The answer to the question, "How much does an anesthesiologist make?" varies based on factors like location, experience, and specialty. According to the Bureau of Labor Statistics, anesthesiologists in the U.S. make an average of $393,215.
Anesthesiology is one of the most vital medical specialties, as it ensures the safety of patients during surgical procedures. Anesthesiologists can also increase their earnings by transitioning into private practices specializing in niche markets like spinal leak care.
This article will explore how much anesthesiologists make on average and some factors that impact their earnings. We'll also discuss how transitioning to specialized fields like spinal leak care increases financial rewards, patient outcomes, and career fulfillment.
Let's take a look at what the data shows about the average incomes of anesthesiologists:
The Bureau of Labor Statistics states that anesthesiologists make an average of $393,215 yearly, which is considerably more than the average income in the U.S., estimated at $48,060. The data also shows that anesthesiologists are one of the top earners in the medical field.
Factors like the location where they practice significantly impact how much an anesthesiologist makes. For example, anesthesiologists who work in metropolitan areas typically earn more than their counterparts in rural areas. In addition, anesthesiologists who have their own clinics typically outearn those hospitals employ.
Anesthesiologists who specialize in certain fields earn more than the national average for the profession. For example, pediatric anesthesiologists earn more than general anesthesiologists because of the specialized care they provide children. The same goes for cardiac anesthesiologists who assist during complex heart surgeries. Cardiac anesthesiologists earn more than all other specialties on average.
There's also a growing demand for anesthesiologists in the spinal leak care space, allowing them to increase their incomes dramatically. The spinal leak care market is estimated at almost a trillion dollars due to factors such as the high rate at which patients are misdiagnosed. More than 2 million women end up with spinal leaks from labor epidurals annually, creating massive demand for private pain management clinics that can provide adequate long-term care.
Some of the factors that can impact how much an anesthesiologist does make include:
As in most medical fields, an anesthesiologist's experience plays a tremendous role in determining their earnings. For example, newly trained anesthesiologists earn around $200,000 to $250,000 yearly, but their earnings increase significantly as they gain experience and develop their reputation. Many will earn close to $400,000 within a decade of practicing.
Anesthesiologists employed by hospitals usually earn a steady salary of around $300,000 to $400,000. However, those who transition to private practices typically see an increase in their earnings because of their ability to set their fees and sidestep some of the limitations imposed by hospitals.
Starting a private pain management practice offers anesthesiologists control over their schedules, fulfillment from walking patients through the entirety of their recovery journeys, and the opportunity to specialize in lucrative niches like spinal leak care.
Insurance reimbursement rates for anesthesiologists working in hospitals have steadily declined in recent years, making the transition to private practice more tempting.
Geography also plays a significant role in determining how much anesthesiologists make. For example, an anesthesiologist’s earnings in California aren't the same as they would earn in Texas. Anesthesiologists who work in major cities typically have higher salaries than those who work in rural areas.
According to the Bureau of Labor Statistics, the states where the greatest number of anesthesiologists are employed include:
|
State |
Number of anesthesiologists employed |
Hourly mean wage |
Annual mean wage |
|
California |
5,380 |
$ 217.76 |
$ 452,930 |
|
Michigan |
2,050 |
$ 137.48 |
$ 285,950 |
|
Massachusetts |
1,880 |
Not published |
Not published |
|
New York |
1,500 |
$ 148.61 |
$ 309,120 |
|
Ohio |
1,460 |
$ 155.15 |
$ 322,710 |
The demand for the services of anesthesiologists also impacts how much they make. For example, regions with high population densities have larger aging populations who require more medical procedures, driving the demand and salaries of anesthesiologists up.
Earning additional specializations like pediatric anesthesia, pain management, and spinal leak care allows anesthesiologists to differentiate themselves, which typically leads to higher earnings. These certifications require additional training but open doors to more complex, higher-paying procedures.
Some of the opportunities for anesthesiologists to increase their incomes by specializing in niche markets include:
Specializing in spinal leak care is one of the most promising opportunities for anesthesiologists to increase their income. Spinal leaks can be caused by accidental dural punctures that occur during epidurals, epidural steroid injections, and spinal surgeries. These punctures can also occur spontaneously as a result of trauma to the body caused by incidents like vehicle accidents or small thoracic osteophytes formed due to the higher rate of incidence of disc herniations in the Ehlers-Danlos syndrome (EDS) population.
It's estimated that over 20 million people in the U.S. have chronic spinal leaks due to inaccurate diagnoses made during the acute stages or due to being told inaccurate information, such as that most spinal leaks self-heal in 7-10 days, which has been disproven repeatedly in current research.
