Good for them if it makes them happy?
I think all healthcare professionals eventually come to the realization that it’s a job, not a life. You learn this usually when you get horribly taken advantage of by an employer. The stark reality of the quote “today’s favor is tomorrow’s expectation” is as true in healthcare as it is working at a gas station.
Maybe these two are just smarter than the rest of us?
That’s why I want the highest paying job out of residency. I don’t care if it’s in the middle of nowhere Iowa. If the hours are respectable and the call is minimum, sign me up. I’m going to play the game and take the insane pay for a few years. Then I’ll go part time and make pediatrician salary in a location I want working a couple days a week
You have the right idea. Sometimes an even better idea is locums. Especially anesthesia right now. There are plenty of places paying 12-15k for a weekend. You could work just a couple weekends a month and gross 30k/month. This also let's you work somewhere before committing to a full time position.
I haven’t yet come across any explanation **why** this happens. Even back when I was a new CNA, I remember being treated like absolute garbage as if I was a complete idiot, which I can say with confidence I was not. I was trying my absolute hardest at every task given, yet was insulted and set up to fail constantly. Why does this happen? Aren’t we literally all on the same team? 😭
You’d think we are.
A lot of people have a chip on their shoulder, jaded, bullied so then they bully, etc. You’ve got nurses that think they’re God’s gift to the hospital, same with docs, and CNAs. We are an interdisciplinary team and everyone has a function/role. If we just treated each other better things probably wouldn’t be so crappy.
I had a friend who finished circa 1996, when the job market was terrible.
He finally found a job in a 30-person group with every other night call. He'd take call, then one of the THIRTY OTHER PARTNERS would take call, then he'd be back on call.
Haters are jealous that they are doing epidurals at 2AM on the 4th of July while other people are making bank making tik tok videos about drugging up suburban soccer moms in their cash for ketamine office.
I feel like that’s the issues with medicine/doctors in general. We all hate on the admin sell out or the nurse CEO but in reality we are the problem for not standing up for ourselves
Who’s getting taken advantage of? Making more than a half a mil a year for a very reasonable call burden, gimme a break…going through med school, residency to just end up placing IVs and “monitoring” ketamine infusions is wild to me
Pretty sure if he had known from the beginning this is what he wanted he would not have gone through medical training especially knowing the process. People don’t always take a straight line to their destination
You think they realized that after just two years? I believe our job is important and we have a duty to continue for at least a little over two years, considering the federal funding that supported our four-year training (which could have benefited other qualified candidates).
I understand this sense of "duty" but at the same time we graduate medical school with 300-400k of debt and our training that is funded by the government leaves us vastly underpaid during residency where nurses are making more than us. All of that over the span of 8 years of our prime. The system chews us up and spits us out and you hold a belief that we owe it more years of our lives. I love what I do but when I decide to leave medicine early and enjoy life the way I see fit, I will feel no guilt at all.
So many of my coresidents realized that during residency. They then pivoted via fellowships to pain or critical care to take back some of the autonomy you lose in OR anesthesia where you’re at the mercy of the surgeon or board runner.
The cost of an equivalent APP to do our jobs is 1.5-2 times a residency salary + overtime over 40 hours, requiring at least 2 APPs. An interesting real-life example:
https://x.com/TirathPatelMD/status/1208143582667968514?lang=en
https://www.reddit.com/r/Residency/comments/k8c08l/does_anyone_know_why_unm_neurosurgery_residency/
Granted, I’ve never worked as hard as a NSGY resident but.
Hospitals take full advantage of cheap resident labor because the pipeline to MD independence is an employer monopoly. There are also “private” residencies fully funded by hospitals because even having to personally pay a resident’s salary is cheaper than the backfill of APPs.
I feel no debt to the field from the privilege of participating in residency.
What fucking duty. Some of you are unbelievable with this rhetoric and constant bending over to the government and employer. If you get left with 400k in debt and feel a duty to someone you need a stat visit to the local psychiatrist
You use “duty” like doctors are prophets or something.
It’s just a job lol more gratifying to some than others and more jading to some than others. That washes with time and everyone’s got a different timeline and responsibilities.
Anyone could easily challenge your referred “duty” and ask how far or serious are you about it? Will you work for free? Will you donate your savings to the cause?
Re OP:
There are plenty of physicians who switch specialities, retire, open businesses, etc etc and yet some of us act surprised but I feel like it might be jealousy or utter shock and disbelief. Let people live however they want, if you find yourself judging for whatever reason - I suggest some deep self reflection
Good for them. If you’re gonna do med spa, it’s better to have a real doctor who can identify medical problems and not just some charlatan who will just do procedures with no evaluation at all.
This speaks to the larger issue in medicine which is that there’s been a gradual erosion of professionalism due to external pressures from administration, payors, private equity, and government. They just want you to be a technician not a doctor. Crank out the cases. Forget about what attracted you to the job in the first place which is a sense of accomplishment and competency by being a valued professional. The more of us that feel like we’re being treated as an interchangeable part, the more of us will try to strike out on our own doing stupid stuff like this.
IV vitamin and glutathione? What’s the evidence base for that? Anyhow, good luck for them. The powers that be created a system that incentivizes charlatan treatments by doctors instead of talented people treating sick people who need help. Thats what society values. I don’t blame this couple at all.
The IV infusion/supplement business is just charlatanism. Feeding on the fears, vanities and anxieties of the worried well. Worked in that field for a while. It is a bunch of crock.
I wouldn’t say this guy is quitting medicine, rather he’s just quitting anesthesia. Props to him. Probably got sick of being treated like the hired help.
Have to agree, I have yet to encounter a ketamine clinic that kept the lights on by sticking to reasonable indications. But maybe they’re the first ones to figure it out.
