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Thank you for the great content Dr. Amanda!

Thank you

MS-2 here. What made you choose anesthesiology residency over internal medicine residency when it comes to the critical care route? Awesome videos!

The care-team model, especially if it is 4:1, is a self inflicted wound by anesthesiologists, for economic gain. I have been in a practice like that ( I left ), in which the anesthesiologists never did their own cases & were relegated to signing the chart. They, largely, were worthless and added no value most of the time. They functioned, not as a physician, but a PA- the CRNA became the go-to person. In addition, billing in a 4:1 model is often fraudulent, as it is impossible in a busy practice to meet all 7 requirements for billing under medical direction. In a different practice that had both anesthesiologists & CRNAs in equal numbers, I did all the cardiac, thoracic & vascular cases myself. My time was much better spent doing that rather than going from room to room watching a CRNA insert an LMA & sign the chart!

Could you do an updated vid for 2025? If anything has changed?

I like to view it as a military structure. Physicians will be the generals. Newer docs will be Brigadier generals and they gain stars with experience. CRNAs are the Lieutenant Colonels and Colonels. AAs will be the Captains and Majors. Nurses and RTs are 2nd and 1st Lieutenants. CNAs are the Corporals and Sargeant’s. EVS, Linen, Dietary are the Privates. We all need each other and while some jobs require less training than others, the hospital would fall apart without each and every employee.

Thanks for the video. I'm a respiratory therapist intern this video was helpful. What type of physians usually are in the team in the same time? My team usually have 4 physians and one consultant. But I don't really know their specialities yet as I have just started my intrrn year

i like the video would you say theres high financial potential in critical care anesthesiology

A lot of MDs becoming youtubers nowadays, it is a trend. They all complaining about the same things you complaining about. The burnout is due to greed. Same with nurses, the hospitals intentionally understaff so they can make more money. Doctors are just high paid slaves.

New subscriber. Aspiring CRNA HERE ❤😘

Hi Dr. Xi, appreciate the informative video. Any recommendations for PAs wanting to go to medical school? About to graduate PA school in a few months, and been having ongoing thoughts about going to medical school. Currently just 25 years old so I do have some time to think about pursuing more school. I know it's uncommon but wanted to hear your thoughts, thanks!

It’s great to hear that you were an engineer. I used to be a lawyer and now I’m a third year medical student! ❤

Hello, are you an anaesthesiologist and do you live in the United States of America?

This is a really insightful video, thanks for making it!

I hope you upload my videos I love your videos

Welcome back

Missed your videos!

Mam do you earn 600k dollars a year as an anesthesiologist? Plz reply. Thanks a lot.

As an aspiring PA, this podcast was very informative.

Very thoughtfull. Thank you.

I am an internal medicine specialist. and I love performing procedures in intensive care. After all these explanations, I started to question my fellowship choice. Should we leave this job to anesthesiologists?

But you guys get paid shit loads of $$?!?! Of course there will be risks.

Every CRNA spends at least a couple years in the ICU managing those “sickest” patients for 12 hours a day before going to school and passing boards with the same exact USME style questions as the MDs.. same books too 🤷‍♂️ who knew.. fun fact, nurses pioneered the anesthesia profession and a lot of early methodologies.. CRNAs are not new.. been there since day 1

Great video.

Just wondering do you think pharmacy would be screwed first

Super helpful thank you!

pls talk about the salaries and the work schedules, any difference between you and someone who went through an emergency medicine fellowship to become CCA.?

Great video, very informative. Thank you.

a solid no. the future is geriatrics, obesity, failed kidneys, regional anesthesia, pain, suicide and litigations. ive rarely seen any asa 1 or 2 patients in my practice. and people shouldnt be doctors if they only think about money. where most parts of the world where money is scarce, most of us anaesthesiologists are also critical care specialists. a reducing number of us is an ominous sign that healthcare is failing, not improving. The surgeons should be worried if that day actually comes.

