist today is the same as it was in 1990, but perhaps there's something I don't know.

Just curious to hear some opinions.

Thanks! :luck:

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i'm fairly new at this, starting anesthesiology in july, so cut me some slack (i'm enjoying saying this, a lot).

i think the salaries were much less ten years back, yo.
 
Ruban said:
So it's true that all specialties wax and wane in their popularity. But some do so far less. For example, anesthesia was fairly unpopular 10 years ago, but is very popular today. But other fields, such as ortho and derm, have always had high numbers of applicants.

My question: did anything change regarding the relative desirability of anesthesia in the past 10-15 years that has now made it one of the more popular specialties, whereas before it was not particularly popular? It seems that the work of an anesthesiologist today is the same as it was in 1990, but perhaps there's something I don't know.

Just curious to hear some opinions.

Thanks! :luck:

In 1994 the Wall Street Journal printed an article about how Anesthesiologists were obsolete, new legislation dictated that CRNA's could legally do limited anesthesia, and current payscales were similair for the type of cases. The big-wigs of anesthesia that had practices took their cue, and stopped hiring newly minted Docs in favor of the cheaper CRNA's. The paucity of jobs led to not only a decreased interest in anesthesia, but a need for fellowship to try to buy time before graduation during a tight market. Those that did enter the workforce were accepting CRNA salaries. A few major lawsuits with the words "negligence" and "malpractice" attached to them was good enough for the big-wigs to realize that Anesthesiologists were needed, and that you couldn't farm out all of your cases to CRNA's. This "newfound" knowledge stimulated them to hire more docs, which in turn stimlated a grossly large pay raise because the supply of graduating anesthesiologists was much less than the demand. Now that it's getting popular again, I suspect that the pay-scale may change in the near future, and that locums jobs won't be as plentiful. I hope the market for Anes. stays ripe, but that continues to be my wish.
So, as I think JPP mentioned before, the big guys at the top of the anesthesia food-chain were making tons of money b/c they would bill for the CRNA cases, and keep a greater piece of the meat, which left the fresh-out-of-residency guy SOL. So you see, the same amount of money and cases were floating around, it's just that CRNA's were doing the cases, and the top docs were keeping all the money.
 
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I think its because all of the other specialties have become less appealing.. Anesthesia hasnt really changed it's face.. its pretty much the same as it was 10-15 years ago. and i think they got paid more 15 years ago if you adjust for inflation.
 
From the infamous 3/17/95 WSJ article:

Copyright Dow Jones & Company Inc Mar 17, 1995
Patrick Kwan has as bright a resume as a young doctor could want, including four years of advanced training in anesthesiology. So when he entered the job market last spring, he expected to be showered with lucrative offers. What happened instead was a painful experience.
After six months of looking, Dr. Kwan got just one full-time offer, to join a group practice at $120,000 a year. He turned it down because the pay was less than half what other partners were making and because the job didn't make use of his subspecialty: anesthesia for cardiac surgery. He thought something better would come along. It hasn't.
Today, the 33-year-old Dr. Kwan is a migrant medical worker, driving his 1989 Mazda across Northern California so he can perform brief, fill-in stints in anesthesia at 10 different hospitals. On Christmas Day, he put in 12 hours at a big Berkeley hospital. At other times, he has spent nights or weekends at rural hospitals. "I can't afford to be choosy," he says. "I'll take whatever is available."


This type of stuff scared the majority of med students away...and medical schools began actually advising agaiinst going into the field according to attendings I know. This above article became like a ghost story, when I heard about it I was told the guy was LIVING in his car. All this speculation and negativity mounted with the primary care/gatekeeper proposed changes to health care, and the Clinton lead CRNA revolution. Funny thing is, when Clinton got his CABG, there was not a single CRNA to be found to do the case. :smuggrin:

Ya just gots to do what you love. One of the GI docs I'm working with this month told me that during this same time, docs post GI fellowship were going to work in primary care because the prospects were so bleak. You can't chase the trends. It takes so damn long to train in medicine that by the time your done the landscape is bound to be different than when you started. We just need to pay attention and stand up for ourselves as physicians.
 
blocks said:
....Funny thing is, when Clinton got his CABG, there was not a single CRNA to be found to do the case. :smuggrin:...
you gotta love the irony.

only reason he advocated for the nurses, was because his mommy was one.
 
ThinkFast007 said:
you gotta love the irony.

only reason he advocated for the nurses, was because his mommy was one.


he is going to speak at the aana convention. I think this summer he is the key note speaker..
 
stephend7799 said:
he is going to speak at the aana convention. I think this summer he is the key note speaker..
yup no conflict of interest there :laugh: :laugh:
 
stephend7799 said:
I think its because all of the other specialties have become less appealing.. Anesthesia hasnt really changed it's face.. its pretty much the same as it was 10-15 years ago. and i think they got paid more 15 years ago if you adjust for inflation.

oh yeah, i forgot inflation. everyone was making less! duh.
 
leopold stotch said:
oh yeah, i forgot inflation. everyone was making less! duh.

in other words there were many anesthesiologists in the early 80s making 200,000 per year.. thats the starting salary today.. and i would say a majority of anesthesiologists out there make less than 300k per annum
 
stephend7799 said:
in other words there were many anesthesiologists in the early 80s making 200,000 per year.. thats the starting salary today.. and i would say a majority of anesthesiologists out there make less than 300k per annum

Actually in the early eightys Gas guys were easily making over $500,000 if not more. These were the golden years of medicine as far as money went, wasnt till the late eightys early nineties with managed care that things went to sht.
 
miamidc said:
Actually in the early eightys Gas guys were easily making over $500,000 if not more. These were the golden years of medicine as far as money went, wasnt till the late eightys early nineties with managed care that things went to sht.

if the above is true.. aint that something.... 500,000 then is like maybe 1.5 mil now.. you barely have guys even approaching 500k today..
 
stephend7799 said:
he is going to speak at the aana convention. I think this summer he is the key note speaker..