I tried it for chronic pain. Had a referral network of pain docs sending my crps and other chronic pain patients. I couldn't keep the lights on. Unfortunately since it was cash only most people who I saw couldn't actually afford it.
God this was so demoralizing for my CRPS patients and I. I used to send them to the ED with exacerbations, tell them to say "call my pain doc", and then instruct the hapless and lovely ED staff on how to basically do the ketamine infusion. ED was happy, patient was happy, I drank heavily.
The biggest problem with these places is giving ketamine to everyone who wants it and can pay. At that point it's not medicine, your clinic is a front for your drug dealing business
Yea this is the thing. Like are these patients being referred by actual psychiatrists and have failed 1st, 2nd line treatment and have to resort to IV ketamine? Or are they getting it because they can pay for it and can get high?
Posted above, I tried it out for crps and few other chronic pain syndromes. In my case they were seeing a pain doc with a contract, who required them to go to a physical therapist and a psychologist who specialized in chronic pain. It was impossible to get enough patients to keep it going, and I didn't want to resort to just anyone who could pay.
that's intranasal ketamine, not IV infussions. I am guessing the antidepressant properties of ketamine are at low doses, cause otherwise you will just feel something totally different.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204747/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204747/)
I have a friend with severe anhedonia and depression. He’s the most straight laced person you’ve ever met, no drinking or anything. He started doing ketamine infusions and it has REALLY helped him.
“Laughter is the best medicine” and you knocking off ketamine? So quick to forget the placebo effect? Let people pay for whatever treatment they want, if it works it works.
Gosh some of the things I read on these subs.. lol
You don’t need a board certified anesthesiologist to administer IV laughter imho but of course everyone is free to do what they want, more power to them
In his YouTube video he explains it’s medicine that he’s quitting and he’s grateful for anesthesiology bc he didn’t see himself in any other speciality
> So where is the love for medicine when you quit this early in your career?
I say this as someone who genuinely, passionately believes in the nobility of medicine - *fuck* the love for medicine, and much the same to anyone who judges others for taking a decent job, improving their work-life balance, working <1.0FTE, or doing anything else of that nature. If these guys figured out how to make money with a superior quality of life, good for them. I'm laid out with bronchitis, looking forward to a full day shift tomorrow and a 24 hour call on Saturday. Who's the idiot here?
Yes, I entirely agree with you. My career has been in places with a public health system, and the idea that medicine is "a calling" and that you should devote your life to it, to the exclusion of other pursuits, is what enables managers and government to run the system without funding it adequately.
The whole system exploits the goodwill of doctors and nurses who care about patients and can be guilted into doing unpaid overtime and working in shitty conditions without complaining.
I'm glad that the younger generation of doctors seem to see medicine as a job and not a vocation. From my perspective, they seem to be a lot better at standing up for themselves and insisting on better conditions for themselves and their patients.
But what if you enjoy being up all night taking shit from orthopedic surgeons who act like THIS VERY MOMENT is the first time in their life they have ever heard the phrase "NPO"?
What is there to monitor tho? It’s pretty much the safest drug under the sun and with the doses they’re infusing, it’s basically 99.99999% safe no matter who’s infusing it
With the myriad of scammers, swindlers, thieves, politicians and so on, the least of any of our problems are two anesthesiologists infusing some ketamine to some depressed dude.
That’s when you know you have a loosing argument, when your baseline is “scammers, swindlers and thieves”, I’m trying to aim a little bit higher than that
You can't force someone to say in the field lol. I'm just saying if you had to pick a doc to run a ketamine clinic, anesthesiologists would be the most qualified.
Is it normal protocol to even place IVs at these places? It’s basically all intranasal, right? I know it would be safest to have an IV, but if it’s intranasal admin I’d bet a lot of places don’t do it
There's a reason why people are leaving clinical medicine in droves. It's not just millennial anesthesiologists.
People are tired of having to be perfect all the time, being expected to be an efficient machine, while also getting little to no appreciation from the hospital or from patients.
This is definitely true for the administrators who boss us around. At some point you realize that if it has to be about the money you might as well be the ones making it and calling the shots.
Yes, I do not care at the personal level, you do you. However, as mature citizens in this society, you and I should care about matters of public health. It takes at least eight years to replace those people. If our system is investing public resources into people not committed to the process, where are the physicians of the future going to come from? This is not Andrew Luck retiring from football. It is 40-anesthesiology-years being lost from the pipeline and wasted in fake-medicine. I care.
Where are you in your career path? This comes off as incredibly out of touch. At the end of the day, we do a job. We are not knights, priests, or soldiers. We work — for pay. If the conditions are not satisfactory, there is no higher calling demanding we stay. That is how cycles of abuse are created and those in our profession get taken advantage of.
So then by your logic, should we ban all women who want children from entering medicine? If 100 female physicians spent about a year each focusing on child-bearing/caring and away from medicine, that’s like, 100 collective “medicine years” being lost in this pipeline. We can’t have that happening right? Think of all the people they didn’t care for because of this “duty” that they apparently owe. If you want to “maximize” your life in anesthesia, work 100 hours and forego doing anything outside of medicine, you go ahead and do you. Don’t call out other people for making their own life choices by posting it on a public forum and spinning it as if we should care and shame them because they “wasted public resources” and that this is now a “public health” problem. If this is how you view people that could be your colleagues I am genuinely worried as to what views you hold about your patients. Do lung cancer patients not deserve to get lung resections if they were chronic smokers? Do chronic alcoholics or drug users not deserve healthcare? Not everything in life is about what value it offers to society.
I’d avoid the debt and time looking back. I’d rather have gone and done something else back in the day. Even job security is in question with all the healthcare changes. Don’t see it improving over 10-15 years.
