ELI5: Why do anesthesiologists make so much money?

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Of course anesthesiologists go through a lot of schooling (4 years of bachelors, 4 years of medical school, 4 years of residency) with all the training that they have of course they would make a lot of money. However some anesthesiologists are making as much or even more than surgeons. For example I shadowed an oral surgeon who said he makes 500k a year, an anesthesiologist that came to my school said that he made 750k in 2024. I should also add that this oral surgeon sedates patients himself while simultaneously performing surgery.

I don’t want to say that anesthesia seems simple because it definitely isn’t, it just seems like a variety of other medical specialists administer anesthesia as part of their job but they still make less than an anesthesiologist. For example emergency medicine physicians make about 300k per year and they sedate patients as part of their job yet. Gastroenterologists sedate patients as part of their job and still make less than anesthesiologists.

Why do anesthesiologists make so much money when other medical specialists administer anesthesia as part of their job and make less.

Comments

  1. Monte_Cristos_Count Avatar

    Supply and demand. Anesthesiologists are an active part of every major surgery and some minor surgeries 

  2. BluntsForBlondes Avatar

    i mean there job is to keep someone juuuust alive enough to not be dead but not alive enough to wake up screaming on the table. i’ll pass on that job lol

  3. Interesting_Ninja210 Avatar

    Because when anesthesia goes wrong, people don’t get better — they die.

    It’s not about pushing the drugs, it’s about keeping someone alive while they’re one bad dose away from disaster. High stakes, high pay.

  4. GreenArrow40 Avatar

    They have the highest malpractice insurance cost of any doctor. Some as high as $300k+ a year.

    Edit: I am not in the medical field. I simply heard one of my friends that is in the medical field say that one time many years ago. No idea how accurate the dollar amount actually is. Take it with a grain of salt.

  5. CurtainKisses360 Avatar

    High skill. High risk. Your job is to keep the person asleep but also alive during surgeries that can often be invasive and delicate like a CABG. (Opening the heart and replacing a vessel with a graft from another part of the body).

  6. SSYe5 Avatar

    i’ve heard a comment describe it was 1% terror and 99% boredom

  7. SinisterSoren Avatar

    Personally, I don’t think they make enough money. When that goes wrong, it can go very wrong very fast, and you might not wake up.
    I would prefer my anesthesiologists be paid enough to care a whole lot about me.

  8. RingGiver Avatar

    If your job is to make sure that people don’t die when someone else is cutting them open and doing some redecoration, that’s actually a pretty valuable skill set and you can get paid pretty well for it.

  9. 10luoz Avatar

    You kind of answered it yourself. Sedation and Anesthesia are classified differently thus attributing the the difference in profession and pay.

    This is like asking why there is a difference in cardiologist(heart) vs orthepedic(muscle)? The heart is a muscle, after all.

  10. Bulky-Protection7078 Avatar

    There is a pretty big difference between giving somebody morphine for a kidney stone and keeping somebody under but alive while they go through a total hip replacement.

  11. e11spark Avatar

    There’s a very fine line between life and death. I’m OK with my anesthesiologist making a fuck ton of money if they keep me alive on the table.

  12. PoopinElmo Avatar

    My friend is an anesthesiologist, she’s always says “they don’t pay me to put you to sleep, they pay me to wake you back up again”

  13. Affectionate-War7655 Avatar

    Because they’re something that’s absolutely necessary for surgery to happen.

    Like yes, a surgery can’t happen without a surgeon to do it. But a surgeon can’t do it without an anesthesiologist.

  14. LawfulnessRemote7121 Avatar

    An anesthesiologist literally has his or her patient’s life in their hands, even more so than the surgeon. They earn every penny they make.

  15. allmimsyburogrove Avatar

    I’m not sure let me sleep on it

  16. Bionic_Ninjas Avatar

    While other medical professionals may administer anesthesia, it’s not the same as being an anesthesiologist.

    To undergo major surgery, you need a significant amount of anesthesia. Enough that you are walking a fine line between being unconscious enough for a surgeon to chop up your body and being so unconscious that you are dead.

    You’re not ever really in a state of equilibrium while under anesthesia, as in, they can’t just put you under and that’s it. They are actively monitoring your condition throughout the surgery and adjusting the amount of anesthesia you’re given.

    I’m sure that like everything else in medicine, most of the time things go smoothly enough. However, there are a lot of of people with medical conditions who still need surgery. People with heart conditions, and other issues that make anesthesia very dangerous.

    The reason these people make the money they do is for surgeries like those where even a minor miscalculation can result in a patient’s death

    I also have to imagine that since it is not as glamorous a specialty as being a surgeon, there is significantly lower supply of anesthesiologists, which means they can demand more for their services. That’s just basic economics

  17. TheEschatonSucks Avatar

    People hate dying while having surgery

  18. rrickitickitavi Avatar

    They don’t get paid all that to put you out. They get paid to bring you back.

