Awakened Anesthetist

Your Complete Guide to Understanding Certified Anesthesiologist Assistants Pt. 4 How Much Do CAAs Make?

• Mary Jeanne, Certified Anesthesiologist Assistant • Season 4 • Episode 69

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Curious about what it truly means to be a Certified Anesthesiologist Assistant (CAA)? You're in the right place! From nearly two decades of experience, I share a clear and comprehensive breakdown of the CAA profession. Think of me as your older sister or best friend, guiding you step-by-step through the essentials—from what CAAs actually do to how much money we make, no topic is off limits. Whether you're an aspiring AA student or simply exploring a career in medicine, this guide equips you with the insights you need to understand the CAA profession.

In Part 4 I am answering the question, "How Much Money Do CAAs Really Make?" Understanding the financial aspects of being a Certified Anesthesiologist Assistant is essential for those in the field or considering entering it. 

In this episode I discuss:

  • Current salary averages ranging from $190,000 to $300,000 
  • The historical evolution of CAA salaries since the 1970s 
  • The average student loan debt for CAAs 
  • Why salaries vary based on location and institution 
  • Insights from CAA job market expert and founder of BagMask.com Patrick Flaherty, CAA
  • Mega Sign-on bonuses and how to navigate 


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Speaker 1:

Welcome to the Awakened Anesthetist podcast, the first podcast to highlight the CAA experience. I'm your host, mary Jean, and I've been a certified anesthesiologist assistant for close to two decades. Throughout my journey and struggles, I've searched for guidance that includes my unique perspective as a CAA. At one of my lowest points, I decided to turn my passion for storytelling and my belief that the CAA profession is uniquely able to create a life by design into a podcast. If you are a practicing CAA, current AA student or someone who hopes to be one, I encourage you to stick around and experience the power of being in a community filled with voices who sound like yours, sharing experiences you never believed possible. I know you will find yourself here at the Awakened Anesthetist Podcast. Welcome in, hello Awakened Anesthetist community and welcome back to the Awakened Anestis podcast. I'm your host, mary Jean. I'm so grateful you're here. If you're a practicing CAA or a current AA student or someone who hopes to one day be a future AA student, I'm really grateful that you found this feed, this podcast, this community. It's such a rare and special thing to find a group of CAAs because, number one, there's not a lot of us and number two, there's even fewer of us, sort of putting ourselves out there trying to find community, create community share about the profession. And as I have continued on this podcasting journey, I can just really feel that one of my main reasons for being is to create deeper connection within the CAA community connection to yourself, connection to your work in the world as a CAA and connections with other people in this community. So I'm just so grateful you're here and I love bringing this podcast to you.

Speaker 1:

Today. You have tuned in to the fourth installment of the Complete Guide to Understanding Certified Anesthesiologist Assistance. This episode is going to be a breakdown of how much money CAAs make. The first three episodes are in the back feed of whatever podcast platform you're listening on. They are a deep dive into what a CAA is and is not. They also include where can CAAs work, which is a more complicated scenario than you would think. And the last one is why I think you should not be a CAA, as well as some reasons why I love the profession and highly recommend it.

Speaker 1:

So to really understand and get the most out of this episode even though this one might be one that draws you in you probably want to listen to those back three episodes because I'm going to be using some language, some jargon. I might be speaking sort of quickly and if you're really new to the profession, it might be hard to get all of the takeaways or really understand what I'm saying without those three prior episodes. So if you're with me and you're all caught up and you want to talk about how much CAAs make, I really want to stress that this is a conversation that's meant to be sort of a best friend conversation or, you know, your mentor, your CAA mentor, just giving it to you really real and giving you some behind the scenes explaining things, just like I would if we were having a friendly conversation over coffee and you were asking me questions about salary and how this is all created and compensation plans and I have recorded this episode, I'm not lying probably four times and I keep not liking it and I'm not exactly sure why, except for the fact that talking about money is a little bit tricky no-transcript, as well as someone who feels very deeply committed to the profession that I in no way want to be like, join our profession. It's so amazing. You get paid a lot of money period, end of story. Oh, amazing, you get paid a lot of money period end of story, because being a CAA, yes, has a perk of making a good salary, and there are so many other reasons to also be a CAA, and it is a very weighted decision and the money will not make you happy if you are not meant to be a CAA.

