Would you choose anesthesiology again?

[nimbus]

Incredibly similar, but I find it odd that pilots are probably way more respected versus anesthesiologists given that we both literally have people's lives in our hands. I think the big difference is you don't have flight attendants trying to fly the plane.

Another important difference is that they have their own lives in their hands. We only have other peoples’ lives in our hands.

---

Members don't see this ad.

 

[Potatoman1800]

I don't find it odd. The ASA and anesthesiologists in general have done a terrible job elucidating how anesthesia is a weeee bit more complex than simply "putting someone to sleep."

Even other medical professionals have no clue about anesthesiology. You should've seen how my pediatrician's demeanor changed at one of my son's first visits when she found out I was also an intensivist and not "just" an anesthesiologist. When she thought it was only the latter she was barely talking to me as if I was in healthcare, let alone an MD.

I mean, they're just tiny adults, right???

 

[Bryan O’Blivion]

Post 911 was tough (per my husband I didn’t know at the time). Kind of like being a doctor in a global pandemic…. the fields are very similar

I’ve done both. I just keep getting lucky that way, I guess.

 

[drdan4]

But they do their own cases and have a bad payor mix (60%+ Medicare). Medicare pays $120-150/hr. As you say, under those conditions, only a big stipend/hospital subsidy, facility fees, or skimming a lot off new employees can get you there. To me the math is very suspect.

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

 

[nimbus]

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

Ahhh my mistake.


$70/unit?!….you guys hiring?

 

[DrOwnage]

I think I'm more impressed you did 24 GI cases in 7 hours.

 

[OptionOffense]

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

did you do those cases solo?

 

[GassYous]

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

Shoot that's like how much I make a week

70/unit is ballin

 

[turnupthegas]

Ya’ll hiring? Damn. Def not in California. How are they getting 70-80 unit? Even in the rich parts of CA - partners are getting ~$50

Back to the original question. I’d entertain total joint surgery or hand surgery. Although, the remimbursment has changed for joints and increased volume might be an issue. Also, the same procedures over and over again get dry. Hand surgery is mostly non emergent and outpatient.

The hospital does like to smooch the taint of the joint, spine, and cardiology docs for the facility fees.

 

[nimbus]

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

That sounds like a nightmare but I would do it for $9k because I’m a ho

 

[Twiggidy]

I think I'm more impressed you did 24 GI cases in 7 hours.

Exactly this. Let's just say they're not trolling and humor them, that would take a very, VERY, efficient system from preop, to nursing, to OR cleaning, etc.

 

[DrOwnage]

Exactly this. Let's just say they're not trolling and humor them, that would take a very, VERY, efficient system from preop, to nursing, to OR cleaning, etc.

Yep that's 17.5 minutes for case time and turnover. Not to mention if there's upper and lowers scheduled I call BS yo. I could usually do 15-17 endos from 8-4 with a pretty efficient surgery center.

 

[nimbus]

Yep that's 17.5 minutes for case time and turnover. Not to mention if there's upper and lowers scheduled I call BS yo. I could usually do 15-17 endos from 8-4 with a pretty efficient surgery center.

Maybe they’re all uppers. There’s some GI literature that correlates scope withdrawal times with adenoma miss rates. Faster withdrawal time—>more missed polyps.

 

[BLADEMDA]

Yep that's 17.5 minutes for case time and turnover. Not to mention if there's upper and lowers scheduled I call BS yo. I could usually do 15-17 endos from 8-4 with a pretty efficient surgery center.

I have seen 20-22 Endo where the Gi doc gets 2 rooms with 2 CRNAs. He/She literally walks from one room to the next so the turnover time is zero.

 

[Arch Guillotti]

I have seen 20-22 Endo where the Gi doc gets 2 rooms with 2 CRNAs. He/She literally walks from one room to the next so the turnover time is zero.

He/She is doing a crappy job without seeing pts. before or after the procedure.

 

[BLADEMDA]

He/She is doing a crappy job without seeing pts. before or after the procedure.

Gi doc speaks with every patient in the suite prior to the procedure then the sedation begins. GI doc takes a few minutes every 4-5 cases to see the patients after the procedure when they are awake prior to discharge. This is a very efficient system with the 20 cases done by 400-430 PM.

 

[blackbolt]

Gi doc speaks with every patient in the suite prior to the procedure then the sedation begins. GI doc takes a few minutes every 4-5 cases to see the patients after the procedure when they are awake prior to discharge. This is a very efficient system with the 20 cases done by 400-430 PM.

But he says he can do 24 cases by 230 ie 7 hours assuming 730 start. Also 126 units @ 70/unit makes it sound like hes doing it all solo.