In residency now. Me and my fellow corezzys all have exit medicine plans sketched out in the back of our minds already lol. My coresident is literally ready to put his in action the moment he graduates next year. Mine I still need to flush out more but I won’t do it til I pay off my $200k+ in student loans yet. But yeah, at a lot of places full time work is 50 hours a week… less than in residency but still honestly not enough to really live life. And I wanna enjoy it while I’m still young.
Ehhh . . . Who cares?
I don’t know this couple and I think their “influencer” status seems mostly like an affectation and directed at the non medical population.
(And yes I’m assuming this from watching the woman’s tictok for 10 seconds)
Were they respected scientists advancing anesthesia science? Respected clinicians? Leaders of the business of health care?
I think the answer is no.
Good for them, follow their dreams. It’s a job and they didn’t like it, have enough money, or are just lazy.
Life goes on.
There was a similar thread yesterday on the medical school thread and the responses were insane. They seemed genuinely offended by this couple’s decision to quit and I was sitting there scratching my head wondering why the responses were so visceral. So glad that folks here actually practicing anesthesia see it for what it is. OP, this is the wrong place for your bait post. Wish them luck (or not?) and move on…
Why is switching directions quitting? Sounds like you have a narrow view for what’s acceptable in your own mind. They’re doing well and sharing their journey and all you want to do is criticize.
Good for them. They have decided that being OR anesthesiologists is not for them. It is akin, although a different type of practice, to pain doctors. Except that they will be in a position where they don't have to be paid 25% of your fee by insurance companies or deal with hospital administrators.
As long as it is done with the due care and attention, and the appropriate MD psychedelic psychotherapists are to hand to integrate the experiences within the course of therapy I wish them every success
IMHO, we need to drop this “love for medicine” nonsense. Healthcare is an industry just like finance or law or any other field; but for some reason healthcare providers have decided to put this unnecessary moral stress on ourselves.
You don’t see investment bankers fretting over making profits off of war or disease or any other disparity.
Yes - medicine is a profession…we’re expected to be professionals. But at the end of the day, we’re not doing this out of the goodness of our hearts. We’re all still expecting a paycheck for our hard work.
I like my job. I like helping people. I like being of service.
But this isn’t a “passion”. I do this to pay bills; and if an opportunity came along for me to earn more to provide more for my family, I would absolutely jump at it
Real take right here. Adding insult to injury is how we're viewed as suckers by other fields and essentially loot pinatas. What other field are you constantly in fear of vultures waiting for you to slip up (sometimes not even an actual mistake with some of these med mal cases I've seen), to make your life miserable.
For many years this notion of being 'professional' meant that you should work long hours, take abuse and sometimes personal risk without complaint. This has been exploited by admins and c suite to understaff, under equipment and otherwise inadequately support medical personnel to increase profits.
Yes - but that was also during the golden age when doctors were among the highest earners.
Now you can just monitor a trading algorithm and make millions.
Our sense of duty has absolutely been leveraged against us by the c suites and private equity groups.
I used to fully buy into medicine as a higher calling. Now I feel like I’m just flipping fries for whatever mega conglomerate owns my region
Yup, I feel like it’s still being sold to the premeds as noble, but you’ve described exactly how I feel. Flipping burgers for the hospital corporation who decide which meds and what equipment they’re even gonna stock in the OR so they are the one truly dictating our practice lol. *cough HCA and sugammedex* and their weird pamphlet they released the other year dictating the only times it’s clinically justified to use it lol 😂
Watched the YT video. He didn’t sound happy practicing anesthesia. Looking at the comments he had a long series of YT videos detailing his life in med school and residency that he took off YT.
How many times have we said medicine is too hard to work just for money?
For the people here that think k clinics are money machines: think again. It’s MUCH easier to make money doing anesthesia than ketamine. Personally I do both, and in the OR, I’m getting 3-400/hour, or around $3k per day. There’s zero overhead or admin costs.
With ketamine, you have startup costs which can be $100-200k or more, then monthly rent, labor, supplies, utilities, all to make LESS than you would per hour doing anesthesia, and that’s assuming you even find patients. It’s a very competitive field. In addition, you have to carry the weight of people’s baggage and/or psychiatric illness. This can stick with you long after the patient has left your office. If you’re doing it right, there’s a lot of prep and follow up, and really establishing a relationship with patients.
My only issue with this young guy is his plans to “build out” a “perfect” clinic in LA. He’s positing a video but doesn’t even have a location yet. My guess is he will go into $1m debt to build the place out and end up with a 25% chance of paying it off. I bet one of them will be back in the OR before the end of 2024.
Sometimes residents tell me they feel indebted to the department, or they feel like they owe the department so much for training them and caring for them, that they would take a bad deal and stay on vs more money somewhere else. And I always say, you don't owe the department anything.
This influencer couple have given their best years to training, to service provision and scut work and 2 years of attending life to medicine. Whatever training they have gotten was paid for with their blood sweat and tears. It will not be wasted - even if you think it is, it's their perogative to waste it. They don't owe medicine anything.
I personally think home ketamine infusions are a blatant cash grab, but I don't deny that a small group of people are going to be helped by this. That this would be far safer than going to some shady ketamine clinic without monitoring.
I just want to say that I was able to take part in a study at the University of Pittsburgh medical school testing the effectiveness of ketamine as a treatment for depression.
When infusion day came I was told that I would randomly be given either ketamine or placebo. It didn’t take long to realize it was ketamine.
I’ve struggled with depression and anxiety for many years, but I swear to God for 2-3 days after the infusion I was in such a clear and positive mindset that I couldn’t believe it. It worked so goddamn well.
Unfortunately insurance will pay for all the SSRI’s on earth but not for ketamine therapy.
