Expert: Ronald Levy, M.D. - 4/18/2010

Question
Hi,

I am a 3rd year medical student considering anesthesia as a career. My question is what do you think of the future of MD Anesthesiologists? With the rise of CRNAs and the new health care bill which may suppress physician salaries, it seems hospitals seem to switching over to using CRNAs rather than Anesthesiologists to save on expenses. Do you feel that the field will one give way to the CRNA putting the MD Anesth. out of business? Do you feel that it will become more and more difficult to find a job as a CRNA. I ask since I was reading a few articles online about the 15 states (including CA which is where I would eventually like to practice) that have already opted out of the Federal Supervision Requirement requiring that CRNAs be supervised by an MD Anesthesiologist and was worried what salary/job prospects will be like over the next 10, 20 or 30 years.

Also, is there anything I can do to help ensure job security in the field such as specializing in a fellowship past my residency in Anesthesiology? If so which ones are least likely to be taken over by CRNAs? Thanks for your help and I really appreciate any advice you can offer.

Sincerely,

Neil Kamdar, MS3

Answer
I think the future is fine for MDAs. I think the law in those states will eventually be repealed because it changes the definition of what is a physician. Those rules are useful in places where they can't get an MDA but I think for most major centers, MDAs will still prevail. The same argument is waging between internists and Nurse practitioners. If you want to ensure job security, any specialty will work, Hearts, Peds, Pain, Critical care will all make you a valuable asset.

Ronald Levy. MD
Professor of Anesthesiology
UTMB-Galveston