It's funny you say that you would love to get to know the patient on a deeper level, but on the other side, we envy OR staff because you guys don't have to deal with patients only for a brief time. I guess the grass is not always greener. LOL :-)

AA starting salary is $200,000.

I really want to know what the repercussions are 10-20 years down the road when anesthesiologists are working in an anesthesia care model. I would 100% rather have some CRNA who has been at the head of the bed for thousands of hours over those 20 years than the MD circulating around pushing propofol for induction. Who is ACTUALLY providing the anesthesia care under this model lol. I’ve only shadowed in the OR’s but from the outsiders view that seems to be the case…

One thing you have to remember that is priceless is that practicing as a doctor is probably the most respected career out there.

Are you able to list out the names of those 12 accredited programs.

Thank you so much for this video Dr. This was so informative

Honestly, mid level health care is a bunch of shit but nobody wants to say it. Ask Lindsay Clancy about her psych NP...

Excellent video! Will be taking my exam in a few months! Thanks for the advice!

Will take my ABA applied exam in a few months. Your video was super helpful. Congrats on all your accomplishments. Wish you the best.

There are not nearly enough MD anesthesiologists to provide Anesthesia for everyone who needs it. There will ALWAYS be a need for MD anesthesiologists. Mid level providers such as CRNAs and AAs simply bridge the gap for care. In summary, no one’s jobs are getting taken away. If anything, there is MORE work than there are providers. If CRNAs and AAs didn’t exist, half of the people who needed anesthesia care would be delayed care or not recieve it at all. In the same token, NPs and PAs are the bridge to care gaps in outpatient and inpatient care settings. Thanks for providing a thorough explanation and non biased opinion.

so discouraging😞

very interesting commentary, I appreciate you sharing your perspective and experiences! im applying currently to med school and have two interviews coming up!

Women have it exponentially easier than men. Women don't choose inept men for marriage, while men will mate for love

This is virtually only an issue in the USA where private hospitals employ nurses to do the job of physician anesthesiologists because of 💰💰💰... no such thing as a CRNA in most countries

When computers came people thought it would replace a lot of engineers, it only made engineers better. In fact where would radiology and anasthesiology be without it. Every nurse needs to know how to use a digital record. It’s pretty asinine that people think technology will replace already established perfect human interventions. Last I checked, we are the only species that can operate on our fellow species. No supercomputer, no matter how smart will ever replace the human-human interaction and care. Technology is just a tool to make human life more advanced and better. AI will not get rid of programmers just as it will not get rid of medical specialists, medicine is archetyped by the rod of Asclepius. Without Asclepius, it’s just a rod. And without doctors and nurses, technology is useless.

Im a PA and I’m glad you don’t seem derogatory to PAs as some physicians do. The only thing is.. PA profession is not a back up plan. Schools do try to filter out these people that use PA as a backup. Although not as hard as medical school, it is very difficult. We also have very minimal breaks (including no summer breaks). I love the PA profession and being a PA. I started in family medicine and I’m now looking into a general surgery and/or hospital medicine position. Something in the hospital rather than a small outpatient practices. My biggest thing I’m so happy about is the lateral mobility that we have. And I don’t mind being open with my salary if it helps anyone. My first job in family med in Florida I made 105k. This is on the lower side and while I do not believe we should be paid as much as physicians, I do wish we were paid a little more. I believe the average for PAs is about 120k. If anyone has any questions I love talking about this. Comment here or message me on instagram @lisafellispac

I’m a PA student about to graduate in about a month and I think the video is very well said!

I will say this... it won't die but if they continue to throw "more money, more courses" than yes it will be a lot more challenging down the road if they keep changing what's required. 😔 In general!

Awesome. Can you talk more about which factors mattered the most for your match?

I don't worry about CRnas replacing anesthesiologists. To put it bluntly, CRnas learn from anesthesiologists, who not only provide medical services, but also have a large number of scientific tasks. A crna is more of a technician and operator, while an anesthesiologist is closer to a medical scientist.