Maybe they'll ask him why he didn't have a CRNA doing HIS anesthesia. ;)
 
I don't know if this is true or if it is just urban legend, but when I was stationed at Bethesda Naval Hospital...where he went for his healthcare.....I was told that his mother killed some kid because of an unrecognzied esophageal intubation when he was Governor.....

and he used his influence to get his mother off.
 
LOS ANGELES TIMES
MAY 19, 1992
Page 1A

Clinton’s Ties to Controversial Medical Examiner Questioned
By JAMES RISEN and EDWIN CHEN
TIMES STAFF WRITERS
LITTLE ROCK, Ark.-Gov. Bill Clinton, the presumptive Democratic presidential nominee, refused for several years to dismiss a state medical examiner whose controversial decrees included a ruling that helped Clinton's mother, a nurse-anesthetist, avoid scrutiny in the death of a patient, according to Arkansas officials and state records.
The medical examiner, Dr. Fahmy Malak, "was sort of protected by the governor and the [state crime laboratory] board," state Rep. Bob Fairchild, a Democrat from Fayetteville, told The Times. Fairchild is the author of legislation to reform the laboratory board, which has authority over the state medical examiner. Clinton appoints the board members.
Clinton, Malak and Clinton's mother, Virginia Dwire Kelley, 68, deny any connection between Malak's longevity in his job and his ruling involving Kelley. Malak, through his attorney, says he did not know that one of his findings had benefited Kelley until years after he issued the ruling.
The governor and his board declined to fire Malak despite more than four years of public criticism of Malak's work. The record shows that Malak testified erroneously in criminal cases, that his rulings were reversed by juries and that outside pathologists challenged his findings. In one instance, he misread a medical chart and wrongly accused a county coroner of killing someone. In another, he based court testimony on tissue samples that DNA tests later indicated had been mixed up with other tissue samples.
Three weeks before Clinton announced his presidential candidacy last Oct. 3, he pushed Malak, whom he had appointed during his first gubernatorial term, to resign. But then the Clinton Administration found Malak another well-paying job in state government. It prompted renewed questions about a conflict of interest growing out of Malak's ruling in 1981 that involved Clinton's mother.
That ruling, which came between terms when Clinton was out of office, helped Clinton's mother avoid legal scrutiny in one patient's death--while she was defending herself in a medical malpractice lawsuit stemming from the death of another patient.
The conflict-of-interest questions have been raised by a county coroner, by Malak critics and by a writer for the Arkansas Gazette. The writer, Max Brantley, a columnist for the Gazette at the time and now editor of the weekly Arkansas Times. said about Malak's resignation and his new position: "We may never know why Malak enjoyed such strong support." He added that "critics will note, accurately, that Malak has made an autopsy finding helpful to Clinton's mother."
Clinton, in a written statement to The Times, responded:
"There has never been any connection between my mother's professional experiences and actions I have taken or not taken as governor of Arkansas, and I resent any implications otherwise....In fact it was several years after the incident that I became aware, through the media. that the ruling made by Dr. Malak in this case was controversial. I do not have the professional knowledge necessary to judge the competency of a forensic pathologist. For several years prior to Dr. Malak's resignation as medical examiner, I requested that reviews of his performance be conducted and that appropriate action be taken by the Crime Lab Board and/or the Medical Examiner Commission. It was their decision to retain him."

http://www.idfiles.com/clintontieslat.htm
 
militarymd said:
I don't know if this is true or if it is just urban legend, but when I was stationed at Bethesda Naval Hospital...where he went for his healthcare.....I was told that his mother killed some kid because of an unrecognzied esophageal intubation when he was Governor.....

and he used his influence to get his mother off.


hey military would love to see if we can get reports/ records on that incident.. certainly it must be public record..
 
blocks said:
LOS ANGELES TIMES
MAY 19, 1992
Page 1A

Clinton’s Ties to Controversial Medical Examiner Questioned
By JAMES RISEN and EDWIN CHEN
TIMES STAFF WRITERS
LITTLE ROCK, Ark.-Gov. Bill Clinton, the presumptive Democratic presidential nominee, refused for several years to dismiss a state medical examiner whose controversial decrees included a ruling that helped Clinton's mother, a nurse-anesthetist, avoid scrutiny in the death of a patient, according to Arkansas officials and state records...

http://www.idfiles.com/clintontieslat.htm


you people rule!!! quite the web searching skills. i just learned how to get free porn. anyway, this was quite entertaining to read.

previous poster:
is it a fact no crnas in clnton's cabg? or just joking?
 
Good replies. Any more thoughts?
 
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