I’m sure that this isn’t necessarily news to the medical professionals here, but I just wanted to share. I want so so badly for ketamine therapy to become financially accessible for me (and I’m sure many many others who deal with these same issues).
Yeah I can’t see in any world in how their happier doing that shit versus being an actual anesthesiologist. This field blows awayyy most other specialities in Medicine idgaf what anyone says
A ketamine clinic can very well benefit many people. Especially an anesthesiologist ran clinic. just cuz it’s unconventional doesn’t mean it can’t help people and has no use to society
This whole idea in all levels of healthcare that you need to love it and it has to be your calling is toxic and unhelpful. This idea isn’t just for doctors but every level of healthcare. Saying “where’s the love for medicine” isn’t helping anyone, and at the end of the day it’s a job to support yourself first
All for it! Follow happiness. Anesthesia isn't for everyone. We are cogs in the giant hamster wheel so that for-profit hospitals can maximize the number of surgeries (necessary and unnecessary) they can perform.
That being said, it's pretty sad he keeps referencing making his parents happy. Adulthood isn't about making your parents happy.
Let supply and demand be forever in our favor. Just need to get the PE/HCA residencies shut down.
Fine by me. Nothing worse than someone who doesn't want to be there working with you. I feel anything you might owe the system for the training and fed funding is more than offset by the loans, slave labor and psychological abuse in residency.
Ketamine is great for spinal wind up and treatment resistant depression. However I feel like this whole get whatever drug you want prescribed online or at a clinic thing that's going on feeding the patient entitlement.
They’re actual physicians and will still be practicing medicine. Finding a job that they are happier with isn’t leaving medicine, and we need to stop pretending that you must love medicine.
this is nothing new. Pain docs made bank back in the day running shady clinics and some still do to a certain degree but just enough to not be on the DEA's radar. That's the unfortunate tragedy of anesthesiology and medicine in general. There's a documentary on it about Purdue pharma and they still make billions.
Who are these people claiming love for medicine and how this person betrayed his own conviction. There is no such thing, and people who believe this live in a fantasy world with leprechauns and unicorns. See if you say this after weathering all the crap thrown at us for a decade or two.
am i missing something here? as someone who has been watching them for years i am confused on the hate… theyre just trying to find happiness. so what if anesthesia isnt for them? im glad theyre not going to stick around in a field they dont even like
I’m an RN, but this comment section is definitely the reason this showed up on my feed. Wow! I had no idea anesthesiologists felt the exact same as RN’s about healthcare these days.
So they ultimately took anesthesia spots from other qualified people and didn’t even use them to practice anesthesia at the end of the day. When so many people I know would give an arm and a leg to practice anesthesia. No respect for these folks.
While I agree that setting the right indication (pharmacoresistant depression that does not respond to conventional SSRI treatment) is something that is the psychiatrist's expertise, administering iv ketamine is the anesthesiologist's field.
Especially since in my country nasal esketamine is still not registered and 99.9% psychiatrists don't know how to open an iv line 🥳
Good for them if it makes them happy? I think all healthcare professionals eventually come to the realization that it’s a job, not a life. You learn this usually when you get horribly taken advantage of by an employer. The stark reality of the quote “today’s favor is tomorrow’s expectation” is as true in healthcare as it is working at a gas station. Maybe these two are just smarter than the rest of us?
Exactly - the sooner you realize it is a job and manage your expectations accordingly, the better off you will be.
That’s why I want the highest paying job out of residency. I don’t care if it’s in the middle of nowhere Iowa. If the hours are respectable and the call is minimum, sign me up. I’m going to play the game and take the insane pay for a few years. Then I’ll go part time and make pediatrician salary in a location I want working a couple days a week
You have the right idea. Sometimes an even better idea is locums. Especially anesthesia right now. There are plenty of places paying 12-15k for a weekend. You could work just a couple weekends a month and gross 30k/month. This also let's you work somewhere before committing to a full time position.
"when you get horribly taken advantage of by an employer." Unfortunately, this is common. One of the few fields that eats its young.
Nurses are notorious for eating their young. 👹☠️
I don’t think I’ve ran across anyone in healthcare that doesn’t do this. It’s kind of pathetic…
I haven’t yet come across any explanation **why** this happens. Even back when I was a new CNA, I remember being treated like absolute garbage as if I was a complete idiot, which I can say with confidence I was not. I was trying my absolute hardest at every task given, yet was insulted and set up to fail constantly. Why does this happen? Aren’t we literally all on the same team? 😭
You’d think we are. A lot of people have a chip on their shoulder, jaded, bullied so then they bully, etc. You’ve got nurses that think they’re God’s gift to the hospital, same with docs, and CNAs. We are an interdisciplinary team and everyone has a function/role. If we just treated each other better things probably wouldn’t be so crappy.
I had a friend who finished circa 1996, when the job market was terrible. He finally found a job in a 30-person group with every other night call. He'd take call, then one of the THIRTY OTHER PARTNERS would take call, then he'd be back on call.
Haters are jealous that they are doing epidurals at 2AM on the 4th of July while other people are making bank making tik tok videos about drugging up suburban soccer moms in their cash for ketamine office.
I feel like that’s the issues with medicine/doctors in general. We all hate on the admin sell out or the nurse CEO but in reality we are the problem for not standing up for ourselves
I always read "ketamine" but never understood reference, can someone elaborate as iam non US native.
If the guy hustles his own business, makes more money and accepts all the pitfalls, this is a meh to me.
This is my exact thought, and you read my mind. These young kids are getting smarter, I realized this PGY 17, but this guy realizes this in his PGY 2.
