Should I go into Anesthesiology?

[bluemagik5]

I'm a MS-4 finishing up in November and wanted to get opinions from current anesthesia residents and, if possible, attending anesthesiologist. I am considering going into anesthesia but have read MANY postings on here, some old and new, explaining why people shouldn't go into anesthesia. Other than decreasing reimbursement rates (which is mostly prevalent in most specialties), unpredictable scheduling at times, some disrespect from surgeons and staff (disrespect happens everywhere), and "encroachment" by mid-level providers are there any other reasons why I should possibly be looking into a different specialty? I would greatly appreciate any insight, positive and negative, so I can make a well-informed decision about my career choice.

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[nimbus]

One of my best friends says, "How can I retire?! It's easy money!"

I don't know how things will be in the future but it's a great job right now. You can read and post on SDN all day between emptying the foley and flirting with nurses. And you get to sit down on a comfy stool or task chair.

 

[Planktonmd]

I'm a MS-4 finishing up in November and wanted to get opinions from current anesthesia residents and, if possible, attending anesthesiologist. I am considering going into anesthesia but have read MANY postings on here, some old and new, explaining why people shouldn't go into anesthesia. Other than decreasing reimbursement rates (which is mostly prevalent in most specialties), unpredictable scheduling at times, some disrespect from surgeons and staff (disrespect happens everywhere), and "encroachment" by mid-level providers are there any other reasons why I should possibly be looking into a different specialty? I would greatly appreciate any insight, positive and negative, so I can make a well-informed decision about my career choice.

It sounds like you already decided to go into anesthesia and just looking for confirmation of your choice.

 

[GA8314]

nobody has a crystal ball. i am happy in my career and would do it over again.

 

[MaximusD]

Just do it

 

[turnupthegas]

Ain't a bad gig. Would do it again. Would consider ortho.


Sent from my iPhone using SDN mobile

 

[FollowTheMoney]

Between AMCs and CRNA expansion, this field will be dead within 10 years. The only reason to go into it is to use it as a means to end to get into pain management, which is better than Derm, Optho, etc in terms of lifestyle and money. Most residents in most programs go into pain now. The field of anesthesiology has been raped and pillaged from all angles over the last 20 years and there's nothing left to look forward to or hang your hat on other than that most of the time the job is easy, hence, why nurses are doing it. However, most other fields are facing monumental problems as well with declining reimbursement and most of the high paying fields have a terrible lifestyle. Unless you can get into derm, plastics, retinal surgery, or ortho spine I would go into pain management.

 

[deleted162650]

Most residents in most programs go into pain now.

Dude, WTF are you smoking (I want some). One of the most ridiculous statements I've seen posted here. That's not even remotely possible given # of residents and # of fellowship spots.

 

[aneftp]

Between AMCs and CRNA expansion, this field will be dead within 10 years. The only reason to go into it is to use it as a means to end to get into pain management, which is better than Derm, Optho, etc in terms of lifestyle and money. Most residents in most programs go into pain now. The field of anesthesiology has been raped and pillaged from all angles over the last 20 years and there's nothing left to look forward to or hang your hat on other than that most of the time the job is easy, hence, why nurses are doing it. However, most other fields are facing monumental problems as well with declining reimbursement and most of the high paying fields have a terrible lifestyle. Unless you can get into derm, plastics, retinal surgery, or ortho spine I would go into pain management.

There are lot of non fellowship pain docs doing pain. Heck Crna's doing pain.

What makes u think pain is immune? Reimbursement for pain going down as well. Sure it's still lucrative for now. But reimbursement isn't what it was

 

[Uisa]

Shields you away from social work
No rounding for hours
Great balance of medical knowledge application based upon real-time data and procedures
Only 4 years of training
Deep understanding of physiology and pharmacology that allows you to be "comfortable" in emergent/code type situations whether they be in the hospital setting or outside world.
fellowships that allows you to be more "medicine" (intensivist) or more "surgical" (pain)
Ability to really treat someone's pain
The fact that when ppl switch specialities anesthesia tends to be a popular one ppl switch into.