 

[nimbus]

Gi doc speaks with every patient in the suite prior to the procedure then the sedation begins. GI doc takes a few minutes every 4-5 cases to see the patients after the procedure when they are awake prior to discharge. This is a very efficient system with the 20 cases done by 400-430 PM.

What happens when the patient has questions or does not speak English?

 

[GassYous]

What happens when the patient has questions or does not speak English?

Those guys get sent to the big house

 

[PikminOC]

I left gas after the first year of gas residency. I went into psych. It's a better field for me.

 

[nimbus]

I left gas after the first year of gas residency. I went into psych. It's a better field for me.

Do I know you? Did you surf during residency? Are you child psych now?

 

[PikminOC]

Do I know you? Did you surf during residency? Are you child psych now?

No surfing. Just surfed to psych.🤪

 

[kidthor]

I left gas after the first year of gas residency. I went into psych. It's a better field for me.

One of my former coworkers jettisoned from full time anesthesia and took a job as the CMO of a CBD products company. He’s very relaxed now.

 

[Arch Guillotti]

Gi doc speaks with every patient in the suite prior to the procedure then the sedation begins. GI doc takes a few minutes every 4-5 cases to see the patients after the procedure when they are awake prior to discharge. This is a very efficient system with the 20 cases done by 400-430 PM.

Which is different from what you said earlier.

The staff must love all those patients laying around waiting to see the gi doc afterwards.

 

[gasresident1]

Matrix is very very lucrative and a great group that's hard to get into.

Like how??? I almost took a job at Pacific and they were quoting partners 500k. How could they be possibly making that much more

 

[Twiggidy]

One of my former coworkers jettisoned from full time anesthesia and took a job as the CMO of a CBD products company. He’s very relaxed now.

I’ve been pondering ways to get into this but honestly may be behind the 8 ball now

 

[nimbus]

I’ve been pondering ways to get into this but honestly may be behind the 8 ball now

Medical marijuana business was good for a while until recreational marijuana was legalized. I think psychedelics (Psilocybin, MDMA, maybe ayahuasca too in some states) will present opportunities in the near future. If only someone could put MDMA in Putin’s water.

 

[anbuitachi]

I left gas after the first year of gas residency. I went into psych. It's a better field for me.

congrats! more money better lifestyle. just too much talking for me

 

[anbuitachi]

I'm just a med student, but from my perspective, there really doesn't seem to be many better options than anesthesia given the downsides of surgery. Could just be the institutions I've been at (large academic medical center and a medium sized community hospital) but I have never seen more unhappy and regretful attendings than the surgeons.

It's one of the major reasons I'm not doing surgery. I always said that if I met 1 surgeon who had a lifestyle I would want for myself, I would feel comfortable doing it. I never met one. I would be happy with 95% of the lifestyles I've seen in my time in anesthesia.

If you remove the surgical specialties, really the only other two specialties that are harder to match and have it better than anesthesia are derm and ophtho. And I think most people who pick anesthesia would not be able to stomach the clinic and note writing of those specialties.

Thats exactly what I was told and thought and why I was essentially 100% sure until M4 I was going to go into a specific surgical sub specialty. But in my limited experience, I didn’t see any of it. Maybe they are just masochists, but most I worked with were not happy with their schedules.

Again, just a med student with obviously limited experience at limited institutions, but the difference between satisfaction between my surgical sub and anesthesia was shocking. Maybe as a med student we just get exposed to the surgeons that have the most undesirable lifestyles and it skews our view.

Lot of variables. its possible just the hospital you rotated at. but when i was a med student, its rare for me to just follow around the ATTENDING. Im mostly seeing patients, presenting to residents, maybe scrub in here and there, so I actually dont see much of the attendings day to day.

surgery resident life sucks. that's obvious. but attendings? not so bad. but im sure its practice dependent. we just had a couple of surgeons complaining about having to work 45 hours a week

 

[anbuitachi]

This is the reality people miss. Ask some private practice ENTs/urologists who are graduating right now what sort of offers they get. The lowness of the starting pay, especially in large cities, may surprise you, IF there's even jobs for them to get. Their partnership tracks are 3+ years as well, and only then do they start making production based money. Their potential is probably higher with practice asset ownership, but they pay a huge price for it with how hard their residencies are, and the generally more saturated job market in large cities.

I'd say most, if not all offers I have heard for fresh general anesthesia grads are much higher than the starting for surgical subspecialties, with maybe ortho being the exception.

the graduating neurosurgery residents would disagree

 

[anbuitachi]

Man, you really can't read...go back to it...clearly says one of my prior jobs had >60% Medicare and we still made more than the AMC offer.