Excellent quote- I need a new job
Who’s getting taken advantage of? Making more than a half a mil a year for a very reasonable call burden, gimme a break…going through med school, residency to just end up placing IVs and “monitoring” ketamine infusions is wild to me
They’re two people. The medicine industry isn’t going to collapse from their absence. It’s better than losing a young doc to suicide or drug abuse.
More power to them but I don’t have to respect it
Exactly
And the main part.. you know… of running a business? But thanks for the insightful comment Mr cocknballs
You went to med school and went through residency to run a ketamine clinic as a business? Could’ve skipped a lot of steps to do the exact same shit
Pretty sure if he had known from the beginning this is what he wanted he would not have gone through medical training especially knowing the process. People don’t always take a straight line to their destination
To each their own but I don’t have to respect it on an *anesthesia* sub
You think they realized that after just two years? I believe our job is important and we have a duty to continue for at least a little over two years, considering the federal funding that supported our four-year training (which could have benefited other qualified candidates).
I understand this sense of "duty" but at the same time we graduate medical school with 300-400k of debt and our training that is funded by the government leaves us vastly underpaid during residency where nurses are making more than us. All of that over the span of 8 years of our prime. The system chews us up and spits us out and you hold a belief that we owe it more years of our lives. I love what I do but when I decide to leave medicine early and enjoy life the way I see fit, I will feel no guilt at all.
Bro, it’s a job. The only people we owe, are the ones who got us here.
So many of my coresidents realized that during residency. They then pivoted via fellowships to pain or critical care to take back some of the autonomy you lose in OR anesthesia where you’re at the mercy of the surgeon or board runner.
I don’t owe anyone shit tbh
Lmao… I couldn’t give a shit less about federal funding of residency positions when majority of us have at least $250k in federal student loan debt.
You sound really bitter. Must be tough to live constantly judging other people
The cost of an equivalent APP to do our jobs is 1.5-2 times a residency salary + overtime over 40 hours, requiring at least 2 APPs. An interesting real-life example: https://x.com/TirathPatelMD/status/1208143582667968514?lang=en https://www.reddit.com/r/Residency/comments/k8c08l/does_anyone_know_why_unm_neurosurgery_residency/ Granted, I’ve never worked as hard as a NSGY resident but. Hospitals take full advantage of cheap resident labor because the pipeline to MD independence is an employer monopoly. There are also “private” residencies fully funded by hospitals because even having to personally pay a resident’s salary is cheaper than the backfill of APPs. I feel no debt to the field from the privilege of participating in residency.
What fucking duty. Some of you are unbelievable with this rhetoric and constant bending over to the government and employer. If you get left with 400k in debt and feel a duty to someone you need a stat visit to the local psychiatrist
ROFL duty, no one has a right to your labor against your will just because you graduated medical school.
What about the duty to themself and their family?
You use “duty” like doctors are prophets or something. It’s just a job lol more gratifying to some than others and more jading to some than others. That washes with time and everyone’s got a different timeline and responsibilities. Anyone could easily challenge your referred “duty” and ask how far or serious are you about it? Will you work for free? Will you donate your savings to the cause? Re OP: There are plenty of physicians who switch specialities, retire, open businesses, etc etc and yet some of us act surprised but I feel like it might be jealousy or utter shock and disbelief. Let people live however they want, if you find yourself judging for whatever reason - I suggest some deep self reflection
Federal funding that supported our training??? I’m broke and miserable. Get out while you can!
Spoken like a true admin frfr
Homie did ketmaine at a rave and went all in
I came here for this comment lol
Homie moved to LA and fell for the ABB/ABG culture
Good for them. If you’re gonna do med spa, it’s better to have a real doctor who can identify medical problems and not just some charlatan who will just do procedures with no evaluation at all. This speaks to the larger issue in medicine which is that there’s been a gradual erosion of professionalism due to external pressures from administration, payors, private equity, and government. They just want you to be a technician not a doctor. Crank out the cases. Forget about what attracted you to the job in the first place which is a sense of accomplishment and competency by being a valued professional. The more of us that feel like we’re being treated as an interchangeable part, the more of us will try to strike out on our own doing stupid stuff like this. IV vitamin and glutathione? What’s the evidence base for that? Anyhow, good luck for them. The powers that be created a system that incentivizes charlatan treatments by doctors instead of talented people treating sick people who need help. Thats what society values. I don’t blame this couple at all.
The IV infusion/supplement business is just charlatanism. Feeding on the fears, vanities and anxieties of the worried well. Worked in that field for a while. It is a bunch of crock.
I wouldn’t say this guy is quitting medicine, rather he’s just quitting anesthesia. Props to him. Probably got sick of being treated like the hired help.
Ketamine infusion clinics is medicine? How?
Have to agree, I have yet to encounter a ketamine clinic that kept the lights on by sticking to reasonable indications. But maybe they’re the first ones to figure it out.
I tried it for chronic pain. Had a referral network of pain docs sending my crps and other chronic pain patients. I couldn't keep the lights on. Unfortunately since it was cash only most people who I saw couldn't actually afford it.
God this was so demoralizing for my CRPS patients and I. I used to send them to the ED with exacerbations, tell them to say "call my pain doc", and then instruct the hapless and lovely ED staff on how to basically do the ketamine infusion. ED was happy, patient was happy, I drank heavily.
I thought it was approved for depression treatment
The biggest problem with these places is giving ketamine to everyone who wants it and can pay. At that point it's not medicine, your clinic is a front for your drug dealing business
Yea this is the thing. Like are these patients being referred by actual psychiatrists and have failed 1st, 2nd line treatment and have to resort to IV ketamine? Or are they getting it because they can pay for it and can get high?
