Job outlook for intensivists?

[bluethroat]

Was reading some threads that said CC will be the new EM in the future. As someone hoping to pursue Pulm/CC in the future, I was hoping for any current fellows/attendings to shed some light on this.

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[CCM-MD]

No one has a crystal ball. Right now things are great. Future is uncertain. You will hear opinions on both sides. Any hospital specialty that has potential for midlevel encroachment has issues, I don’t think CCM will be immune. I think having the pulmonary piece will be nice to offset some of the risks.

 

[lunaire]

Private practice job market is all over the place right now. Some places have extenders getting $175 per hour with minimal intensivist coverage. That is just a hair lower than physician hourly salary in some places. Lots of places just wants intensivist to rubber stamp extenders' work. There are also a bunch of places that offers 90 percentile MGMA salary, with 90 percentile workload. That seems to be the trend, higher census, with lower pay/extender help, or higher pay but worse working condition.

Academia will always be around, I guess. They typically underpay like crazy...

I would encourage you to learn about the business/economics of medicine. It helps to know how and how much you bring to the employer, and how much money is actually on the table. Do that for other specialties as well, and see what makes sense for your future.

 

[grt398]

I don't disagree with anything mentioned above...I will say that depending on your definition of quality of life, specifically how much $$$ you need per month to meet your needs, and family situation of course, there is likely to remain a good deal of flexibility covering ICU's/pulm. If you were to work hard for the first 5-7 years after fellowship (and save appropriately), you could likely save enough to partial FIRE without any stress (aka work only however many shifts per month needed to cover your living expenses, and just let compounding returns do their thing for the next 25 years). That would buy you back a LOT of free time. Or you could transition to doing 0.5 FTE of pulm only outpatient clinic, maybe with 1-2 days/month in bronch suite, and probably cover your living expenses as well. There's a huge need for pulm in the community and it's one of the oldest specialties in terms of physician age. That would leave you working something like 10 days/month of outpatient hours. And you could flex up if needed.

So yes, there's definitely midlevel encroachment issues, and the workload is absolutely changing in the way that lunaire discusses, but there's also a lot of flexibility to shape your life however you want.

Addendum: For those curious, according to AAMC in 2019, 91% of active pulmonary physicians were 55+ years old. Now that may speak to being able to practice that longer (since 79% of CCM physicians were under 55 years old) but I would argue that adds to the flexibility discussion above.

Active Physicians by Age and Specialty, 2019

Active Physicians by Age and Specialty, 2019

www.aamc.org