At the end of the day, the number one thing that got me to choose this specialty was not a laundry list of positives and negatives, but simply the fact that I LIKED it.

Best of luck in your decision.

 

[rakotomazoto]

Sounds like you have been weighing lots of the pros and cons. If some of these comments by strangers on the internet can convince you not to do it, maybe you already have your answer.

I am still in residency, so my opinion on this is essentially useless, I haven't landed my first job yet. But for what it is worth, I love my job. At this point, I wouldn't trade specialties with anyone. Feeling like you are in the right place for you is important but to some degree, none of us know what we are getting ourselves into when we match. Make a plan and be open to changing your plan. There are plenty of people who switch into anesthesiology and I also personally know some that have switched out for other things. This field is definitely not for everyone.

 

[anbuitachi]

Many great fields out there. seems like you know the negatives of anesthesiology. If you want a better life, surgery subspecialties is good too. They make more money, (ortho makes a LOT more) and you get to be your boss

 

[bluemagik5]

Thank you all so much, I really appreciate the insight shared thus far! Guess the only thing left to do is talk to the wife even though I'm pretty sure what she will say (do what makes you happy.. something along that line).

 

[deleted171991]

Regarding happiness, I'll give you an easy litmus test: if you strongly consider surgery as an alternative, anesthesiology may be good for you (and a surgical subspecialty even better). If you're more of a medicine person, stay away. This is a knee-jerk surgical specialty, in real life, regardless how "intellectual" it looks from the outside. That's why it can be practiced solo by CRNAs.

Many people you will deal with in your professional life will be surgical quality arses, mostly simple-minded arrogant mediocrities, whose intellectual level maxes out at gossip, bad jokes and yesterday's medical knowledge (the type of emperor that wears no clothes, surrounded by the typical court). These will also be the people who will pass judgment on your skills and knowledge, but especially on everything else that shouldn't matter (but it does). This is a job where artistic impression matters more than technical merit (because nobody outside the specialty has a friggin idea about what you really do), where advanced practice nurses can do 90% of your job and few people really appreciate the other 10% (beyond being the malpractice lightning rod and safety net for anesthetists), where technological advances don't empower you to provide better care, but a safe way for the bean counters to replace you with cheaper cogs (the next couple of big ones will probably wipe out anesthesiology as a medical specialty).

And if you are considering anesthesiology as a stepping stool to CCM or pain, remember that anesthesiology has always been the ugly unwanted stepchild of CCM (and has been treated accordingly by the job market - here's the SOCCA job database for ya), and that pain reimbursements are at such a low that there are possibly more pain-boarded people practicing anesthesiology than pain (which probably applies to CCM, too).

 

[Planktonmd]

Regarding happiness, I'll give you an easy litmus test: if you strongly consider surgery as an alternative, anesthesiology may be good for you (and a surgical subspecialty even better). If you're more of a medicine person, stay away. This is a knee-jerk surgical specialty, in real life, regardless how "intellectual" it looks from the outside. That's why it can be practiced solo by CRNAs.

Many people you will deal with in your professional life will be surgical quality arses, mostly simple-minded arrogant mediocrities, whose intellectual level maxes out at gossip, bad jokes and yesterday's medical knowledge (the type of emperor that wears no clothes, surrounded by the typical court). These will also be the people who will pass judgment on your skills and knowledge, but especially on everything else that shouldn't matter (but it does). This is a job where artistic impression matters more than technical merit (because nobody outside the specialty has a friggin idea about what you really do), where advanced practice nurses can do 90% of your job and few people really appreciate the other 10% (beyond being the malpractice lightning rod and safety net for anesthetists), where technological advances don't empower you to provide better care, but a safe way for the bean counters to replace you with cheaper cogs (the next couple of big ones will probably wipe out anesthesiology as a medical specialty).

And if you are considering anesthesiology as a stepping stool to CCM or pain, remember that anesthesiology has always been the ugly unwanted stepchild of CCM (and has been treated accordingly by the job market - here's the SOCCA job database for ya), and that pain reimbursements are at such a low that there are possibly more pain-boarded people practicing anesthesiology than pain (which probably applies to CCM, too).