Obviously this job has a way better payor mix. My day yesterday: 24 GI cases, 21 insured, 126 units @ $70/unit (conservative) = $8820/ 7hr = $1260/hr. There is a reason Greedy POS GI guys want to bring Anesthesia and Path in house and steal billing.

thats pretty impressive. thats a lot of charting and propofol drawing up and stuff you have to do.

a bunch of GI places are hiring around me, but they paying like 1600-1800 for the day which sucks

 

[painballer27]

congrats! more money better lifestyle. just too much talking for me

Just curious, how do you figure that psych is more money? MGMA data strongly indicates that anesthesia makes more

 

[D P356]

Exactly this. Let's just say they're not trolling and humor them, that would take a very, VERY, efficient system from preop, to nursing, to OR cleaning, etc.

Yep that's 17.5 minutes for case time and turnover. Not to mention if there's upper and lowers scheduled I call BS yo. I could usually do 15-17 endos from 8-4 with a pretty efficient surgery center.

Easier when you split up doubles and call them two “separate” cases

 

[GassYous]

Easier when you split up doubles and call them two “separate” cases

Don't think you can do that

 

[sevo00]

congrats! more money better lifestyle. just too much talking for me

How is it more money if their average is less than ours?

 

[DrZzZz]

Just curious, how do you figure that psych is more money? MGMA data strongly indicates that anesthesia makes more

How is it more money if their average is less than ours?

C'mon guys, look who posted that comment. There's your answer.

 

[D P356]

Don't think you can do that

From a billing standpoint, No.

But when tooting your horn on the internet, one can take care of 12 pts but do 24 “cases.”

It’s a joke.

 

[GassYous]

From a billing standpoint, No.

But when tooting your horn on the internet, one can take care of 12 pts but do 24 “cases.”

It’s a joke.

Some places actually book that many patients and are done at a reasonable time.

 

[PikminOC]

Just curious, how do you figure that psych is more money? MGMA data strongly indicates that anesthesia makes more

It's way less hours, less responsibility and less wear and tear on our necks and backs. No overnight shifts.

 

[We'llBeDoneIn15Minutes]

What happens when the patient has questions or does not speak English?

Just do this, 🤷, and put em to sleep.

 

[anbuitachi]

It's way less hours, less responsibility and less wear and tear on our necks and backs. No overnight shifts.

exactly. a ton of them are cash only too. i wonder if they are even responding to mgma..

mgma isnt hourly rate anyway

 

[PikminOC]

exactly. a ton of them are cash only too. i wonder if they are even responding to mgma..

mgma isnt hourly rate anyway

We don't respond to that nonsense.

I couldn't deal with all the obese patients in gas.

 

[chocomorsel]

Pilot pay is very good but so is anesthesia pay. I don’t think too many folks on this board would we happy with 400k.

Depending on how much one worked, some of us would. Making the good income we make is not typically a 30-40 hour week.

 

[chocomorsel]

In SF/LA, it is very difficult to get a surgical job in the city proper that isn't complete ****. One of the ortho fellows couldn't find a Job in LA and is doing per diem at Kaiser. I have two friends who are plastics trained and they couldn't find jobs in SF. Bay Area graduates ~10-11 fellow a year amongst the programs and they have nowhere to go.

They need to move to less saturated markets, start a practice of join one and print money.

 

[chocomorsel]

I think its possible. 900k over 46 weeks (6 weeks of vacation), 50ish hours a week comes out to $375/hr. If he has a great payor mix, does 1:4 supervision, hospital throws in stipends for taking calls/weekends, maybe taking a high % from new attendings on partnership track, its possible. Certainly, I agree its an outlier and many things have to line up, but those jobs definitely exist out there.

It's the kind of money I am looking at with locums now. But not full time though.

 

[chocomorsel]

Matrix

They make that kind of money? So she wasn't lying?

 

[chocomorsel]

Exactly this. Let's just say they're not trolling and humor them, that would take a very, VERY, efficient system from preop, to nursing, to OR cleaning, etc.

And no computer charting.

 

[chocomorsel]

He/She is doing a crappy job without seeing pts. before or after the procedure.

They can always see the pre ops in clinic though. They do need to be seen after for sure though.
Although I have met many GI docs who don't see the patient before had. Does't stop idiot patients though.

 

[chocomorsel]

Yep that's 17.5 minutes for case time and turnover. Not to mention if there's upper and lowers scheduled I call BS yo. I could usually do 15-17 endos from 8-4 with a pretty efficient surgery center.

He's doing a ****ty job most likely and missing some masses or polyps and such.

 

[chocomorsel]

I left gas after the first year of gas residency. I went into psych. It's a better field for me.

You are living my part time dream.