Research has shown that brain MRI features such as diffuse pachymeningeal enhancement (DPE) frequently disappear in a matter of weeks after the onset of the spinal leak as the body adjusts to compensate for the injury.
Radiology often only looks for DPE to diagnose a spinal leak. This means that spinal leak patients who are told by anesthesiology to wait 7-10 days or longer will often be subsequently failed by radiology as well. Radiology does not use the Bern score as a multi-factor way to look for subtle shifts in brain structures rather than solely looking for DPE. The fraction of the population with spinal leaks continues to rise rapidly, especially among women whose symptoms are often wrongly assumed to be caused by hormonal imbalances.
Many of these patients spend as much as $24,000 yearly on ineffective treatments and conservative pain management like IV saline due to the extremely high rates at which patients are misdiagnosed. Most of these patients only experience limited relief from their symptoms.
Outdated diagnostic techniques, like lumbar punctures to test opening pressure, haven't helped address the spinal leak care crisis. Such procedures also come with a risk of accidental dural punctures. Lumbar punctures are used to measure tonsillar descent, a sign of low cerebrospinal fluid volume. However, physicians often dismiss this indicator when it is less than 5 mm despite its clear connection to symptoms of spinal leaks like headaches. The opportunity costs are significant for physicians and patients when they fail to diagnose spinal leaks.
Anesthesiologists are ideally positioned to help address the spinal leak crisis given their experience administering treatments like epidural blood patches, the leading treatment for spinal leaks, and using more effective diagnostic tools like the Bern Score.
The Bern Score is a multi-feature approach to analyzing the subtle shifts in brain structures that can be analyzed with magnetic resonance imaging to detect signs of intracranial hypovolemia, a secondary symptom of spinal leaks. It's a more accurate way to detect symptoms of spinal leaks since it focuses on multiple features instead of one, as radiologists sometimes do. This makes the Bern Score a more suitable tool for diagnosing spinal leaks since factors like a patient's biology and the severity of the leak can lead to drastically different symptoms.
Unlike invasive, outdated diagnostic techniques like CT myelograms, which can miss intermittent or small leaks while posing a risk of causing new dural punctures, using the Bern Score used to read brain MRIs is noninvasive, and it's emerged as the new standard for diagnosing spinal leaks.
Some centers opt for non-invasive MR myelography with IV contrast dye rather than a CT myelogram due to the risks involved. Anecdotally, many anesthesiologists use CT scans of the spine rather than CT myelograms to look for small calcified protrusions in a suspected spontaneous leak case.
CT myelograms already notoriously miss small anterior thoracic leaks, as most radiologists lack the knowledge to identify a suspected leak site and adjust with different body positioning, delaying imaging after intrathecal contrast injection, and so on.
Anesthesiologists' expertise allows them to charge premium rates and provide comprehensive long-term care to patients who desperately need it.
Transitioning to a concierge-based private pain management clinic is another way anesthesiologists can boost their incomes, especially when focused on high-demand niches like spinal leak care.
A cash-based structure allows anesthesiologists to provide personalized care to patients willing to pay a premium for effective care. It allows anesthesiologists to charge monthly subscription fees for access to specialized care whenever needed.
A concierge-based model offers anesthesiologists who transition to private practice higher earnings, increased job fulfillment from offering long-term care plans, and increased patient satisfaction. It's a stark contrast to the hospital setting, where anesthesiologists only interact with patients with dural punctures once, and what's best for patients isn't always a priority.
The rate of spinal leaks being misdiagnosed remains high, partly due to the use of outdated information on the condition and ineffective diagnostic tools. This opens up an opportunity for anesthesiologists looking to invest time in learning the intricacies of spinal leak care.
Anesthesiologists specializing in spinal leak care can charge high rates for their services because of the high demand for their skills and relatively little competition.
It's estimated that accidental dural punctures during epidural procedures occur at a rate of around 1.5%. As many as 58% of these patients will still be symptomatic 18 months after getting an epidural blood patch to address the leak.
Patients with spinal leaks are often misdiagnosed with anxiety, migraines, postural orthostatic tachycardia syndrome (POTS), and chronic fatigue, leading to ineffective care that prioritizes treating symptoms instead of the root cause of the patient's condition.
Some of the challenges that limit how much anesthesiologists can earn include:
One of the biggest challenges facing how much anesthesiologists make today, especially those who work in hospitals, is the low reimbursement rates offered by insurance providers. These companies have caps on how much will be paid for some procedures, which can negatively impact an anesthesiologist's bottom line.
For example, reimbursement rates for administering epidural blood patches can be as low as $75, while anesthesiologists who run private practices charge as much as $800. Anesthesiologists can start private pain management clinics to avoid these limitations. A cash-based model allows them to set their own prices.