This is the simple truth without hand holding and hugging.

 

[deleted171991]

Sounds like you have been weighing lots of the pros and cons. If some of these comments by strangers on the internet can convince you not to do it, maybe you already have your answer.

I am still in residency, so my opinion on this is essentially useless, I haven't landed my first job yet. But for what it is worth, I love my job. At this point, I wouldn't trade specialties with anyone. Feeling like you are in the right place for you is important but to some degree, none of us know what we are getting ourselves into when we match. Make a plan and be open to changing your plan. There are plenty of people who switch into anesthesiology and I also personally know some that have switched out for other things. This field is definitely not for everyone.

Except that your current job is not the same as your job as an attending will probably be. Your current job is a CRNA job. Nice and cushy. I would take one in a heartbeat. The hourly rate of an employed anesthesiologist is (as shown in a recent post) very similar to a CRNA's, anyway.

Any MS interested in anesthesiology should rotate through an AMC, preferably one with an ACT model. That's the future, not academia, not PP groups. Those are the jobs you will get upon graduation, especially on the East Coast, unless you go to BFE (and slowly but surely even there, and in the Mid/West).

 

[MaximusD]

There are lot of non fellowship pain docs doing pain. Heck Crna's doing pain.

What makes u think pain is immune? Reimbursement for pain going down as well. Sure it's still lucrative for now. But reimbursement isn't what it was

Most major systems expect you to be pain boarded. Don't perpetuate bad info.

 

[Consigliere]

If you opt to "go into anesthesiology", then you deserve what you get.

 

[aneftp]

Most major systems expect you to be pain boarded. Don't perpetuate bad info.

Nope.

Most pain practices are outpatient

Most "pain docs" are "board certified". Doesn't mean they are boarded in pain. Patients don't know the difference. They have referral base.

Doesn't matter if u got fellowship or not in pain. My buddies are rolling it in 50-100k a month. No fellowship. One is rehab doc with no fellowship. One is FP. One is anesthesia doc. Interventional pain. They do rfa, spinal cord stimulators etc. not just straight basic epidural injections.

 

[FollowTheMoney]

Nope.

Most pain practices are outpatient

Most "pain docs" are "board certified". Doesn't mean they are boarded in pain. Patients don't know the difference. They have referral base.

Doesn't matter if u got fellowship or not in pain. My buddies are rolling it in 50-100k a month. No fellowship. One is rehab doc with no fellowship. One is FP. One is anesthesia doc. Interventional pain. They do rfa, spinal cord stimulators etc. not just straight basic epidural injections.

If you don't do a fellowship and you are sticking needles in people's spines then you are a ****ing idiot who is waiting for a massive lawsuit. I know the average person is ignorant, but it takes a special ***** to see some random person with no credentials and have them stick needles in their spine. What is even more ridiculous is that you can see a Pain Specialist boarded in Pain for the same price. I am sure there are random doctors from foreign countries and mid level providers trying to perform surgical procedures out there when they have no training in it, but the advantage of being outpatient in every field is that people know who you are and what your credentials are and its easy to look up and verify. That is why a nurse will never be able to do pain because no one in their right mind would go see some unqualified mid level provider for interventional pain procedures. It's never going to happen even if they legalize it. The only reason CRNAs have the power they do against anesthesiologists is because they are in a hospital and the PATIENT HAS NO IDEA that some mid level provider is the one looking after them. Most people are horrified when I tell them nurses are practicing anesthesia, especially independently in many places. The perspective about mid level providers in the real world from real people is that they can take care of a cold or a sore throat, but not surgical procedures and that is not going to change any time soon.

 

[aneftp]

If you don't do a fellowship and you're sticking needles in people's spines then you are a ****ing idiot who is waiting for a massive lawsuit. I know the average person is a *****, but it takes a special ***** to see some random person with no credentials and have them stick needles in their spine especially when you can see a Board Certified Pain Specialist Boarded in Pain for the same price.

People learn on the fly. Attend some courses. Have a few "proctored" cases. It's not rocket science.

Ur license allows u to practice medicine.