Speaker 1:

Giving anesthesia is a very particular type of career. Being a CAA is actually a very limiting career in terms of transitioning your skills to other areas in the medical workforce Certainly not impossible to transition, but it is a very unique, very specialized master's of anesthesia degree that you know makes you basically an expert in doing exactly one job. So the purpose of this episode is to shed some light onto three areas that I think are particularly important to understand, as well as three areas that I think people haven't really talked a lot about, and those three areas are the history of money and the CAA profession. The second one is my take on how the salary is one aspect of the money, and we also have to remember on the flip side of every big salary is also a large amount of student loan debt. So I really want to share some more information about how much it costs to become a CAA.

Speaker 1:

And then the third piece that I really want to talk about is trying to break down why the salary of a CAA can vary so much from state to state or city to city within the same state, or even from institution to institution within the same city. There can be different salaries and sometimes a large range of salaries, and if you are not familiar with this profession and or if you're a CAA and you just only know about your local community of CAAs, you might not realize that you could make more or work less or work differently in a different area of the state or city or country, because CAAs, again, there's not very many of us and we tend to just only know about our immediate surroundings. It's kind of new for us to be out there on social media talking about how much money we make and where we live and why we get paid, what we do and how you make that money, and so I'm just going to add some clarity to all of that for people who are practicing CAAs and especially for people who are new to the profession or considering becoming a CAA, so you can kind of understand what goes into someone's salary, all the many factors, what goes into someone's salary, all the many factors. Okay, so we probably should start with just me stating what the average annual salary of a CAA right now currently it is January 2025. And I would say that the average full-time salary of a working CAA with zero years of experience so a new grad is anywhere from $190,000 a year to $300,000 a year. And the wide range of that salary the $190,000 to $300,000, can be very confusing, as why there's there that difference and what makes up that difference. And so in this episode I really want to shed light on where those numbers even come from.

Speaker 1:

How can there be such a difference? I want to explain some of that, but I first think it's really interesting to start with the history of our salary, because we certainly were not making $190,000 or anywhere near that when the profession started in the very early 1970s, when the first classes were graduating and working as practicing AAs. At the time they were called anesthesiologists assistants at the time, and I have just a unique perspective because my dad, dan Ladke, happens to be the second graduating class of CAAs out of one of the original schools. So teeny history lesson Emory University in Atlanta and Case Western Reserve University, their main campus in Cleveland, were the first two AA schools and the only AA schools for decades and it is only recently now where we have more than 20 AA schools and counting as of 2025, all of that growth has happened really within my career.

Speaker 1:

I graduated from the same school my dad did Case Western Reserve University in Cleveland Ohio. I graduated in 2008 and my dad graduated in 1974. So really in the 17 years I've been practicing as a CAA, there's been a gigantic boom in schools created. That, will you know, create more CAAs in the world, which has obviously had a huge impact on the economy for CAAs and our salaries. So I have this very special person I could call my dad and I'm going to play a clip right now because I was like wouldn't that be interesting to hear how much AAs used to make? And so I called my dad and I just asked him some questions about his beginning salary, what he could remember and let me play that now because it's super interesting I think you're going to be kind of blown away. So where you come in is hoping you could remember how much you made you graduated in 1974. And then how much you made in the first job and then, if you remember your first big jump in pay.

Speaker 2:

I remember both of them. Okay, my first job, st Vincent Charity I made $12,000 a year. That did not include call or overtime pay, which took me up to about $18,000. Okay, there was about 6,000 in overtime and call. The next big jump that I had was when I went to Seattle in 76, mary was that and my salary went to $25,000 a year but there was no overtime. Thousand dollars a year, but there was no overtime. There was just a straight eight hours a day and no, no calls, no weekends or anything like that. Then I came back from seattle 81 or 82. 81 or 82. Back to Cleveland and my salary was probably at $50,000. $40,000. $40,000? Yeah, it was about $50,000. It doubled almost my salary in Seattle.

Speaker 3:

Yeah.

Speaker 2:

Okay.

Speaker 1:

All right. Well, that was what I was hoping for. I don't think very many people can call one of the earliest CAAs and ask them how much they made, so I know that will be an interesting thing.

Speaker 2:

Yeah, now we were at 12,000 a year. We were the highest in the city. Wow, I know Metro, that was a charity. Yeah, that was a charity. Um, metro, I think, was at 10. They started 10 000 a year and, yeah, they may have had better benefit, I don't know but awesome interesting, awesome, okay, oh, and also wait.