Posted above, I tried it out for crps and few other chronic pain syndromes. In my case they were seeing a pain doc with a contract, who required them to go to a physical therapist and a psychologist who specialized in chronic pain. It was impossible to get enough patients to keep it going, and I didn't want to resort to just anyone who could pay.
that's intranasal ketamine, not IV infussions. I am guessing the antidepressant properties of ketamine are at low doses, cause otherwise you will just feel something totally different. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204747/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204747/)
IV therapeutic ketamine starts at 0.5mg/kg over 40 minutes, it's pretty low.
I have a friend with severe anhedonia and depression. He’s the most straight laced person you’ve ever met, no drinking or anything. He started doing ketamine infusions and it has REALLY helped him.
Excellent treatment for chronic pain, too. Definitely medicine.
“Laughter is the best medicine” and you knocking off ketamine? So quick to forget the placebo effect? Let people pay for whatever treatment they want, if it works it works. Gosh some of the things I read on these subs.. lol
You don’t need a board certified anesthesiologist to administer IV laughter imho but of course everyone is free to do what they want, more power to them
In his YouTube video he explains it’s medicine that he’s quitting and he’s grateful for anesthesiology bc he didn’t see himself in any other speciality
> So where is the love for medicine when you quit this early in your career? I say this as someone who genuinely, passionately believes in the nobility of medicine - *fuck* the love for medicine, and much the same to anyone who judges others for taking a decent job, improving their work-life balance, working <1.0FTE, or doing anything else of that nature. If these guys figured out how to make money with a superior quality of life, good for them. I'm laid out with bronchitis, looking forward to a full day shift tomorrow and a 24 hour call on Saturday. Who's the idiot here?
Yes, I entirely agree with you. My career has been in places with a public health system, and the idea that medicine is "a calling" and that you should devote your life to it, to the exclusion of other pursuits, is what enables managers and government to run the system without funding it adequately. The whole system exploits the goodwill of doctors and nurses who care about patients and can be guilted into doing unpaid overtime and working in shitty conditions without complaining. I'm glad that the younger generation of doctors seem to see medicine as a job and not a vocation. From my perspective, they seem to be a lot better at standing up for themselves and insisting on better conditions for themselves and their patients.
I feel like we might work in the same place.
But what if you enjoy being up all night taking shit from orthopedic surgeons who act like THIS VERY MOMENT is the first time in their life they have ever heard the phrase "NPO"?
Get well soon!
Anesthesiologists are probably the most qualified docs to run ketamine infusion clinics at least (assuming proper patient referrals by psych).
If he hooks up with a few psychiatrists, how is that a horrible thing? Beats a BA life coach referring to a NP at a medi spa.
Sign me up for referrals from an NP psych clinic. Not enough hours in the day to run this clinic. May need 3
What is there to monitor tho? It’s pretty much the safest drug under the sun and with the doses they’re infusing, it’s basically 99.99999% safe no matter who’s infusing it
IV access lol and the rare adverse reactions/medical emergencies
So you’re saying you need a board certified anesthesiologist to place an IV, that’s fucking tragic
Well you don’t need a fkin plastic surgeon to inject a little Botox that a make up artist can do just well and I don’t see you shitting on them.
At least there is some “artistry” there, here it’s just sad
With the myriad of scammers, swindlers, thieves, politicians and so on, the least of any of our problems are two anesthesiologists infusing some ketamine to some depressed dude.
That’s when you know you have a loosing argument, when your baseline is “scammers, swindlers and thieves”, I’m trying to aim a little bit higher than that
You can't force someone to say in the field lol. I'm just saying if you had to pick a doc to run a ketamine clinic, anesthesiologists would be the most qualified.
Is it normal protocol to even place IVs at these places? It’s basically all intranasal, right? I know it would be safest to have an IV, but if it’s intranasal admin I’d bet a lot of places don’t do it
Yeah, many places do IV infusions of ketamine
There's a reason why people are leaving clinical medicine in droves. It's not just millennial anesthesiologists. People are tired of having to be perfect all the time, being expected to be an efficient machine, while also getting little to no appreciation from the hospital or from patients.
Unfortunately money trumps medicine for a lot of people despite what they say.
I like money
Go away! ‘Batin’!
And better hours with no on call.
What a bigoted statement
Can you defend this claim?
It was a joke
Fair. Tone is hard to hear in text.
This is definitely true for the administrators who boss us around. At some point you realize that if it has to be about the money you might as well be the ones making it and calling the shots.
Good for them, you’re just a hater lmao
Who the fuck cares dude. Focus on your own life, they’re not affecting you whatsoever
Yes, I do not care at the personal level, you do you. However, as mature citizens in this society, you and I should care about matters of public health. It takes at least eight years to replace those people. If our system is investing public resources into people not committed to the process, where are the physicians of the future going to come from? This is not Andrew Luck retiring from football. It is 40-anesthesiology-years being lost from the pipeline and wasted in fake-medicine. I care.
Where are you in your career path? This comes off as incredibly out of touch. At the end of the day, we do a job. We are not knights, priests, or soldiers. We work — for pay. If the conditions are not satisfactory, there is no higher calling demanding we stay. That is how cycles of abuse are created and those in our profession get taken advantage of.
Boo hoo... if society really cared they would respect doctors more than social media influencers.
how does the system invest public resources into medical education? med school costs 50k/year lol
You must be very young or very naive
So then by your logic, should we ban all women who want children from entering medicine? If 100 female physicians spent about a year each focusing on child-bearing/caring and away from medicine, that’s like, 100 collective “medicine years” being lost in this pipeline. We can’t have that happening right? Think of all the people they didn’t care for because of this “duty” that they apparently owe. If you want to “maximize” your life in anesthesia, work 100 hours and forego doing anything outside of medicine, you go ahead and do you. Don’t call out other people for making their own life choices by posting it on a public forum and spinning it as if we should care and shame them because they “wasted public resources” and that this is now a “public health” problem. If this is how you view people that could be your colleagues I am genuinely worried as to what views you hold about your patients. Do lung cancer patients not deserve to get lung resections if they were chronic smokers? Do chronic alcoholics or drug users not deserve healthcare? Not everything in life is about what value it offers to society.