It's just technique. Most people will master technique with repetition.

So a doc who does 50-70 pain procedures a week for 4-5 years. Vs inexperience new fellowship pain grad

At the end of the day. Pain procedures are all technical skills. The doc usually always has the medical knowledge for the the basic needs of the pain procedures and the rest is acquired via experience.

If you don't do a fellowship and you are sticking needles in people's spines then you are a ****ing idiot who is waiting for a massive lawsuit. I know the average person is ignorant, but it takes a special ***** to see some random person with no credentials and have them stick needles in their spine. What is even more ridiculous is that you can see a Pain Specialist boarded in Pain for the same price. I am sure there are random doctors from foreign countries and mid level providers trying to perform surgical procedures out there when they have no training in it, but the advantage of being outpatient in every field is that people know who you are and what your credentials are and its easy to look up and verify. That is why a nurse will never be able to do pain because no one in their right mind would go see some unqualified mid level provider for interventional pain procedures. It's never going to happen even if they legalize it. The only reason CRNAs have the power they do against anesthesiologists is because they are in a hospital and the PATIENT HAS NO IDEA that some mid level provider is the one looking after them. Most people are horrified when I tell them nurses are practicing anesthesia, especially independently in many places. The perspective about mid level providers in the real world from real people is that they can take care of a cold or a sore throat, but not surgical procedures and that is not going to change any time soon.

 

[MaximusD]

Nope.

Most pain practices are outpatient

Most "pain docs" are "board certified". Doesn't mean they are boarded in pain. Patients don't know the difference. They have referral base.

Doesn't matter if u got fellowship or not in pain. My buddies are rolling it in 50-100k a month. No fellowship. One is rehab doc with no fellowship. One is FP. One is anesthesia doc. Interventional pain. They do rfa, spinal cord stimulators etc. not just straight basic epidural injections.

Your buddies must be in an underserved area.

 

[Nivens]

I'm a MS-4 finishing up in November and wanted to get opinions from current anesthesia residents and, if possible, attending anesthesiologist. I am considering going into anesthesia but have read MANY postings on here, some old and new, explaining why people shouldn't go into anesthesia. Other than decreasing reimbursement rates (which is mostly prevalent in most specialties), unpredictable scheduling at times, some disrespect from surgeons and staff (disrespect happens everywhere), and "encroachment" by mid-level providers are there any other reasons why I should possibly be looking into a different specialty? I would greatly appreciate any insight, positive and negative, so I can make a well-informed decision about my career choice.

There are days I think I have the best job in the world, and days where I'm not sure I can do it for another minute. Same goes for my friends in other specialties. I can't tell you what you should do, but I will say I wish I'd focused more on what the nature of the jobs and less on what I liked reading about in textbooks, because the former is what seems to affect MY satisfaction the most right now. Physiology and pharmacology are really cool and all, but when I'm treating hypotension with neo I'm not thinking to myself "This hypotension is likely secondary to decreased SVR in the setting of volatile anesthetics. I am going to give 40mcg of an alpha-1 agonist to increase intracellular calcium and induce vasoconstriction! I am a MASTER OF PHYSIOLOGY AND PHARMACOLOGY!"

 

[aneftp]

Your buddies must be in an underserved area.

I wouldn't call Miami, Philly, orlando, underserved areas.

 

[Stank811]

Except that your current job is not the same as your job as an attending will probably be. Your current job is a CRNA job. Nice and cushy. I would take one in a heartbeat. The hourly rate of an employed anesthesiologist is (as shown in a recent post) very similar to a CRNA's, anyway.

Any MS interested in anesthesiology should rotate through an AMC, preferably one with an ACT model. That's the future, not academia, not PP groups. Those are the jobs you will get upon graduation, especially on the East Coast, unless you go to BFE (and slowly but surely even there, and in the Mid/West).

Nope. Maybe you should rotate to BFE. AMC bring nothing to the table over a PP group except a unstable and constantly changing pool of docs and mid levels providing anesyhesia

 

[aneftp]

Nope. Maybe you should rotate to BFE. AMC bring nothing to the table over a PP group except a unstable and constantly changing pool of docs and mid levels providing anesyhesia

I think there are two different type of AMC situations.

