Should I go into Anesthesiology?

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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.

So I'm assuming you would just have to move to BFE to start the next one?

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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.

Here's an honest, no BS answer:

First: the pay in anesthesiology is still pretty damn good. Yes, some jobs and some locations are better than others, but compared to other physicians, we do quite well.

Second: you need to decide how much control you have over your schedule. As an anesthesiologist, you can have a fairly regular work schedule. Take a job where you're not taking call, and you can have a very regular work schedule. But expect your pay to be about $70-$100k less than your colleagues who take call.

Third: you need to decide how much control you want over what you do at work. As an anesthesiologist, your work activities are pretty-much at the mercy of the surgeons - not only in terms of what cases you do, but even how you do them. I work with some orthopedists who don't like regional anesthesia, and want general anesthesia for certain cases (e.g. hips and shoulders). One of the general surgeons at my hospital doesn't do any hernia repairs under sedation, ever. Often, the surgeons select the type of anesthetic for you (subject to your approval). Similarly, the surgeons don't give a damn how busy you are or whether or not you need a break. If a urologist wants to add on a laser lithotripsy, you're going to do it. Other people are dictating your work and your workload, and admittedly, it can definitely wear thin on you.

Fourth: you have to be honest with yourself and decide how important "respect" is to you. While it's true that, when the **** hits the fan in the operating room or PACU, you're the king. But pretty much everywhere else, everybody thinks they can tell you how to do your job. Just a couple weeks ago I had a f-ing midwife try to tell me how to adjust the dose of an epidural when the patient couldn't push.

Fifth: you have to decide if you want to work with CRNAs. Some are respectful. The majority are not. Exceedingly few of them are particularly bright, and even fewer of them make sound medical decisions, but every last one of them who's been in practice for more than a few years thinks they know everything, thinks that you are a superfluous entity, and doesn't want to be told what to do by you. And you will have to placate them and keep them happy (as long as they're not doing something that can seriously harm the patient), because the practice needs them as much as they need you.

So, what makes anesthesiology a good specialty? The fact that your services are needed in almost every area of health care for every demographic, and that you arr qualified to autonomously take care of patients who are literally a couple minutes from death - inside and outside of the OR. Your knowledge of cardiac and pulmonary physiology is indeed that good by the time you finish an anesthesiology residency.
 
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Here's an honest, no BS answer:

First: the pay in anesthesiology is still pretty damn good. Yes, some jobs and some locations are better than others, but compared to other physicians, we do quite well.

Second: you need to decide how much control you have over your schedule. As an anesthesiologist, you can have a fairly regular work schedule. Take a job where you're not taking call, and you can have a very regular work schedule. But expect your pay to be about $70-$100k less than your colleagues who take call.

Third: you need to decide how much control you want over what you do at work. As an anesthesiologist, your work activities are pretty-much at the mercy of the surgeons - not only in terms of what cases you do, but even how you do them. I work with some orthopedists who don't like regional anesthesia, and want general anesthesia for certain cases (e.g. hips and shoulders). One of the general surgeons at my hospital doesn't do any hernia repairs under sedation, ever. Often, the surgeons select the type of anesthetic for you (subject to your approval). Similarly, the surgeons don't give a damn how busy you are or whether or not you need a break. If a urologist wants to add on a laser lithotripsy, you're going to do it. Other people are dictating your work and your workload, and admittedly, it can definitely wear thin on you.

Fourth: you have to be honest with yourself and decide how important "respect" is to you. While it's true that, when the **** hits the fan in the operating room or PACU, you're the king. But pretty much everywhere else, everybody thinks they can tell you how to do your job. Just a couple weeks ago I had a f-ing midwife try to tell me how to adjust the dose of an epidural when the patient couldn't push.

Fifth: you have to decide if you want to work with CRNAs. Some are respectful. The majority are not. Exceedingly few of them are particularly bright, and even fewer of them make sound medical decisions, but every last one of them who's been in practice for more than a few years thinks they know everything, thinks that you are a superfluous entity, and doesn't want to be told what to do by you. And you will have to placate them and keep them happy (as long as they're not doing something that can seriously harm the patient), because the practice needs them as much as they need you.

So, what makes anesthesiology a good specialty? The fact that your services are needed in almost every area of health care for every demographic, and that you arr qualified to autonomously take care of patients who are literally a couple minutes from death - inside and outside of the OR. Your knowledge of cardiac and pulmonary physiology is indeed that good by the time you finish an anesthesiology residency.
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Here's an honest, no BS answer:

First: the pay in anesthesiology is still pretty damn good. Yes, some jobs and some locations are better than others, but compared to other physicians, we do quite well.