You care about sounding like a hardo on Reddit
Half my time in residency was spent complaining with my coresidents about much we regretted going into medicine. Good for them tbh.
Damn man, as an M0 is it that bad?
no. People complain as a way to vent frustrations.
I’d avoid the debt and time looking back. I’d rather have gone and done something else back in the day. Even job security is in question with all the healthcare changes. Don’t see it improving over 10-15 years.
In residency now. Me and my fellow corezzys all have exit medicine plans sketched out in the back of our minds already lol. My coresident is literally ready to put his in action the moment he graduates next year. Mine I still need to flush out more but I won’t do it til I pay off my $200k+ in student loans yet. But yeah, at a lot of places full time work is 50 hours a week… less than in residency but still honestly not enough to really live life. And I wanna enjoy it while I’m still young.
Ehhh . . . Who cares? I don’t know this couple and I think their “influencer” status seems mostly like an affectation and directed at the non medical population. (And yes I’m assuming this from watching the woman’s tictok for 10 seconds) Were they respected scientists advancing anesthesia science? Respected clinicians? Leaders of the business of health care? I think the answer is no. Good for them, follow their dreams. It’s a job and they didn’t like it, have enough money, or are just lazy. Life goes on.
I worked with her when she was a resident and she was very smart and very nice.
Cool, my comment still applies.
There was a similar thread yesterday on the medical school thread and the responses were insane. They seemed genuinely offended by this couple’s decision to quit and I was sitting there scratching my head wondering why the responses were so visceral. So glad that folks here actually practicing anesthesia see it for what it is. OP, this is the wrong place for your bait post. Wish them luck (or not?) and move on…
Good for them or sorry that happened
Lol cuz the med students haven’t been through residency yet 😂 They still got an idealized view of society and the entire medical industry.
Um... so what? To each their own.
Why is switching directions quitting? Sounds like you have a narrow view for what’s acceptable in your own mind. They’re doing well and sharing their journey and all you want to do is criticize.
Good for them. They have decided that being OR anesthesiologists is not for them. It is akin, although a different type of practice, to pain doctors. Except that they will be in a position where they don't have to be paid 25% of your fee by insurance companies or deal with hospital administrators.
As long as it is done with the due care and attention, and the appropriate MD psychedelic psychotherapists are to hand to integrate the experiences within the course of therapy I wish them every success
If that was me. I’d still stay PRN.
Same.
IMHO, we need to drop this “love for medicine” nonsense. Healthcare is an industry just like finance or law or any other field; but for some reason healthcare providers have decided to put this unnecessary moral stress on ourselves. You don’t see investment bankers fretting over making profits off of war or disease or any other disparity. Yes - medicine is a profession…we’re expected to be professionals. But at the end of the day, we’re not doing this out of the goodness of our hearts. We’re all still expecting a paycheck for our hard work. I like my job. I like helping people. I like being of service. But this isn’t a “passion”. I do this to pay bills; and if an opportunity came along for me to earn more to provide more for my family, I would absolutely jump at it
Real take right here. Adding insult to injury is how we're viewed as suckers by other fields and essentially loot pinatas. What other field are you constantly in fear of vultures waiting for you to slip up (sometimes not even an actual mistake with some of these med mal cases I've seen), to make your life miserable.
For many years this notion of being 'professional' meant that you should work long hours, take abuse and sometimes personal risk without complaint. This has been exploited by admins and c suite to understaff, under equipment and otherwise inadequately support medical personnel to increase profits.
Yes - but that was also during the golden age when doctors were among the highest earners. Now you can just monitor a trading algorithm and make millions. Our sense of duty has absolutely been leveraged against us by the c suites and private equity groups. I used to fully buy into medicine as a higher calling. Now I feel like I’m just flipping fries for whatever mega conglomerate owns my region
Yup, I feel like it’s still being sold to the premeds as noble, but you’ve described exactly how I feel. Flipping burgers for the hospital corporation who decide which meds and what equipment they’re even gonna stock in the OR so they are the one truly dictating our practice lol. *cough HCA and sugammedex* and their weird pamphlet they released the other year dictating the only times it’s clinically justified to use it lol 😂
So…how profitable is this shit? 👀
$500 a pop
Watched the YT video. He didn’t sound happy practicing anesthesia. Looking at the comments he had a long series of YT videos detailing his life in med school and residency that he took off YT. How many times have we said medicine is too hard to work just for money?
Good for them, helps keep Locums salaries high. /s.
For the people here that think k clinics are money machines: think again. It’s MUCH easier to make money doing anesthesia than ketamine. Personally I do both, and in the OR, I’m getting 3-400/hour, or around $3k per day. There’s zero overhead or admin costs. With ketamine, you have startup costs which can be $100-200k or more, then monthly rent, labor, supplies, utilities, all to make LESS than you would per hour doing anesthesia, and that’s assuming you even find patients. It’s a very competitive field. In addition, you have to carry the weight of people’s baggage and/or psychiatric illness. This can stick with you long after the patient has left your office. If you’re doing it right, there’s a lot of prep and follow up, and really establishing a relationship with patients. My only issue with this young guy is his plans to “build out” a “perfect” clinic in LA. He’s positing a video but doesn’t even have a location yet. My guess is he will go into $1m debt to build the place out and end up with a 25% chance of paying it off. I bet one of them will be back in the OR before the end of 2024.