Anesthesiologists have stressful roles in hospital settings due to their demanding schedules, limited time with patients, and lack of appreciation for their expertise. They often have to work long shifts, which gives them little control over their work-life balance.
Private practice offers a solution to many of these challenges, giving anesthesiologists more control over their work-life balance. Specializing in a high-demand field often allows anesthesiologists to increase their income while working fewer hours.
Some of the reasons why anesthesiologists who specialize in spinal leak care position themselves for long-term growth include:
The spinal leak care market is a growing niche that offers long-term financial stability to anesthesiologists who make it their specialty. The demand for spinal leak care continues to grow, particularly in the U.S., where millions of spinal procedures are performed annually.
Anesthesiologists who specialize in spinal leak care position themselves as experts in a medical field expected to grow significantly in the next several decades.
An advantage anesthesiologists specializing in spinal leak care enjoy is the potential to offer ongoing care. Patients with spinal leaks sometimes need multiple blood patches and long-term care, which hospitals don't provide. Many of these patients end up meeting with an anesthesiologist for an epidural blood patch once, with no follow-up.
These patients often enjoy immediate relief once a blood patch has been applied because of the tamponade effect, as the patch pushes cerebrospinal fluid into the head. However, this relief is often gone in as little as 48 hours after administering the blood patch.
Spinal leaks can reopen, primarily when caused by a small osteophyte. Some anesthesiologists opt for a maintenance approach toward blood patches used to treat leaks caused by osteophytes to address symptoms without exposing patients to surgery risks. They might re-patch the site once or twice a year after the patients accidentally re-open it and continue to provide patient education on avoiding activities that can cause this to happen.
Considering patient mortality and further disability from spinal surgery for small osteophyte leaks, several anesthesiologists in the spinal leak care field have chosen maintenance patching until medicine evolves with a lower-risk approach to shave osteophyte edges.
Anesthesiologists who transition to private practices that specialize in spinal leaks can charge $1,200 annual subscription fees, $300 per quarterly visit, and $800 per epidural blood patch – with patients needing perhaps three yearly with additional experimentation to see how large a patch is needed at what level to produce success and then continuing to replicate this in the future with adjustments as needed if the patient re-opens the site.
Re-opening a site is not limited only to patients with leaks from osteophytes. Cases have been reported of epidural leaks in which the patient had immediate relief and full mobility restored for eight months after the first patch, only to accidentally re-open the site during a bowel movement when the patient was straining. Any Valsalva maneuver can increase pressure, and the previous leak site can still be thinner despite the patient appearing functional and potentially taking a year or more to heal.
This brings each patient's annual costs to around $4,000 and allows them to return to work, much less than the $24,000 annual average they spend on ineffective or only slightly effective treatments that often do not allow them to be functional enough to return to work.
Following this business model, serving 200 patients would bring a private practice's revenue to $800,000 annually.
Many patients diagnosed with spinal leaks complain about how challenging it is for them to find specialists who can provide the comprehensive care they need. Anesthesiologists who open pain management clinics are in high demand, but most report that they have not performed a blood patch in decades despite the known high rate of accidental punctures during epidural steroid injections at pain management clinics.
In fact, due to this knowledge gap, many pain management patients try to seek help with radiology due to the pain management anesthesiologists’ inability to perform blood patches. Unfortunately, due to limited foundational knowledge on blood patches, radiologists commonly cause many additional issues during patches.
Radiology nurses have reported witnessing many injuries during blood patches due to the radiologists injecting the blood far too fast and often with a needle gauge that is too small, causing high epidural pressure, quivering of the needle tip, and commonly dural tears and punctures.
Pain management anesthesiologists have experience applying epidural blood patches during their residency, but that's where it ends. Regional and obstetric anesthesiologists have a clear advantage over other specialties since they typically have extensive experience performing blood patches while working in hospitals compared to physicians who went into private practice directly after a pain management fellowship.
Signs of spinal leaks like post-dural puncture headaches (PDPH) can drastically lower a patient's quality of life. To make things worse, many of these patients have a difficult time getting accurate diagnoses that reveal the source of their headaches.
About 2 million women in the U.S. will experience PDPH after labor epidurals annually, and the latest research rejects the idea of it being self-limiting. Studies show that many of these patients will remain symptomatic years after getting a labor epidural without appropriate care.
Current data shows that up to 20 million people in the U.S. need spinal leak care, and that number is expected to keep growing for the next several years. This leaves a tremendous opportunity for anesthesiologists to serve patients desperate for adequate care that brings long-term relief while increasing these physicians’ income.