Second: you need to decide how much control you have over your schedule. As an anesthesiologist, you can have a fairly regular work schedule. Take a job where you're not taking call, and you can have a very regular work schedule. But expect your pay to be about $70-$100k less than your colleagues who take call.

Third: you need to decide how much control you want over what you do at work. As an anesthesiologist, your work activities are pretty-much at the mercy of the surgeons - not only in terms of what cases you do, but even how you do them. I work with some orthopedists who don't like regional anesthesia, and want general anesthesia for certain cases (e.g. hips and shoulders). One of the general surgeons at my hospital doesn't do any hernia repairs under sedation, ever. Often, the surgeons select the type of anesthetic for you (subject to your approval). Similarly, the surgeons don't give a damn how busy you are or whether or not you need a break. If a urologist wants to add on a laser lithotripsy, you're going to do it. Other people are dictating your work and your workload, and admittedly, it can definitely wear thin on you.

Fourth: you have to be honest with yourself and decide how important "respect" is to you. While it's true that, when the **** hits the fan in the operating room or PACU, you're the king. But pretty much everywhere else, everybody thinks they can tell you how to do your job. Just a couple weeks ago I had a f-ing midwife try to tell me how to adjust the dose of an epidural when the patient couldn't push.

Fifth: you have to decide if you want to work with CRNAs. Some are respectful. The majority are not. Exceedingly few of them are particularly bright, and even fewer of them make sound medical decisions, but every last one of them who's been in practice for more than a few years thinks they know everything, thinks that you are a superfluous entity, and doesn't want to be told what to do by you. And you will have to placate them and keep them happy (as long as they're not doing something that can seriously harm the patient), because the practice needs them as much as they need you.

So, what makes anesthesiology a good specialty? The fact that your services are needed in almost every area of health care for every demographic, and that you arr qualified to autonomously take care of patients who are literally a couple minutes from death - inside and outside of the OR. Your knowledge of cardiac and pulmonary physiology is indeed that good by the time you finish an anesthesiology residency.
Here's an honest, no BS answer:

First: the pay in anesthesiology is still pretty damn good. Yes, some jobs and some locations are better than others, but compared to other physicians, we do quite well.

Second: you need to decide how much control you have over your schedule. As an anesthesiologist, you can have a fairly regular work schedule. Take a job where you're not taking call, and you can have a very regular work schedule. But expect your pay to be about $70-$100k less than your colleagues who take call.

Third: you need to decide how much control you want over what you do at work. As an anesthesiologist, your work activities are pretty-much at the mercy of the surgeons - not only in terms of what cases you do, but even how you do them. I work with some orthopedists who don't like regional anesthesia, and want general anesthesia for certain cases (e.g. hips and shoulders). One of the general surgeons at my hospital doesn't do any hernia repairs under sedation, ever. Often, the surgeons select the type of anesthetic for you (subject to your approval). Similarly, the surgeons don't give a damn how busy you are or whether or not you need a break. If a urologist wants to add on a laser lithotripsy, you're going to do it. Other people are dictating your work and your workload, and admittedly, it can definitely wear thin on you.

Fourth: you have to be honest with yourself and decide how important "respect" is to you. While it's true that, when the **** hits the fan in the operating room or PACU, you're the king. But pretty much everywhere else, everybody thinks they can tell you how to do your job. Just a couple weeks ago I had a f-ing midwife try to tell me how to adjust the dose of an epidural when the patient couldn't push.

Fifth: you have to decide if you want to work with CRNAs. Some are respectful. The majority are not. Exceedingly few of them are particularly bright, and even fewer of them make sound medical decisions, but every last one of them who's been in practice for more than a few years thinks they know everything, thinks that you are a superfluous entity, and doesn't want to be told what to do by you. And you will have to placate them and keep them happy (as long as they're not doing something that can seriously harm the patient), because the practice needs them as much as they need you.

So, what makes anesthesiology a good specialty? The fact that your services are needed in almost every area of health care for every demographic, and that you arr qualified to autonomously take care of patients who are literally a couple minutes from death - inside and outside of the OR. Your knowledge of cardiac and pulmonary physiology is indeed that good by the time you finish an anesthesiology residency.

This is an EPIC response!! Thank you!
 
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