My mind was fully set to anesthesia before I read this forum..

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Stellar Clouds said:
I have no doubt that anesthesia will exist when I finish residency (and certainly well beyond). It does concern me that so many groups are selling out, but I hope to be protected in the world of academia (NOT the reason why I want to stay in academics). I didn't pick anesthesia to make a million a year. I could have gone into any specialty, but instead I picked anesthesia because I love it. There has been no time in medical school that I was genuinely excited to go to the hospital on a daily basis, except when I was on my anesthesia rotations. Hell, just like jet, I'd wake up before my alarm went off. I know I've picked the right specialty, and no amount of doom and gloom on SDN will ever change that for me.
Click to expand...

:thumbup:

I love people like you because this is what going into a specialty should be all about. This is not the field for those who are looking for "lifestyle" or "tons of money". I think there's this general stigma that all anesthesiologists do is sip coffee and play on their iPads looking up at the monitor or patting the CRNA on the back in between strenuous sessions of angry birds. And I think a lot of people go into this field expecting that kind of job. I mean, let's face it, most of the people that don't match their primary specialty and scramble into our field think "Well, at least that'll be easy".

The 'doom-and-gloom' committee have all but quit their jobs but I won't give up until the war is obviously won or lost. In my opinion, everyone should support ASAPAC, get involved in local politics, lobby, write to congressmen, do whatever possible even if it will turn out to be fruitless. On the small chance that the perfect storm hits, no sense in letting our field slip away without a grueling fight.
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BLADEMDA said:
Anesthesia will exist. And you all will likely find jobs. But, will they be good jobs? Again, you get determine what the definition of good means.

Jet and Sevo are making boat loads of money right now. Top 1 percent income. This doesn't reflect on the average new grad getting an AMC job.

Longer term out (5-7 years) anesthesia could be facing the perfect storm. I hope it doesn't happen but it seems quite possible if not probable.

1. Major cut in reimbursement by Medicare/Medicaid
2. More Collaborative practice or independent practice by CRNAs
3. Fewer jobs available due to cheap and abundant midevel labor
4. More AMCs and hospitals downsizing Anesthesiologists and using cheaper CRNA labor
5. More Medicaid patients
6. Fewer jobs due to Anesthesiologists working longer and increased supply
7. More practices selling out to AMCs
8. Hospitals cutting subsidies (take it or leave it attitude by CEO)
9. The doctor CRNA (CRNA DNAP) circa 2015
10. More Surgicenters using solo CRNAs and more opt out states
Click to expand...

Blade,

Aare we saying top 1% job = 450K? So should I assume these are mostly in BFE?

Also, what income is more typical for new grads (or even established docs?)

thanx
 
Silent Cool said:
Blade,

Aare we saying top 1% job = 450K? So should I assume these are mostly in BFE?

Also, what income is more typical for new grads (or even established docs?)

thanx
Click to expand...

:laugh: top 1 percent is over $650 my friend. And I'm not talking pesos. Most top 1 percent jobs are $700K plus benefits (W-2). They are hard to find but once you get one waking up in the morning before your alarm clock sounds won't be a problem.;)

Median jobs are $425 plus bennies (W-2). Most AMCs are 25th percentile with bad benefits.

Camelot is here right now and some members of SDN are at the round table. But, Camelot won't last much longer and it is doubtful you will ever sit at the round table

New graduates without a fellowship start around $300K. With a fellowship the odds increase you will make more money by joining a lucrative practice. For example, Peds fellowship trained new graduates should be able to land a partnership track starting in the mid 200s with partners pulling in $600 or so.
This is still out there for the hard working Peds Anesthesiologist. Even with reimbursement cuts that Peds Anesthesiologist should still enjoy quite a nice income as a partner ($500K)

Just as significant as the money is the work environment and independence that a private practice brings to the Anesthesiologist. The AMC and employee model squashes that environment
 
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Silent Cool said:
Blade,

Aare we saying top 1% job = 450K? So should I assume these are mostly in BFE?

Also, what income is more typical for new grads (or even established docs?)

thanx
Click to expand...

My Radiology buddy makes just as much money as a Camelot Anesthesiologist. He has no trouble waking up in the morning either but his day starts at 0800.

Yet, the odds are that a med student matching into diagnostic radiology today will need to do a fellowship in order to earn 1/2 of what my buddy is pulling down today.

My point is that the future may look nothing like the past and the golden age of Camelot is coming to an end.
 
Money depends on the number of hours you work. People are working a lot for the figures that are being thrown about here.
 
