What Drives Today's Anesthesiologists? 5 Points From TeamHealth Anesthesia
Still, the specialty is in good hands with each crop of residents embracing the new system, says Sonya Pease, MD.
Dr. Pease has practiced anesthesiology for more than 20 years, and she serves as the chief medical officer for TeamHealth Anesthesia, a national organization that specializes in outsourced anesthesia and pain management services.
Here are Dr. Pease's five points about what drives today's anesthesiologists to pursue the profession.
1. Diversity of the specialty. As a specialty, anesthesiology attracts people looking for diversity in their daily duties. Administering anesthesia requires a broad knowledge base and clinical skills that encompass the entire body.
On any given day, an anesthesiologist is part internal medicine physician, part cardiologist, part surgeon, part interventional proceduralist, part ultrasonographer, always an expert in airway management techniques using videoscopes, and more, Dr. Pease says.
Anesthesiologists also tend to be drawn to how service-oriented the specialty is. They are the physician leaders within the perioperative environment and work strategically with surgeons and patients to ensure the best surgical outcomes in the most cost effective and efficient way possible.
"We go into it because we want to take care of patients and focus on customer service," she says.
2. Job stability. Physicians coming out of their residencies are drawn to job stability now more than ever before, Dr. Pease says.
"The days of private practice are slowly winding to an end," she says. She attributes much of this transition to new quality reporting measures, which require more financial and time resources than many small practices can supply.
Anesthesiologists look to the specialty to provide a high quality of life, as well.
"This is still a specialty that draws," she says. "It offers a good lifestyle balance; when you are off [work], you are off."
Most new anesthesiologists can choose between practicing at an acute care hospital, some with trauma centers and high acuity cases or outpatient ambulatory surgery centers where the patient population is generally healthier. Each setting has its own set of challenges and priorities that are equally demanding. This wide spectrum offers significant flexibility and opportunity for finding the right fit based on each physicians personal preferences.
3. Increased expectations. Just in the last 15 years, the demands of performing anesthesia have changed tremendously, Dr. Pease says. One of her main quality measures was to administer antibiotics quickly prior to a surgical incision, but now there are a multitude of different quality processes that have to be measured for each and every case.
“We have gone from learning not just the art of our specialty to now added layers of quality measures that dictate of lot of what we do and how we do it,” she says.
These quality control measures of how well an anesthesiologist has performed his or her job add extra complexity to an already-complex specialty.
As the healthcare system has changed, so have the expectations for anesthesia. Improved technology and resident training has increased accuracy and decreased the mortality rate associated with anesthesia.
"It's not just the technology that has changed," she says. "It's the mindset. Quality is expected; a certain level of care expected is a given. What we did was once an art, but not it’s an expectation."
4. Flexibility. In decades past, anesthesiologists could expect to be hired out of their residency and spend 20 to 30 years as a partner at a practice. Today, however, the specialty has become more mobile, and anesthesiologists often work at different practices or hospitals throughout their careers.
Anesthesiologists are becoming more flexible and able to provide the same level of care from practice to practice, from state to state, Dr. Pease says.
"The standard of care has become more uniform," she says. "It's a more flexible specialty. Anesthesiologists who are hospital-based are more flexible to be able to go to different locations."
With this additional flexibility, anesthesiologists will need to work harder to prove their value to hospital systems as the cost of healthcare increases and hospitals look to cut expenses wherever possible.
Anesthesiologists still work in an environment where 40 percent of the hospital's expenses and 50 percent of its profits come from core perioperative procedures.
"How we show value in the future will be based on cost effectiveness," she says. "We must be a hospital partner, aligned with the hospital's goals."
This will require a shift in mentality from providing patient care alone to also becoming leaders in the perioperative arena and leaders in cost-effectiveness, she says.
5. Money. Anesthesiologists are also driven by money, as the specialty among the top six grossing medical fields, according to Medscape's 2012 Anesthesiologist Compensation Report. But many young physicians have unrealistic expectations for the career, Dr. Pease says.
Some physicians expect to come straight out of training to a $400,000 annual paycheck. In 2011, anesthesiologists earned an average income of $309,000, down from $325,000 in 2010. Decent salaries still exist for anesthesiology and for pain management physicians, she says, but they have to work hard for the money, building their patient base and deliver outstanding quality of work.
"In the old days, when you had to start your own practice, the dynamic was very different," she says. "When you join a group practice, you are sheltered from having to start from scratch, but at the same time, the rewards are still very much there for those who want to work hard and grow their patient base."
More Articles on Anesthesia:
Can ASCs Still Profit From Anesthesia? A Review of OIG Guidance
4 Key Issues in Ambulatory Anesthesia
4 Key Areas for Anesthesia Groups to Achieve the Highest Quality of Care
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