The places where they "steal" or "strong arm" the existing group practices. By strong arming I mean the existing partners take whatever they get or lose their contract anyways.

Those situations can lead to high turnover very quickly.

The situation where the AMC buyout the practice and partners have to stay 3-5 years. They tend to be the more stable AMC situation where the partners are forced to stay 3-5 years and also because AMCs tend to let these groups run themselves. As long as they are making money. The AMCs don't give a F how the group is run. Of course the senior former partners may choose to run the practice unfairly for the new guys coming in.

So I won't say all AMC practices are bad. Some are fair. As in life. Hard to do generalizations. But I do recommend to stay away from mass exodus with AMC hostile takeovers

 

[deleted697535]

Anaesthesics best job going. Couple it with ICU and cardiac/paeds then go where crnas don't exist...

 

[Timeoutofmind]

Nope.

Most pain practices are outpatient

Most "pain docs" are "board certified". Doesn't mean they are boarded in pain. Patients don't know the difference. They have referral base.

Doesn't matter if u got fellowship or not in pain. My buddies are rolling it in 50-100k a month. No fellowship. One is rehab doc with no fellowship. One is FP. One is anesthesia doc. Interventional pain. They do rfa, spinal cord stimulators etc. not just straight basic epidural injections.

I know a lot about pain markets and am fairly broadly networked.

Very misleading post in every way, not that I question your intentions. You are just naieve.

I don't feel like typing an epic response.

Basically:
If you are not ACGME fellowship trained, opportunities can be very limited, more and more every year.
And there are extremely few doctors making the kind of money you talk about. And an extremely small percentage of that extremely small amount of doctors are ethical dudes who are just business savvy and extremely hard working. The rest are pill mill, midlevel mania, workers comp scam fest dbags, who you are correct might as well be and often are FP doctors because there really are no credentials that are required to run that type of practice.

And finally, while the technical skills for advanced interventional pain management procedures are quite sophisticated and not easily acquired (I am still learning every day!), it is my honest opinion that that is still the easiest part of pain practice. There is so much to know, and patients are so complicated. I find it much more demanding intellectually then when I was in the OR. But maybe others feel differently, just my two cents.

 

[aneftp]

I know a lot about pain markets and am fairly broadly networked.

Very misleading post in every way, not that I question your intentions. You are just naieve.

I don't feel like typing an epic response.

Basically:
If you are not ACGME fellowship trained, opportunities can be very limited, more and more every year.
And there are extremely few doctors making the kind of money you talk about. And an extremely small percentage of that extremely small amount of doctors are ethical dudes who are just business savvy and extremely hard working. The rest are pill mill, midlevel mania, workers comp scam fest dbags, who you are correct might as well be and often are FP doctors because there really are no credentials that are required to run that type of practice.

And finally, while the technical skills for advanced interventional pain management procedures are quite sophisticated and not easily acquired (I am still learning every day!), it is my honest opinion that that is still the easiest part of pain practice. There is so much to know, and patients are so complicated. I find it much more demanding intellectually then when I was in the OR. But maybe others feel differently, just my two cents.

Nope. I'm not naive. Been out in practice 13 years. I've been invited in these and other pain practices and pass on it. Simply because i don't need the money

But I do agree with u. It's about networking and referral base. That's the key. U do a good job. Referrals fly off the shelves. FP and IM know me and my friends. Big network. I just happen to know so many people all around the country.

Key thing is network. Make friends. Do a good job. Its that simple.

 

[repititionition]

I know a lot about pain markets and am fairly broadly networked.

Very misleading post in every way, not that I question your intentions. You are just naieve.

I don't feel like typing an epic response.

Basically:
If you are not ACGME fellowship trained, opportunities can be very limited, more and more every year.
And there are extremely few doctors making the kind of money you talk about. And an extremely small percentage of that extremely small amount of doctors are ethical dudes who are just business savvy and extremely hard working. The rest are pill mill, midlevel mania, workers comp scam fest dbags, who you are correct might as well be and often are FP doctors because there really are no credentials that are required to run that type of practice.

