Long time poster here under a different name, but here is an example of doing well:
I currently do very well for myself as an anesthesia attending. Two years ago I wasnt partner till most of the way through. Made 940 taxable income from the hospital. Last year will be better but dont have final numbers. Income at our group has been on the rise for the past 14 years. I firmly believe we have reached a peak for our income last year. Next year projected is >10% lower.
We take 9 weeks vacation, do 12-14 weekends per year. Payers is 45% commercial. Work ~65 hours a week average, some weeks 30, some weeks 100.
Beyond that, investment has been very good to me with a ~2-3 mil investment portfolio at 3.5 years out of residency. I honestly am waiting for a shoe to drop somewhere in my life.
Job was basically handed to me by an attending during training, with minimal to no effort, unlike the options I found when looking for myself of the following:
Hospital employee: Start and all future years hovering around 375, better hours, same vacation
Private group, more BFE: Start 280, 2 years to partner progressing to 450-550 partner depending on amount worked.
Private group urban: Start 180, 3 years to partner, progressing to 700 or so.
Private group urban: Start 225, 5 years to partner, progressing to 550 or so.
Private group urban: Every year 400.
Academic, clinician path: 350-370
A good friend in all MD model urban environment was making 750, group replaced by AMC 2 years ago with same docs having same job (now plus CRNAs) with the addition of more in house call and 2/3 the vacation for 350 MAX (earned a percent of max compensation based on very hard to meet metrics) I should note that he, and almost all the other good anesthesiologists left that practice. He was begged to come back by admin and AMC at a much better rate, but still not anywhere close to what he left. He stayed away. That hospital continues with the AMC, despite surgeons who at least tell me they are unhappy with anesthesia. Who knows what they say when I am not around.
I am doing my best to make hay while the sun is shining, and invest heavily during this point in my life. My family of 4 lives off <100k per year including debt repayment (delayed for aggressive investments) and insurances. Income is already showing signs it will begin a decline for my group, and within 5 years I expect my compensation to be 1/2 current, and that is without us being replaced by an AMC or anything like that. I do far better than any of my residency classmates financially, but also work more hours and work harder when I am there. If my comp was lower I would unequivocally work less, life is much more than money in the bank. I am stressed at work and feel wiped out when I get home many days. If I didnt love my job I would be a very miserable rich guy.
So yes, salaries have been very high in the past, and are currently very good IF you make certain sacrifices. Many are not willing to make those sacrifices. Even so, I expect the income to decline across the board at varying rates to a point where salaries are in the 2-450 range for most people. Still a great income, but not 7 figures. Most in America would actually kill for this type of salary, and I see guys complain about their low salaries or difficulty living on that, and I want to punch them.
Please do not forget that you are a very privileged person, and all these discussions about pay will only make others jealous when they find out someone has it better than them, and make the "public" who reads this forum only resent anesthesiologists more for reading it.
Oh, and on that note, the neurosurgeons I work with make as much as my total compensation in call stipends yearly, even if they never do a case