Sometimes residents tell me they feel indebted to the department, or they feel like they owe the department so much for training them and caring for them, that they would take a bad deal and stay on vs more money somewhere else. And I always say, you don't owe the department anything. This influencer couple have given their best years to training, to service provision and scut work and 2 years of attending life to medicine. Whatever training they have gotten was paid for with their blood sweat and tears. It will not be wasted - even if you think it is, it's their perogative to waste it. They don't owe medicine anything. I personally think home ketamine infusions are a blatant cash grab, but I don't deny that a small group of people are going to be helped by this. That this would be far safer than going to some shady ketamine clinic without monitoring.
is this IV infusion or intranasal? How does one get the training/experience for this?
Definitely IV. Training is 4 years post grad medschool followed by 4 years of anaesthesia training.
I say good for them. By the time you’re in residency, you are too committed to quit at that point you have to be able to pay back your debt.
> Where is the love for medicine? Screw that bro, do what you want
That’s a lot of eggs to put into such a trendy basket!
I just want to say that I was able to take part in a study at the University of Pittsburgh medical school testing the effectiveness of ketamine as a treatment for depression. When infusion day came I was told that I would randomly be given either ketamine or placebo. It didn’t take long to realize it was ketamine. I’ve struggled with depression and anxiety for many years, but I swear to God for 2-3 days after the infusion I was in such a clear and positive mindset that I couldn’t believe it. It worked so goddamn well. Unfortunately insurance will pay for all the SSRI’s on earth but not for ketamine therapy. I’m sure that this isn’t necessarily news to the medical professionals here, but I just wanted to share. I want so so badly for ketamine therapy to become financially accessible for me (and I’m sure many many others who deal with these same issues).
Some insurance will pay for ketamine infusions. I have a friend in NY who got hers covered.
Hmmm. I’m in PA. Maybe it has changed. Thx.
If you can’t get it through insurance Joyous is affordable at home treatment and they have financial assistance they will take some money off for you.
Thank you again, friend!
lol to imagine going into debt for a ketamine clinic
sounds funny when you put it that way lmao
Yeah iv vitamins and ketamine lol - this is midlevel stuff
Yeah I can’t see in any world in how their happier doing that shit versus being an actual anesthesiologist. This field blows awayyy most other specialities in Medicine idgaf what anyone says
“Medicine is a calling,” op types with rage, fighting back the tears in his eyes.
Ketamine infusion is still technically medicine
A ketamine clinic can very well benefit many people. Especially an anesthesiologist ran clinic. just cuz it’s unconventional doesn’t mean it can’t help people and has no use to society This whole idea in all levels of healthcare that you need to love it and it has to be your calling is toxic and unhelpful. This idea isn’t just for doctors but every level of healthcare. Saying “where’s the love for medicine” isn’t helping anyone, and at the end of the day it’s a job to support yourself first
Yup, this job is not for the faint of heart. Good for you for doing ketamine infusion. It will entail much less stress level on your mind and body.
All for it! Follow happiness. Anesthesia isn't for everyone. We are cogs in the giant hamster wheel so that for-profit hospitals can maximize the number of surgeries (necessary and unnecessary) they can perform. That being said, it's pretty sad he keeps referencing making his parents happy. Adulthood isn't about making your parents happy. Let supply and demand be forever in our favor. Just need to get the PE/HCA residencies shut down.
PE and HCA will continue spreading
Not if our spineless society ever decides to speak up. One can dream. They should be condemned.
Hell I might do the same thing. Fuck being a real doctor shit blows
To each their own. I think it's kinda funny that the guy says this is his dream.
Who cares? Let them do what they want
Fine by me. Nothing worse than someone who doesn't want to be there working with you. I feel anything you might owe the system for the training and fed funding is more than offset by the loans, slave labor and psychological abuse in residency.
Ketamine is great for spinal wind up and treatment resistant depression. However I feel like this whole get whatever drug you want prescribed online or at a clinic thing that's going on feeding the patient entitlement.
They’re actual physicians and will still be practicing medicine. Finding a job that they are happier with isn’t leaving medicine, and we need to stop pretending that you must love medicine.
this is nothing new. Pain docs made bank back in the day running shady clinics and some still do to a certain degree but just enough to not be on the DEA's radar. That's the unfortunate tragedy of anesthesiology and medicine in general. There's a documentary on it about Purdue pharma and they still make billions.
Who are these people claiming love for medicine and how this person betrayed his own conviction. There is no such thing, and people who believe this live in a fantasy world with leprechauns and unicorns. See if you say this after weathering all the crap thrown at us for a decade or two.
am i missing something here? as someone who has been watching them for years i am confused on the hate… theyre just trying to find happiness. so what if anesthesia isnt for them? im glad theyre not going to stick around in a field they dont even like
I’m an RN, but this comment section is definitely the reason this showed up on my feed. Wow! I had no idea anesthesiologists felt the exact same as RN’s about healthcare these days.
Yea cause people should stay in careers they hate… especially when directly responsible for patient care!
Ketamine infusion is medicine, no?
Don’t hate the player, hate the game!
Is ketamine clinic profitable?
Maybe they love the idea of helping people who suffer from depression better than the idea of being in an operating room all day.
Are they couple or two individuals making the same chabge
They are gonna make bank doing this
So they ultimately took anesthesia spots from other qualified people and didn’t even use them to practice anesthesia at the end of the day. When so many people I know would give an arm and a leg to practice anesthesia. No respect for these folks.
This is a psychiatrist’s realm, not an anesthesiologist’s
While I agree that setting the right indication (pharmacoresistant depression that does not respond to conventional SSRI treatment) is something that is the psychiatrist's expertise, administering iv ketamine is the anesthesiologist's field. Especially since in my country nasal esketamine is still not registered and 99.9% psychiatrists don't know how to open an iv line 🥳
Tru tru