And finally, while the technical skills for advanced interventional pain management procedures are quite sophisticated and not easily acquired (I am still learning every day!), it is my honest opinion that that is still the easiest part of pain practice. There is so much to know, and patients are so complicated. I find it much more demanding intellectually then when I was in the OR. But maybe others feel differently, just my two cents.

.

 

[nimbus]

+1 for great Steely Dan reference username

I thought it was Bob Dylan. Guess it's both...and a movie based in Bellevue Hospital.

 

[Stank811]

I think there are two different type of AMC situations.

The places where they "steal" or "strong arm" the existing group practices. By strong arming I mean the existing partners take whatever they get or lose their contract anyways.

Those situations can lead to high turnover very quickly.

The situation where the AMC buyout the practice and partners have to stay 3-5 years. They tend to be the more stable AMC situation where the partners are forced to stay 3-5 years and also because AMCs tend to let these groups run themselves. As long as they are making money. The AMCs don't give a F how the group is run. Of course the senior former partners may choose to run the practice unfairly for the new guys coming in.

So I won't say all AMC practices are bad. Some are fair. As in life. Hard to do generalizations. But I do recommend to stay away from mass exodus with AMC hostile takeovers

As you stated above...as long as they are making money...and not just a little bit. So the old partners get a buy out and have to stay several years at half their previous income but the new people coming in get to start at 40 percent of the previous partners income and work harder for it. Doesn't equate to a long term stable plan in my opinion.

 

[deleted171991]

Anaesthesics best job going. Couple it with (ICU plus cardiac)/paeds then go where crnas don't exist...

Fixed it for you. Although the peds market seems to be saturating.

 

[aneftp]

As you stated above...as long as they are making money...and not just a little bit. So the old partners get a buy out and have to stay several years at half their previous income but the new people coming in get to start at 40 percent of the previous partners income and work harder for it. Doesn't equate to a long term stable plan in my opinion.

Couple of ways to look at this

Old partnership track
250k, 275k, 300k than partner (average make 500-550k) (by the way my sister partnership track in Maryland is like this even in 2017).

AMC offers new grad $350k non boarded with $25k metric bonus

Boarded 375k with 25k metric bonus.

So it will take u 5 years (2 years as full partner and 3 years in partnership track) to start coming out ahead.

To be honest. Most new grads do not look 5 years in the future. They got bills to pay.

 

[GA8314]

This Q has been asked over and over again. I would still do it recognizing the challenges inherent to MOST of medicine. I would do it again over many other specialties. Pay off debt EARLY. Read White Coast Investor. Have that "X factor" he speaks of. Live like a resident for 2-4 years (with some upgrades of course). Pick up extra shifts. Then, expect to live an upper middle economic class lifestyle, not a hot shot rich guy lifestyle.

If you save aggressively, you'll still be able to live very very comfortably, and have $$ for retirement.
Never lose your skills. We are lucky in that we sit our own rooms with enough frequency that we keep the "flow" of things. But, even 100% supervision, you can still maintain your skills. You just need to make more effort. Indeed other skills of yours will flourish such as regional and getting things done efficiently. Sitting your own cases has advantages also.

If you CAN, avoid being geographically inflexible. I think this was paramount to my own very nice practice. It's important and you don't need to go to BFE for it.

You can have a rewarding career even in an ACT model. More days than not, I get something rewarding out of my job. Does it become "routine" at times? Of course, but shouldn't it??

Take on the attitude that JPP and others used to espouse. That of a cog in the OR wheel. Keep things moving. Make things happen. Hustle and facilitate the OR cash flow assembly line. It is what it is. Do this with skill and safety and you will be highly valued. Others will shi.t on this post but it's true. Be service oriented.

 

[Stank811]

Couple of ways to look at this

Old partnership track
250k, 275k, 300k than partner (average make 500-550k) (by the way my sister partnership track in Maryland is like this even in 2017).

AMC offers new grad $350k non boarded with $25k metric bonus

Boarded 375k with 25k metric bonus.