  19. CommitteeOfOne Avatar

    The best description I’ve ever heard of an anesthesiologist’s job is “they keep the surgery from killing you.”

  20. Professional-Rip561 Avatar

    Because it’s a very difficult job with dire consequences if done incorrectly.

  21. Faangdevmanager Avatar

    You bring people on the brink of death. They get paralyzed, stop breathing on your own, organs are fighting back like hell, and it puts a stress on everything. And yet you have to do it with the minimum dose with constant adjustments.

    For every 25 year old healthy patient that just follows the standard protocol, we have like 10 elderly patients with comorbidities who can code at anytime but must be kept fully paralyzed for 6 hours.

  22. Flatulent_Father_ Avatar

    I’m an anesthetist. I make pretty good money. I came out of school with $270k in loans.

    There is a lot of responsibility with the job and a lot of risk, relative to other specialties. When things go wrong, they can go really wrong. I would not do this for less. I would find a more chill, easier job. I also wouldn’t be able to pay off my loans making much less unless I paid them over 30 years.

    Also, it’s worth looking into what else goes into that figure you quoted. If the anesthesiologist is doing a lot of locum 1099 work, they can make way more than normal (like easily double). If they’re working a lot more than 40 hours per week (the ones in my group probably average 50-60ish with in house call), they’ll be making more. If they’re a part owner of their group, they’ll make more.

    Also, the way billing works, if an anesthesiologist is in a state with CRNAs and the state requires direct oversight, the anesthesiologist can (basically) bill for half of each of the 4 cases they are overseeing. It effectively doubles what they’d be able to make if they were doing cases in the OR themselves.

  23. AlecMac2001 Avatar

    anesthesiologists are focussed on keeping the surgeons victim alive. Most important person in the room.

  24. Tinfoil_cobbler Avatar

    My wife is an anesthesiologist and literally went to school for ten years. We still have $250k in student debt. Also, I saw lots of people fail out of her program, it nearly broke her, it was like the Navy BUDS of schooling. I got a front row seat to all of her training. And now, her work is still not that easy.

    I think they deserve every penny, and I usually don’t say that about most jobs.

  25. DrSuprane Avatar

    Your numbers are quite off. I know EM who makes more than me and that oral surgeon is very likely making double what I make. Most anesthesiologists aren’t making 750k.

    Half of a hospital’s revenue comes from the OR. It’s in their interest to have anesthesiologists that can support their revenue generating business. What we do is complex and poorly understood by almost everyone. But we’re paid well because without us surgery doesn’t happen.

  26. St_Beuve Avatar

    I used to tell my interns that we weren’t paid for the job we do but for the job we can do. When shit hits the fan everybody look at the anesthesiologist hoping he will save the situation.

  27. chirpchirp13 Avatar

    My pal is a now retired anesthesiologist. He described it as the hardest and most stressful resource management video game anyone could play. He retired at 45 because of the stress.

  28. Ok-Package-7785 Avatar

    My Dad, also a physician, explained it best; it’s 15 minutes of the most stress you have ever experienced followed by 45 minutes of boredom. Highly skilled, high risk, high liability equals more pay.

  29. Kange109 Avatar

    If I am being cut open, i sure am willing to pay to ensure i dont wake up with my gut still sliced open.

  30. Dedward5 Avatar

    They don’t get paid to put you to sleep. They get paid to make sure you wake up again later.

  31. Low-Speaker-6670 Avatar

    Anaesthetist here.

    Let me try explain. An anaesthetist or anaesthesiologist isn’t just sedating someone. In essence we are the ones keeping you alive while the surgeon is often doing things which would kill you.

    The science is complex and difficult but as someone who’s been both a surgical trainee and an anaesthetic trainee anaesthetics is harder academically (in the UK at least). It’s tough to explain without actually showing you what goes into it but to me it’s like flying a plane you don’t see the pilot and hey it’s a clear sky so surely it’s a simple job. But you just aren’t appreciating how badly things can go wrong and how much goes into making it look easy.

    And no, no surgeon can give an anaesthetic and perform surgery safely. Sedation and a general anaesthetic aren’t the same thing. A heavy whiskey can be used as sedation, a general anaesthetic is in essence hooking you up to life support.

  32. koro_survivor Avatar

    Anesthesiologist here.

    One thing that hasn’t been mentioned: anesthesiologists have very low overhead.

    Surgeons often bring in more money than anesthesiologists for doing a surgery, but their overhead can be 40 to 60%. They have to pay rent and utilities for their office, plus salaries for front desk staff, schedulers, billers, nursing/physician’s assistants, imaging techs, plus higher malpractice insurance, the list goes on.

    An anesthesiology group’s overhead can be less than 10%. They can have one or two administrators for dozens of doctors. There is no office to pay rent for. If there are assistants, like CRNAs or CAAs, they are generating income and paying for themselves. Malpractice insurance tends to be lower depending on the state.

    So while an anesthesiologist might generate less money than a surgeon for getting a patient through a surgery, they are keeping more of it.