The commentary and negative outlook on this thread is crazy. I guess anesthesiologist are built to think about the very worse outcome. Usually it's avoidable. I'm sure this won't be the end.
 
I've been looking for an excuse to use this .gif, and this thread is perfect!

haters-gonna-hate-o.gif
 
I get soo sick of hearing all the complaining from student on this site. You got into medical school hopefully for the reasons. Good for you. You'll get way more money than the average American and have prestige. There are thousands of people who wish they could be doctors who will never be able to. So STOP complaining about who gets payed how much and who deserves how much and who thinks the profession is going down hill just because they think they might be making 300,000 a year instead of 320,000. In the end, even doctors die so who cares? You cant spend money when you are dead Just focus on being the best doctor you can be.
 
AnesThrow said:
:thumbup:

I love people like you because this is what going into a specialty should be all about. This is not the field for those who are looking for "lifestyle" or "tons of money". I think there's this general stigma that all anesthesiologists do is sip coffee and play on their iPads looking up at the monitor or patting the CRNA on the back in between strenuous sessions of angry birds. And I think a lot of people go into this field expecting that kind of job. I mean, let's face it, most of the people that don't match their primary specialty and scramble into our field think "Well, at least that'll be easy".

The 'doom-and-gloom' committee have all but quit their jobs but I won't give up until the war is obviously won or lost. In my opinion, everyone should support ASAPAC, get involved in local politics, lobby, write to congressmen, do whatever possible even if it will turn out to be fruitless. On the small chance that the perfect storm hits, no sense in letting our field slip away without a grueling fight.
Click to expand...
no doubt many are concerned about lifestyle and compensation, but for the most, it is job satisfaction that is bothering us. of course if you do 100% your own cases and get paid something like 200K, it's a little bit disappointment but not a big problem as long as you enjoy what you do. it's still damn good money to live a decent life. but now i realize this kind of setting is getting less common every year.

and if you get paid 500K supervising CRNAs doing exactly the same thing as they do in the next room, it might be 'endurable'. it sucks but the $$ is sweat.

but are you willing to bear that with 200K or even less? no matter how I love what I do, the idea of mid level cockroaches encroaching something that is supposed to be solely my territory itself bothers me. and it's getting not worth it.

i think that's how many MS students feel about this field these days and why it's getting less competitive.

i would rather do surgical sub specialties or IM sub specialties like Cards, GI which are relatively immune from mid-levels even though I might make 200K or so. it's going to make me crazy if i pursue this cuz my 2 anesthesia paper and 1 LOR from anesthesiologist will be depreciated, if not useless.
 
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theeastsky said:
no doubt many are concerned about lifestyle and compensation, but for the most, it is job satisfaction that is bothering us. of course if you do 100% your own cases and get paid something like 200K, it's a little bit disappointment but not a big problem as long as you enjoy what you do. it's still damn good money to live a decent life. but now i realize this kind of setting is getting less common every year.

and if you get paid 500K supervising CRNAs doing exactly the same thing as they do in the next room, it might be 'endurable'. it sucks but the $$ is sweat.

but are you willing to bear that with 200K or even less? no matter how I love what I do, the idea of mid level cockroaches encroaching something that is supposed to be solely my territory itself bothers me. and it's getting not worth it.

i think that's how many MS students feel about this field these days and why it's getting less competitive.

i would rather do surgical sub specialties or IM sub specialties like Cards, GI which are relatively immune from mid-levels even though I might make 200K or so. it's going to make me crazy if i pursue this cuz my 2 anesthesia paper and 1 LOR from anesthesiologist will be depreciated, if not useless.
Click to expand...

GI, cards, and anesthesia are completely different fields. It is crucial you do what you think you will enjoy and can still manage to do relatively happily in 30 years. It is a stupid decision to have to make after 1 month of exposure to the various fields, but it is what it is. Do NOT make money-based decisions, going to medical school was when you decided maximizing your income was not a priority, dont half ass your way out of that commitment now.

And the only field "safe" from midlevels is surgery (by the nature of how long it takes to mint a surgeon). Nurse endoscopists are on the horizon for GI, and while interventional cards is safe, cards fellowships for NPs already exist.

