The answer to the question, "Is being an anesthesiologist hard?" depends on many factors, like where you work and your specific role.
The most straightforward answer is "yes," but it's much more complicated. Being an anesthesiologist can be challenging, particularly for those who work in hospitals, but it's also one of the most rewarding career paths in medicine.
Anesthesiologists are physicians with additional training in managing complex surgical cases, relieving pain, and, in some specialties, addressing the root cause of conditions like spinal leaks.
Where an anesthesiologist works is one of the primary factors that determines how challenging their day-to-day schedule is. Anesthesiologists who work in hospitals usually report lower career satisfaction than those who run private practices. The latter rarely report feeling being an anesthesiologist is hard.
Being an anesthesiologist in a hospital is typically the more challenging choice, especially for regional and obstetric specialists, who usually have busy, unpredictable schedules.
Their roles could include anything from administering labor epidurals and epidural blood patches to providing anesthesia during high-risk surgeries. Depending on the hospital and the number of staff, these anesthesiologists often work on different types of cases during any given shift, never knowing what they'll be facing next.
The high-pressure environment of hospitals leaves many anesthesiologists feeling exhausted by the end of the day.
Some of these physicians find great satisfaction when they provide immediate relief to patients in considerable pain. For example, watching a headache dissipate almost instantly after an epidural blood patch is injected reminds many anesthesiologists why they chose the field. Unfortunately, they rarely get to provide follow-up care to their patients in hospitals as the patients are in and out of the emergency department for a blood patch.
Some regional and obstetric anesthesiologists find themselves drawn to the stability of private practice after a long career in a hospital setting. They see private practice as a 9-to-5, predictable environment where they can consistently engage with patients.
The trillion-dollar spinal leak care market has emerged as one of the most immense opportunities for anesthesiologists looking to move away from working in the hospital system. Over 20 million people in the U.S. are believed to have spinal leaks, and that number grows by about 2 million with each passing year.
Some of the factors that have led to the current spinal leak crisis include:
One of the most significant factors driving the spinal leak crisis is the high rates of misdiagnosis, as some of its symptoms mimic those of other health conditions. For example, about 1.5% of women who get labor epidurals develop spinal leaks, which have a persistence rate of nearly 60% at 1.5 years, but these women’s symptoms often aren't taken seriously as they're often mistaken for hormonal imbalances and other issues.
Anesthesiologists working in hospitals typically only interact with spinal leak patients quickly and never see these same patients again. They sometimes mistake the immediate relief they see their patients experience after performing epidural blood patches as a lasting solution.
However, research notes that many patients require repeat patches. The initial relief is simply a displacement of spinal fluid to the brain via the tamponade effect without necessarily verifying that the healing mechanism has taken place as the blood clot at the leak site and the dura mater quickly forms a layer across the leak site before the body reabsorbs the blood.
The latter aspect typically happens in the 48-72 hour range. A patch is considered “ineffective or inadequately performed” if it has not provided lasting relief after 48 hours. However, without long-term care by anesthesiology, there is no knowledge of whether the patch worked.
On the other side of care, neurology often will tell patients incorrectly that a single patch has healed the spinal leak and that the patient now has another condition. Additionally, neurology is often unaware of the inner workings of epidural blood patches, sometimes equating it to a spinal tap, believing it to involve a dural puncture, and thus advising patients to avoid getting an epidural blood patch.
Additionally, with patients often needing to go to interventional radiology for long-term care rather than anesthesiology to try to seek additional help, these patients often face great disinformation, such as radiology telling patients that repeat blood patches can only be performed every two months–thus leaving patients in pain and disability.
A recent case in Georgia involved a young woman with a spontaneous spinal leak due to a thoracic osteophyte who was admitted to the hospital and patched four times while inpatient within a matter of days until a patch finally held and the patient was able to go home.
Unfortunately, this is a situation that most patients can only dream of. In radiology, in addition to often using the incorrect needle for blood patches with a 22-gauge Gertie Marx, there would also have been a significant time issue with four patches taking eight months that this woman would have been bedbound.
True healing for spinal leaks only occurs when blood clots at the site of the leak, blocking the leak and encouraging rapid repair of the dura. Misconceptions about the symptoms of spinal leaks and how epidural blood patches work are significant factors contributing to the spinal leak crisis.
A private pain management practice focused on spinal leak care provides anesthesiologists with a better platform to provide comprehensive long-term care to patients, including pre-procedure bloodwork and imaging.
While being an anesthesiologist can be hard, moving to private practice often increases career satisfaction while offering a range of rewards, like improved financial freedom, better work-life balance, and more personal relationships with patients.
Private practice allows anesthesiologists to create predictable routines, foster long-term relationships with patients, and improve their work-life balance after spending years in the fast-paced, high-stakes hospital setting.
The move to private practice offers a unique niche for anesthesiologists. There is an immense demand for effective spinal leak care because of the high number of patients who receive ineffective conservative treatments, typically because of misdiagnoses.
A private practice that uses a cash-based subscription model positions anesthesiologists to provide the specialized care patients with spinal leaks need.
A business model that charges a $100 monthly subscription for access to your services, $300 per quarterly visit, and $800 per epidural blood patch would position anesthesiologists to bring in $800,000 annually in revenue with 200 patients. They also get the satisfaction of watching their patients' full recovery from spinal leaks that often leave them bedridden.
Anesthesiologists who thrive on creative problem-solving and delivering long-lasting relief to patients report significantly higher job satisfaction after transitioning to providing specialized care on spinal leaks.
Current estimates indicate that the average person with spinal leaks spends over $20,000 yearly on conservative symptom management like IV saline. Other reported costs have included an additional $20,000 per year for a primary care physician who performed home visits as the patients were bedbound in rural areas. The costs of inaccessibility to excellent spinal leak care are immense–financially and in terms of quality of life.
A private practice specializing in spinal leaks can provide comprehensive long-term care that substantially improves patients’ quality of life for around $4,000 per year–a stark contrast to the cumulative costs of managing all secondary symptoms, paying for care accessibility, and trying to cover costs while unable to work or enjoy life.
Another considerable benefit of anesthesiologists starting private practice is the control they gain over their schedules and business model, choosing what type of care to offer patients and their prices.
A more flexible schedule gives these physicians time to hone their skills with additional training to ensure each patient receives cutting-edge care.
Being an anesthesiologist can be challenging, but it can also be richly satisfying and rewarding for those who start private pain management practices.
Focusing on a high-demand market like spinal leaks allows anesthesiologists to make lasting differences in their patients' lives while building a fulfilling, profitable career that's not as stressful as working in hospitals.