So it will take u 5 years (2 years as full partner and 3 years in partnership track) to start coming out ahead.

To be honest. Most new grads do not look 5 years in the future. They got bills to pay.

I hope the new grad that can't look 5 yrs ahead on a 20+ yr career are few and far between. They will loose out on 2,250,000 dollars at minimum, 50-60 wks (around a year) of vacation, and work much longer hours during the next 15 years working for an AMC. To each their own I guess.

 

[GravelRider]

I hope the new grad that can't look 5 yrs ahead on a 20+ yr career are few and far between. They will loose out on 2,250,000 dollars at minimum, 50-60 wks (around a year) of vacation, and work much longer hours during the next 15 years working for an AMC. To each their own I guess.

Many new grads are viewing the "partnership tracks" as being for suckers. Everyone knows someone or have themselves been conned by a group promising a partnership after lowballing them on salary for a couple of years. I'm not saying it's right or wrong, but the reality of the current environment.

 

[nimbus]

Many new grads are viewing the "partnership tracks" as being for suckers. Everyone knows someone or have themselves been conned by a group promising a partnership after lowballing them on salary for a couple of years. I'm not saying it's right or wrong, but the reality of the current environment.

I'd venture to say more partnership track promises were delivered than not. You just hear from the ones who were screwed. The ones who made it are quietly enjoying the good life.

 

[d9sccr]

I'd venture to say more partnership track promises were delivered than not. You just hear from the ones who were screwed. The ones who made it are quietly enjoying the good life.

This is more the truth. Many of the "partnership" tracks around our training program are B.S.

- 1 subspecialty partnership group negotiated a sell out (which fell through) with an AMC and left a junior partner out of the deal (3 months from full partner in a 5 year track)
- 1 has partners and "PARTNERS". The "PARTNERS" are limited to a small group of people who work 30 hours/week and are the only ones allowed to see the books. Several people have not even made the partner rank based on likability, or so I'm told.
- 1 group works hard 6am-5pm most days and several days/week running longer. They also have cut people out of the partnership track for being kicked out of specific rooms and things of that nature. The older guys are also trying to take less call. They're compensating for it, but still

In a major metropolitan area, those are the only 3 remaining "partnerships" available. Most everything else is Sheridan w/ a few other AMCs around the area. It's not hard to skip these BS partnership tracks for a job that pays better out of the gate.

 

[nimbus]

This is more the truth. Many of the "partnership" tracks around our training program are B.S.

- 1 subspecialty partnership group negotiated a sell out (which fell through) with an AMC and left a junior partner out of the deal (3 months from full partner in a 5 year track)
- 1 has partners and "PARTNERS". The "PARTNERS" are limited to a small group of people who work 30 hours/week and are the only ones allowed to see the books. Several people have not even made the partner rank based on likability, or so I'm told.
- 1 group works hard 6am-5pm most days and several days/week running longer. They also have cut people out of the partnership track for being kicked out of specific rooms and things of that nature. The older guys are also trying to take less call. They're compensating for it, but still

In a major metropolitan area, those are the only 3 remaining "partnerships" available. Most everything else is Sheridan w/ a few other AMCs around the area. It's not hard to skip these BS partnership tracks for a job that pays better out of the gate.

There is a disconnect between posts like this and the residency threads that say "people from X residency get great jobs and fellowships". You should out your residency as one where the graduates can't get good jobs. The best way not to get screwed is by networking and knowing who you're future partners are. That happens in residency.

 

[repititionition]

There is a disconnect between posts like this and the residency threads that say "people from X residency get great jobs and fellowships". You should out your residency as one where the graduates can't get good jobs. The best way not to get screwed is by networking and knowing who you're future partners are. That happens in residency.

How, practically, does a resident do this? Serious question.

 

[nimbus]

How, practically, does a resident do this? Serious question.

Develop good relationships with your senior residents, fellows and faculty. Stay in touch with them after they have moved on.

 

[GravelRider]

Develop good relationships with your senior residents, fellows and faculty. Stay in touch with them after they have moved on.