Make yourself valuable, be active in improving yourself and your setting, and stop trying to predict the future--nobody has been able to do this yet, what makes you think you can?
 
many apologies - this post was ill considered - there is an entire forum devoted to the kind of crap I rambled about
:smack:

sorry
 
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BLADEMDA said:
:laugh: top 1 percent is over $650 my friend. And I'm not talking pesos. Most top 1 percent jobs are $700K plus benefits (W-2). They are hard to find but once you get one waking up in the morning before your alarm clock sounds won't be a problem.;)

Median jobs are $425 plus bennies (W-2). Most AMCs are 25th percentile with bad benefits.

Camelot is here right now and some members of SDN are at the round table. But, Camelot won't last much longer and it is doubtful you will ever sit at the round table

New graduates without a fellowship start around $300K. With a fellowship the odds increase you will make more money by joining a lucrative practice. For example, Peds fellowship trained new graduates should be able to land a partnership track starting in the mid 200s with partners pulling in $600 or so.
This is still out there for the hard working Peds Anesthesiologist. Even with reimbursement cuts that Peds Anesthesiologist should still enjoy quite a nice income as a partner ($500K)

Just as significant as the money is the work environment and independence that a private practice brings to the Anesthesiologist. The AMC and employee model squashes that environment
Click to expand...

So your biggest fear is making 500K instead of 650K?

Jet, I've read your thread re: 450K vs 150K. Good thread. Could you comment on this?

Honestly, if your biggest concern is making *only* 500K....I really don't understand it. Medical incomes are artificially inflated due to a controlled labor market. I really don't care if I make 500K instead of 650K because, as I said, it's all artificial. And either way...that is a f*** L*** of money. And these kinds of things are cyclical. My father never made more than 100K a year--not even that, actually.

If I have to, uh, "SETTLE" for 500K (that still cracks me up)...lol...I think I can live with that.


unreal....
 
Silent Cool said:
So your biggest fear is making 500K instead of 650K?

Jet, I've read your thread re: 450K vs 150K. Good thread. Could you comment on this?

Honestly, if your biggest concern is making *only* 500K....I really don't understand it. Medical incomes are artificially inflated due to a controlled labor market. I really don't care if I make 500K instead of 650K because, as I said, it's all artificial. And either way...that is a f*** L*** of money. And these kinds of things are cyclical. My father never made more than 100K a year--not even that, actually.

If I have to, uh, "SETTLE" for 500K (that still cracks me up)...lol...I think I can live with that.


unreal....
Click to expand...

You really don't understand the situation. The focus should be on what type of job you will have and who will employ you. Then, we will see whether you will be smiling when that alarm clock rings.
 
imfrankie said:
Money depends on the number of hours you work. People are working a lot for the figures that are being thrown about here.
Click to expand...

Some work very hard for that type of money. Others (not me) enjoy a great payer mix and work 40-45 hours a week on average for big dollars.

Have you ever figured out the income for aNesthesiologist supervising 4 rooms with a 80% Commercial payer mix? The figure is staggering.
But, the same work hours covering 4 rooms with an 80% Medicare payer mix would result in a 50-70% reduction in reimbursement.

This is why AMCs exist and why they will proliferate like a malignant cancer once ObamaCare takes hold circa 2017.
 
BLADEMDA said:
Some work very hard for that type of money. Others (not me) enjoy a great payer mix and work 40-45 hours a week on average for big dollars.

Have you ever figured out the income for aNesthesiologist supervising 4 rooms with a 80% Commercial payer mix? The figure is staggering.
But, the same work hours covering 4 rooms with an 80% Medicare payer mix would result in a 50-70% reduction in reimbursement.

This is why AMCs exist and why they will proliferate like a malignant cancer once ObamaCare takes hold circa 2017.
Click to expand...

I've not been interested in "the income for aNesthesiologist supervising 4 rooms with a 80% Commercial payer mix?"

I would however be interested in the income for one of four anesthesiologists with an 80% Commercial payor mix.

I believe the primary of the malignancy you describe lies with those in our profession whose book the AMCs have read.
 
BLADEMDA said:
You really don't understand the situation. The focus should be on what type of job you will have and who will employ you. Then, we will see whether you will be smiling when that alarm clock rings.
Click to expand...

So if you are making 500K, then whether or not you smile depends on your employer. Huh.

Still getting my head around that....
 
Don't think you'll get 500k when you finish.
The people making big money will sell the groups to national investors before they retire and your salary will be as low as the suits can make it while being able to staff the ORs. Just how low will depend on supply and demand which is no longer favorable and will get worse with crna-mills increasing supply.
 
