with all the infor on this board, i am getting scared to apply for gas

[dhb]

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If the US is going the European way here's something to cheer you up: there will always be people who have boatloads of cash and that will want MD care and pay appropriately for it.
So yes urban academic environments will not be the most rewarding financially (just as they are know) but there will still be some sweet gigs out there.

 

[justin5790]

They took our jobs!
Day tek er joobs!
De derrker derrrr!!

 

[sevo85288]

Dear blade,
Medicare currently pays $21/unit for anes. So based on your calculations that would be 210,000/yr minus 10% overhead.

Cards has about 40% overhead. Based on your calculations 480,000 minus say 50% is 240,000+. Also, please remember that the RVUs are different for the specialities. Lap chole can get you 10 units. A cath can get you 5 units in cards. So we are talking apples/oranges. 10,000 units is a lot for cardiologists. It is possible but would require greater than 60 hrs. However, 10000 units in anes is easily doable. Around 40 hrs week.

Cards has midlevels too. They are called APNs. See pts in clinic, order tests, adjust meds. They don't do invasive procedures; but no every cards dude does procedures....they also have to take tons of calls/consults from ER etc...lifestyle sucks....

Here is bold prediction: We will all get equally hurt. If you are good at what you do; you will be ok.

 

[BLADEMDA]

Dear blade,
Medicare currently pays $21/unit for anes. So based on your calculations that would be 210,000/yr minus 10% overhead.

Cards has about 40% overhead. Based on your calculations 480,000 minus say 50% is 240,000+. Also, please remember that the RVUs are different for the specialities. Lap chole can get you 10 units. A cath can get you 5 units in cards. So we are talking apples/oranges. 10,000 units is a lot for cardiologists. It is possible but would require greater than 60 hrs. However, 10000 units in anes is easily doable. Around 40 hrs week.

Cards has midlevels too. They are called APNs. See pts in clinic, order tests, adjust meds. They don't do invasive procedures; but no every cards dude does procedures....they also have to take tons of calls/consults from ER etc...lifestyle sucks....

Here is bold prediction: We will all get equally hurt. If you are good at what you do; you will be ok.

Sevo,

I appreciate the post. You are correct that Medicare reimburses at $21 per unit. You are also correct that overhead runs about 10%. This leaves an icome of $190,000 or so. Then, you must pay malpractice, health, retirement, etc which leaves you $130,000. Finally, the government/IRS gets its share.

As for your analyasis of Invasive Cardiology I must disagree. The "average" Invasive Cardiologists currently earns twice what an Anesthesiologist does; in addition, APNs are no threat to Invasive Cardiology and patients will NEVER equate an APN with a Board Certified Heart Specialist.

Medicare cuts will hurt Cardiology. But, in the end they will still earn double what an Anesthesiologist does in a 100% Medicare model.

Hence, if you value "living the good life" Cardiology is a better choice than Anesthesiology going forward. If lifestyle is your thing then becoming an Anesthesiologist for CRNA level pay should be always be available.

My posts are intended to INFORM the young and naive that this field will not be the cash cow it is today going forward. There are better choices.
However, Anesthesiology is still a legitimate choice provided one chooses the field with his/her eyes wide open.

 

[BLADEMDA]

Interventional Cardiologist Compensation: Averages about $545,000 per year, according to the MGMA.


In my area an Interventional Cardiologist earns more like $800K with a few surpassing $1 million per year.

 

[mercaptovizadeh]

Interventional Cardiologist Compensation: Averages about $545,000 per year, according to the MGMA.


In my area an Interventional Cardiologist earns more like $800K with a few surpassing $1 million per year.

I'm a little shocked at these figures. The discrepancy from general IM is so drastic. I thought the figures for interventional cards were more like 400k, not twice that. I guess the lifestyle is not much better than surgery, so I don't begrudge them.

They will take a big hit in Obamacare.

 

[titanjones]

study harder and go into dermatology.

 

[miamidc]

The last house committee that just passed changed the bill so that the new program, even though a government program, will not pay doctors based on medicare rates. An independant council will asign the rates. That means you almost for sure will not be getting paid 33% of private insurance. That also means, there is a possibleity that anesthesiologists may be getting paid more than they are now. Demand is only going up. I would say u have to specialize, however. I think this is going to be key in anesthesia. If you specialize u will be insulated from any reach by CRNAs. Our role will be mainly supervisory, but hey that is not bad at all.