Speaker 1:

Do you remember how much Case cost Case when it was an undergrad? Do you remember what the cost of school was my freshman year with tuition.

Speaker 2:

Just tuition was $4,000. Oh my gosh, yeah, $4,000. And if you had room and board, I think that added on another $2,000. So I think it was about 6,000 total. Of course I was living at home, so I was 4,000.

Speaker 1:

Yeah, okay, all right, thank you, I'll talk to you later All right, bye, bye.

Speaker 1:

Thanks, dad, for offering those memories and your experience. I actually started my love of storytelling from my dad and if you knew him as a CAA, he was a big storyteller. He was also a really great educator and spent the last years of his career at University of Missouri, kansas City MSA program. He retired several years ago and now is enjoying retirement with my mom and you could tell that they've been married for almost 50 years because you hear my mom in the background answering the questions for him. But yeah, I just I love that I have that resource and I can share him with all of you. Okay, I will then share that.

Speaker 1:

When I first started in 2008, I was working in the state of Missouri, which was a fairly new state for AAs at the time, and my beginning base salary was $120,000 a year, and then I had the additional ability to make about $40,000 to $50,000 extra in call pay and overtime pay, and so I think the first year I came out with about $160,000 of salary, of money made, and now I am overall, like per year, making around a hundred thousand dollars total. I make two hundred dollars an hour working PRN and I'm working about four to six shifts a month. So I'm working far less and making you know almost my base salary. I probably I haven't actually got my W-2 yet for this first year of working PRN, but I suspect I made more than $120,000 just working that little. So it may seem kind of obvious to state, but I want to put a fine point on the fact that they can advertise. So a job can advertise, you know, a $250,000 salary or compensation package and within that you're going to want to figure out the fine print of how many hours you need to be working in order to make that amount of money. So, for example, you might be guaranteed some sort of base salary let's say $170,000 base salary and all the additional money to get from $170,000 to $250,000 is call pay or overtime opportunities or working weekends or nights.

Speaker 1:

That could be true and it also could be true that it's $250,000 and maybe you get put into the call pool. You don't have a choice whether you take call or not. Maybe you can like trade them away, but the $250,000 per year means that you have to take your fair share of call. And of course the next question is what does call mean? Does call mean I'm sleeping at the hospital? Does it mean that I have to live within a certain mile radius and be available immediately on my phone to come in. You know, to drop everything, come in and so the money is sort of a useless point until you know how much work you need to do to secure that compensation package.

Speaker 1:

And again, I keep using salary versus compensation package because they are two different things Salary is the money that you get in your paycheck every two weeks and your compensation, which can be listed in a job, like they can say, the total compensation is $300,000 or $350,000, but your salary maybe is only $250,000. And the other extra money is maybe them referring to things such as sign-on bonus or travel allotments for educational opportunities or CME funds or ways that they cover your insurance or distributions into a profit sharing. All of these things in terms that you're going to need to understand to really have an understanding of how much money you should be expecting in your paycheck every two weeks or month or week or however they pay you, and then where this other compensation is going. Because it is still valuable to, let's say, have your employer pay your entire health insurance premium. That is still a value to you. That has money attached to it, but it's not actual money put into your paycheck. Ok, hopefully that's clear enough to say that you need to ask a lot of questions, that things are rapidly changing when it comes to salary, compensation, the money that you will receive as a working CAA, and that it is very much tied to the economy, to supply and demand, to a lot of other outside factors that we're going to talk about later on this episode, like location, like where you are in the United States and how desperately your hospital needs people, yeah. So hopefully that helps sort of clarify why some websites or places on the internet can say, yeah, the average salary is $170,000. And then another place says, oh, the salary is $350,000. That's kind of a lot of different money and how did they come up with that? So, ask questions, be your own best advocate and understand what you're getting into before you just think, oh, this is a really great way to make a big salary. Okay, let's move on, because we have so much more to talk about.

Speaker 1:

The second thing I wanted to talk about is student debt. So, yes, we make $190,000 to $300,000 of salary or of compensation, but you have to pay to go to AA school. There is no scholarship. There's no full ride to AA school. Unless you have someone in your life who is helping you pay for it, you will be coming out of grad school AA school with a significant amount of student loan debt. It is not possible to work in any appreciable way while in AA school, so unfortunately that means you have to take out a lot of student loans or have a bunch of savings. Now, when I graduated from Case Western Reserve University in 2008, I had a total of $160,000 of student loan debt. That was about $40,000 from undergrad and $120,000 from graduate. I would say that was probably about average, and because I've graduated so long ago, I wasn't sure how those numbers had changed, and so I kind of phoned several other CAA friends, caa content creators, who are not shy either about sharing their salary or how much debt they were in or are still in, and it seems that you know, despite the circumstance where you have someone who pays for it or you had a huge savings before you went to AA school, about $200,000 of student loan debt is normal to come out of AA school with.