This is why most people dont like physicians. It's because they are more worried about being able to afford that Lexus and 600,000 dollor house then they are about their patients. If a patient dies on the table, will you be able to look at yourselves in the mirror at the end of the day? Will it be worth all the money then? Enjoy being an anesthesiologist. Oh yeah, one more thing....better not make any mistakes! :)
 
I am 1.5 years out of training, fellowship-trained, board certified, etc, recently elected as my section chair and have surpassed the $450K mark (W-2) @ a job in BFE.

The notion that $450K is a lot of money is B.S in my opinion. Just wait until you see half of it evaporate in taxes. It ain't all that.
 
Oh really?? Ur way out of touch with reality, buddy. Your parents must have been rich then because you're crazy to think that.
 
ProRealDoc said:
I am 1.5 years out of training, fellowship-trained, board certified, etc, recently elected as my section chair and have surpassed the $450K mark (W-2) @ a job in BFE.

The notion that $450K is a lot of money is B.S in my opinion. Just wait until you see half of it evaporate in taxes. It ain't all that.
Click to expand...

Yep it's about 10x the median income in this country. Sucks to be you!
 
ProRealDoc said:
I am 1.5 years out of training, fellowship-trained, board certified, etc, recently elected as my section chair and have surpassed the $450K mark (W-2) @ a job in BFE.

The notion that $450K is a lot of money is B.S in my opinion. Just wait until you see half of it evaporate in taxes. It ain't all that.
Click to expand...

I told you so. Real money is a job where you bank high six figures but pay Romney or Buffett type tax rates. It ain't what you earn but what you keep that matters.
 
ProRealDoc said:
I am 1.5 years out of training, fellowship-trained, board certified, etc, recently elected as my section chair and have surpassed the $450K mark (W-2) @ a job in BFE.

The notion that $450K is a lot of money is B.S in my opinion. Just wait until you see half of it evaporate in taxes. It ain't all that.
Click to expand...

Wow.
 
BLADEMDA said:
I told you so. Real money is a job where you bank high six figures but pay Romney or Buffett type tax rates. It ain't what you earn but what you keep that matters.
Click to expand...

So what would you do to get "real money?"
 
geronamo26 said:
This is why most people dont like physicians. It's because they are more worried about being able to afford that Lexus and 600,000 dollor house then they are about their patients. If a patient dies on the table, will you be able to look at yourselves in the mirror at the end of the day? Will it be worth all the money then? Enjoy being an anesthesiologist. Oh yeah, one more thing....better not make any mistakes! :)
Click to expand...

Oh God, you're a pre-health douchebag that knows absolutely nothing. Leave your naive optimism behind and come back to these forums when you grow some hair on your nuts.
 
Consigliere said:
Oh God, you're a pre-health douchebag that knows absolutely nothing. Leave your naive optimism behind and come back to these forums when you grow some hair on your nuts.
Click to expand...

Exactly. Who wants all the stress and liability, covering multiple rooms with sick patients all day for plumber's pay. STFU, please.
 
geronamo26 said:
Oh really?? Ur way out of touch with reality, buddy. Your parents must have been rich then because you're crazy to think that.
Click to expand...

Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.
 
I enjoy watching the transformation that takes place in many med students during med school, start Dem and end Republican...

Funny how lil ole life comes along and changes our plans.
 
Controllers, CFO, COO, CEO, Actuary partners, account executives, quats, engineers etc. make "big money" with out the length of training, debt, and liability that physicians do. Not to mention the amount of taxation that occurs. Do you know how many layers of management are present in hospitals making 100k+ off of physician production? Doctors EARN their money - why give up the market rate so easily?

There is a real skills gap that separates physicians from joe-wanna-be that would like to practice medicine. Also, the number of physicians is constrained because the capital to train people to acquire the necessary skills is very expensive. There is nothing artificial about it.

At my hospital we have a VAD surgeon that I've heard makes 7 figures. If you look at his call schedule, and the lives he effects, I would say he's earning it.
 
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pgg said:
Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.
Click to expand...

+1
You stated it much better than I ever could.
 
pgg said:
Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.
Click to expand...

:laugh:

I had a business before medical school. Nothing opens your eyes to government (and insurance) malarkey like being a sole proprietor and paying double the taxes your friends do.
 
pgg said:
Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.
Click to expand...

I agree completely. But, because of our paychecks, it is impossible to explain our frustrations and dissatisfaction to almost anyone who hasn't been through it.
 
geronamo26 said:
Oh really?? Ur way out of touch with reality, buddy. Your parents must have been rich then because you're crazy to think that.
Click to expand...