Networking is important, but it could also be a case of the blind leading the blind. Often relatively new grads know as much as soon-to-be new grads about a job...even one they work at. Your buddy from residency may be inviting you onto a sinking ship without even knowing it. This "great" 5-year partnership track might seem good now, but in 2 years your workload has doubled because the group sold out to an AMC and your prospects for better income have sunk. This is the decision that many new grads are facing...risk the 3-5 year partnership track while making 300k or less or take the 400k AMC job where you at least have some idea of what you are getting yourself into. For many new grads the 3-5 year partnership track seems like a crummy entry into a job where you'll end up working for an AMC anyway.

I get the idea that there is no reward without risk and thus partnership tracks are risks with a much better potential reward than working for an AMC. However, in the current environment where practices are selling out every day, the lowball "buy-in" salary and long partnership track seems very risky. The AMCs give the illusion of stability in an unstable market and is big reason why they have spread rapidly.

 

[nimbus]

Networking is important, but it could also be a case of the blind leading the blind. Often relatively new grads know as much as soon-to-be new grads about a job...even one they work at. Your buddy from residency may be inviting you onto a sinking ship without even knowing it. This "great" 5-year partnership track might seem good now, but in 2 years your workload has doubled because the group sold out to an AMC and your prospects for better income have sunk. This is the decision that many new grads are facing...risk the 3-5 year partnership track while making 300k or less or take the 400k AMC job where you at least have some idea of what you are getting yourself into. For many new grads the 3-5 year partnership track seems like a crummy entry into a job where you'll end up working for an AMC anyway.

I get the idea that there is no reward without risk and thus partnership tracks are risks with a much better potential reward than working for an AMC. However, in the current environment where practices are selling out every day, the lowball "buy-in" salary and long partnership track seems very risky. The AMCs give the illusion of stability in an unstable market and is big reason why they have spread rapidly.

It's very regional. I'm out west where 5 year partnership tracks are unheard of. Most are 1-2 years and you either make partner pay from day one or close to it. So there's not much risk. And if Dr. X at Best Anesthesia Group gets screwed, it would get back to the program pretty quickly. The practices won't be able to recruit the best residents without a good reputation.

 

[deleted171991]

There is a disconnect between posts like this and the residency threads that say "people from X residency get great jobs and fellowships". You should out your residency as one where the graduates can't get good jobs. The best way not to get screwed is by networking and knowing who you're future partners are. That happens in residency.

It's very regional. I'm out west where 5 year partnership tracks are unheard of. Most are 1-2 years and you either make partner pay from day one or close to it. So there's not much risk. And if Dr. X at Best Anesthesia Group gets screwed, it would get back to the program pretty quickly. The practices won't be able to recruit the best residents without a good reputation.

Smeagol, all you needed to do was ask Gollum.

 

[aneftp]

Agree many true partnerships are regionally centered and in big cities sporadic patches where legit groups will take on new partners.

My advice is if AMCs are all over the place u are at. It's not a matter if. But a matter when the private group sells out. Everyone group has a magic number. Don't take on more than a 1 year partnership if group u are joining has AMCs within a 30 mile radius. Chances are that AMC has already made an offer to offer to that private group.

 

[Turtlez]

It's very regional. I'm out west where 5 year partnership tracks are unheard of. Most are 1-2 years and you either make partner pay from day one or close to it. So there's not much risk. And if Dr. X at Best Anesthesia Group gets screwed, it would get back to the program pretty quickly. The practices won't be able to recruit the best residents without a good reputation.

Could you please define "west"? Thanks!

 

[aneftp]

Could you please define "west"? Thanks!

I consider anywhere West of Colorado Just my opinion. New Mexico Arizona to me at southwest.

California Washington state Oregon are west

 

[FollowTheMoney]

How hard is it to start your own AMC?

 

[BLADEMDA]

How hard is it to start your own AMC?

Typically, you need SIZE to start an AMC. The roup in Nashville did it solo. But, USAP merged 2-3 large groups together and created USAP. So, 5-6 smaller groups could create an AMC. In fact, I think if 30 smaller groups merged to form an AMC for billing, negotiations with insurance companies, malpractice and recruitment that is the way to go.