Many patients and healthcare providers remain unaware of the symptoms of spinal leaks, leading to a high rate of misdiagnosis. This creates an opportunity for anesthesiologists who run private practices to educate patients and peers about the most effective ways to diagnose and treat spinal leaks. Doing so offers additional revenue streams while positioning them as experts in the field.
Physician reliance on incorrect, anecdotal information rather than robust research-based information on diagnosing and treating spinal leaks remains one of the most significant factors contributing to the current crisis. Current data highlights the shortcomings in interventional radiology as the lead for spinal leak care. The foundational knowledge of flow dynamics that anesthesiologists have makes them the best-suited physicians to provide comprehensive spinal leak care.
Many patients have received epidural blood patches that lead to dural punctures by interventional radiologists who sometimes use three needles to insert 2 to 5 mL of blood simultaneously from multiple angles. Anesthesiologists do not need such risky procedures since they understand that blood naturally flows around the spinal cord. They typically perform blood patches with an interlaminar approach using a single needle. Anesthesiologists are typically taught the dangers of distraction and of leaving needles unattended.
Anesthesiologists are ideally suited to provide long-term care to patients with spinal leaks because of their experience performing epidural blood patches, which allows them to manage their patients' recovery from start to finish. This often includes educating other healthcare professionals, such as neurologists, about the value of non-invasive diagnostic tools like the Bern Score combined with brain MRIs.
Many anesthesiologists report high levels of fulfillment when administering epidural blood patches due to the instant relief provided to patients thanks to the tamponade effect. However, that's often where the interaction ends in hospitals because of the misconception that spinal leaks are self-limiting.
Many of these patients will need follow-up care in as little as 48 hours after getting a blood patch, highlighting the pressing need for more private practices to provide the long-term care such patients need.
Establishing a reputation as a leader in spinal leak care helps to increase the earning potential of anesthesiologists who open private pain management clinics. This can be done by writing informational articles, hosting educational seminars, and engaging with patient advocacy groups.
Building up their reputations helps anesthesiologists increase their visibility in the medical community. This often leads to patient referrals, collaboration with other specialists, and opportunities for media appearances and other speaking engagements.
Anesthesiologists who establish themselves as experts on spinal leak care have more patients seeking them out for long-term care, increasing the demand for their services and allowing them to command higher fees for consultations and treatments.
Many anesthesiologists who open up pain management clinics report increased career fulfillment from raising awareness about spinal leaks, educating patients and peers, and contributing to advancements in the field.
Anesthesiologists can also differentiate themselves from their competitors by offering whole-person care. This model focuses on improving patients' overall wellness while treating their dural punctures, including providing stress management, nutrition counseling, and epidural blood patches. Having a comprehensive approach helps to enhance the body's natural healing process, improving patient outcomes.
Telemedicine has enjoyed increased popularity in the last decade, allowing anesthesiologists to expand their private pain management practices beyond their local area. Services like virtual consultations, follow-up appointments, and diagnostic evaluations offer convenience to patients whose ability to travel might be hindered by spinal leaks.
Telemedicine allows anesthesiologists to broaden their patient base, increasing their revenue stream. They can provide their much-needed expertise to patients who are dissatisfied with the care they're currently receiving.
Continuous education is vital for anesthesiologists looking to maximize their earnings. They can remain competitive in an always-evolving medical industry by staying current on the latest diagnostic techniques and treatment options.
Earning certifications in specialties like spinal care leak, pain management, or pediatric anesthesia increases the value of an anesthesiologist's skill, leading to higher earnings. Additionally, image guidance training in a fellowship or mini-fellowship can allow regional and obstetric anesthesiologists to perform epidural procedures more safely in an outpatient setting.
Investing in additional certifications requires valuable time and financial resources upfront, but the long-term rewards are worth the investment. Anesthesiologists with additional certifications are better equipped to treat patients with more complex health conditions, attracting a broader patient base.
Anesthesiologists are some of the highest-paid professionals in the medical space. Factors like their experience, where they plan to work, and their specializations determine how much each anesthesiologist earns.
Anesthesiologists also have the option to transition to private practices to enjoy greater financial rewards. While working in a hospital provides a steady salary, starting private practice pain management clinics specializing in high-demand niches, like spinal leak care, offers greater financial rewards.
Anesthesiologists are positioned to provide a valuable service to patients who are often bedridden due to spinal leaks while increasing their income by leveraging their unique skills, embracing up-to-date diagnostic techniques, and building a reputation as a leader in the spinal leak care field.
If you're considering starting a private practice, specializing in spinal leak care could be the key to greater career satisfaction, improved work-life balance, and increased income.