Quite the opposite. I was born in a third-world sh*thole, grew up poor in a single-parent household and English is my second language. What's your excuse?
 
Oh please! All I hear is whinning and complaining in here. I hope Obamacare rips all of the greedy doctors in here a new one! Then we'll see who REALLY "Love loves helping people!"
 
Silent Cool said:
Jet, I've read your thread re: 450K vs 150K. Good thread. Could you comment on this?
.
Click to expand...

DUDE IF I COMMENT ON THAT THREAD AGAIN I PROBABLY RISK SDN HIT MEN CLANDESTINELY STALKING ME AND TRYING TO KILL ME.:D

All kidding aside, that post was very controversial but very true.

Last I heard the SDN Stupidvisors....no sorry... I mean supervisors had stashed it away in the group Topics In Healthcare (or something like that) but because of the inflammatory nature (albeit absolutely TRUE) I don't think it even exists anymore.....someone I think hired

DAVID COPPERFIELD and

POOF

I believe it is not a part of SDN for your reading enjoyment anymore.

Even tho it had something like

70,000 HITS.
 
ProRealDoc, WTH? You should know. Sounds like someone is going into medicine for the wrong reasons. So now you feel like you have to prove something to everyone huh?
 
geronamo26 said:
Oh please! All I hear is whinning and complaining in here. I hope Obamacare rips all of the greedy doctors in here a new one! Then we'll see who REALLY "Love loves helping people!"
Click to expand...

Well, I graduated from medical school with zero debt and have ample retirement savings already.
You want an Obamacare reality check, YOU'RE going to get it.
Good luck chief. :thumbup:
 
AnesThrow said:
It seems that your main prerogative is to crush any smidgen of optimism and have everyone join your pity party. You have clearly stated your belief that this field as a whole is doomed. You may be right or you may be wrong but there's no need for continuous underhanded remarks against those who don't share your particular view.
Click to expand...

Hey Dude,

Concerning your comments about PLANK'S Opinion,

DON'T YOU SEE?

THAT'S WHAT MAKES THIS PLACE GREAT, MAN.

I don't know another site on SDN that has such an

ACTIVE ATTENDING AUDIENCE!!!

Dude, you have practicing anesthesiologists out in the Real World (like Plank), paying their bills doing this craft, willing to come to this site and contribute and offer their opinions.

THAT'S GOLDEN MAN.

We're all different. We practice differently, we think differently, we have different opinions.

You don't have to agree with our opinions.

Quite frankly,

You are benefiting from our opinions and it is to your advantage at your stage to see

ALL SIDES OF THE EQUATION.

The only way you can see ALL SIDES OF THE EQUATION is to

LISTEN TO DIFFERENT SIDES OF THE STORY (this ain't North Korea dude...it still IS ok to have an opinion).

Dude, don't get me wrong.

I'm glad you're here and just you being here proves you're a

MOTIVATED MO FO

BUT

Don't lose perspective, man. Think of the development of

YOU. AS A DOCTOR.

Would you rather hear one side only? A biased side probably? All thru

ROSE COLORED GLASSES?

No man.

I'm gonna take the lead here and respectfully give you some advice at this point...advice you can use thru the rest of your development as a physician:

LISTEN TO ALL SIDES MAN. DON'T SHUT OUT OPINIONS OR SUGGESTIONS.

Listen to ALL since the more opinions/suggestions/ways to do procedures/how things are in general

you hear,

The better decision you can make

FOR YOURSELF.

Shunning opinions makes you

SMALLER IN KNOWLEDGE BASE.

You don't have to agree, but it will

HELP YOU GROW

IF YOU LISTEN.

Especially if the info is coming from a RELIABLE SOURCE.

Like Plank.

I'm not saying I agree with him, FYI.

But listening to him makes my knowledge base WIDER.

Listen to all sides.

IT MAKES THE DECISION YOU MAKE IN THE END FOR YOURSELF WISER.
 
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gasblaster said:
http://www.nytimes.com/2013/03/28/h...eam-jobs-disappearing.html?smid=fb-share&_r=0

Anesthesiology isn't alone.
Click to expand...

Apparently we are now competing with a whole new type of midlevel, meet the "nurse-anesthesiologist." :confused:





"Anesthesiologists, facing competition from nurse-anesthesiologists and Medicare cutbacks, were down by 5 percent, to $309,000. Ophthalmologists were up by 9 percent, to $270,000, but have not recovered from earlier cuts for procedures like cataract surgery, sped up by technology."
 
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