Blade, are you specialized? I am wondering if you are feeling the heat and this is why you are scaring the sheet out of all the med students out there. All the specialists (ICU, Cardiac, Pain, Peds) are all very confident their jobs are secure and feel very marketable. However, I do think that without specialization you are expendable. The cardiac guys here at my program (academic mind u) are making $2000/day.

If you are a med student please do a little more homework before you totally discount the field, seriously.

 

[BLADEMDA]

The last house committee that just passed changed the bill so that the new program, even though a government program, will not pay doctors based on medicare rates. An independant council will asign the rates. That means you almost for sure will not be getting paid 33% of private insurance. That also means, there is a possibleity that anesthesiologists may be getting paid more than they are now. Demand is only going up. I would say u have to specialize, however. I think this is going to be key in anesthesia. If you specialize u will be insulated from any reach by CRNAs. Our role will be mainly supervisory, but hey that is not bad at all.

Blade, are you specialized? I am wondering if you are feeling the heat and this is why you are scaring the sheet out of all the med students out there. All the specialists (ICU, Cardiac, Pain, Peds) are all very confident their jobs are secure and feel very marketable. However, I do think that without specialization you are expendable. The cardiac guys here at my program (academic mind u) are making $2000/day.

If you are a med student please do a little more homework before you totally discount the field, seriously.

I am NOT feeling any heat other than the hot air coming from guys like ArmyGas CRNA. I have a great job and have no regrets about my "economics" of this field. But, it would be dishonest of me to encourage Medical Students to enter this field based on the PAST. Looking forward the field looks like it faces many more hurdles than most other medical specialties.

For years I have encouraged Residents to do Fellowships. I have been quite vocal that is the best way to avoid being a glorified CRNA.

I am vary wary about the government option/govt. run Co-ops for Anesthesiology. Do you know who is going to run this thing? Sebelius.
She has no love for the ASA or Anesthesiology. So, while the next 2-3 years may still be Sunny the storm clouds are brewing and the Med Students better bring an Umbrella.

Please feel free to pick Anesthesiology as a Specialty. But, you must understand the UNIQUE problems this specialty faces compared to most other procedure based specialties.

 

[sevo85288]

blade
the 10% overhead covers malpractice in my dire scenario. Interventional cards in my area don't make $800K. Yes they can make "545k" but you have to subtract overhead from that;(just like you did with anes, malpractice/retirment ) as well quantify how hard they work for that.

You would be shocked how low compensation for a diagnostic cath is. (around $250) Also, reading echos sounds lucrative; but consider the cost of the tech/machine/etc. Cards is a overhead intensive speciality. I agree that it can pay very well if you work hard and have lots of volume.

APNs see most patients in clinics for busy cards guys. They take phone calls/arrange office, etc. They order tests/labs/and adjust meds. So they can do the bulk of the office work. They are highly paid. (overhead) Of course, they don't do procedures like caths, read echos,etc. In some places they do place lines in ICU and manage hemodynamics.

 

[AK_MD2BE]

I predict 2-3 docs and 20 CRNAs in about ten years.

Where are all of these CRNA's going to come from? Sure, CRNA schools are churning out lots of nurses, but CRNA's have been around long enough that some of them are retiring as well.
All of the talk on this board makes it seems as if there are just hundreds of thousands of nurses becoming CRNA's every year...a little alarmist, maybe? (which isn't a bad thing if it awakens anesthesiologists to the very real threat that is the AANA)

 

[flashgordon]

Where are all of these CRNA's going to come from? Sure, CRNA schools are churning out lots of nurses, but CRNA's have been around long enough that some of them are retiring as well.
All of the talk on this board makes it seems as if there are just hundreds of thousands of nurses becoming CRNA's every year...a little alarmist, maybe? (which isn't a bad thing if it awakens anesthesiologists to the very real threat that is the AANA)

You must not have done a rotation in the ICU. About 80% of the nurses in our ICU are applying for CRNA school. Whatever you do, don't let them find out you're applying for anesthesiology residency. They can go from nice to b!tch in the blink of an eye.

Nevertheless, I ended up marrying one- though she is happying being an ICU nurse (and a damn good one).

 

[maceo]

For years I have encouraged Residents to do Fellowships. I have been quite vocal that is the best way to avoid being a glorified CRNA.
.

is that what i am? a glorified crna? i guess you are right. and im not being sarcastic either according to the law