Speaker 1:

And I spoke with the founder of Anesthesia OneSource, which is a fabulous website if you are a prospective AA student and wondering which AA school would be your best fit. Anesthesiaonesourcecom absolutely incredible resources. She has a really cool and recently updated infographic of the cost of all of the AA schools and she was kind enough to allow me to link it in the show notes. But it really shows how expensive AA school is. And per Jen, who is the founder of Anesthesia OneSource, aa school only gets more expensive year after year. The prices keep going up. You know several reasons. I don't know that I'm going to get into them now, but just to expect that AA school will only become more expensive.

Speaker 1:

The least expensive school at this moment total tuition costs, so not including fees, like all your books and supplies and things, and not including living expenses, which of course you have to factor in. So this is not including that. The cheapest school is if you are a Colorado resident and going to the University of Colorado is $87,780. The most expensive school is University of Texas at Houston to non-residents. So of course that's a state school. If you're a resident it's a little cheaper. If you're a non-resident it is $192,000. Yikes, let me see what Case is, just because now I'm interested. Case is $144,276 tuition only to go to their AA school and it looks like that's across all their campuses. Wow, that's kind of expensive.

Speaker 1:

So again, yes, you make a great salary, but you're going to come out with a hefty amount of student loans to be paid back over the course of whatever the loan terms are 10 years, 15 years, 20 years and, of course, you have options to consolidate loans, to put it on a personal loan, pay off all the student loans, put it on one consolidated personal loan and pay that. Of course, there's interest rates involved with all of this and interest accrues on your student loans and all of that financial stuff needs to be thought of when you are looking at this profession, as well as when you are about to graduate and wanting to take your first job. Yes, maybe you're going to make $200,000, but you need to be aware of what your plan is to pay off your student loans or the debt you have. You know, going into your first job, do you want to sort of hit it hard and pay it all off? You know, within the first few years of working, do you want to spread it out? How much of your budget are you going to put towards paying off your student loan debt?

Speaker 1:

Huge, huge suck of your salary is paying off your student loan debt. Huge, huge suck of your salary is paying off your student loan debt and people approach that in different ways. So one of the beautiful things about being a CAA is that you make enough money that you can reasonably pay off your student loans. You know, if you were to think of getting maybe a teaching degree from Harvard or something, you could come out with the same amount of student loan debt and then if you think of trying to pay that back on a teacher's salary, it's going to take you a lot longer than paying off $200,000 of student loan debt as a CAA who's able to make $200,000 plus a year. So that's a huge perk of the CAA salary is that you actually can afford to pay off the school that it took to get there, but it's not nothing.

Speaker 1:

I believe I was paying close to $3,000 every month on my student loans and it still took me nine years to pay off my student loans. Of course I got married and I paid for my own wedding and we bought a house and of course life happens and I was able to pay for all of that myself, but it still took me nine years to pay off $160,000 of student loan debt. I think that's all I want to say about that. But, yes, do not forget that it's going to cost you money to make money. So the third thing that I want to share is what I was probably most ignorant about and most nervous to comment on, which is current market trends.

Speaker 1:

And you know the very active job market right now and that number that I told you, sort of top of the episode salaries being, on average, $190,000 to $300,000. That's very new. It's very new for a CAA to be reaching that $300,000 top mark and even now I just saw a salary for more than $300,000. Like actively, it's changing day by day, depending on a whole bunch of things that I'm not super sure of. I kind of know, but I wanted to bring in an expert for this piece so that CAAs could be armed with the most current information, even if it's changing rapidly. And if you are a prospective AA student, I think this is really going to give you a great resource.

Speaker 1:

Number one the expert I'm about to introduce and give you a really good sense of why there can be that large fluctuation of salary, why some hospitals can be paying $190,000 and some hospitals maybe have to pay $300,000 or are paying $300,000 or more, and again, I just wanted to give more of the nuance behind some of these big numbers that we're currently hearing in the CAA profession. So, without further ado, let me introduce Patrick Flaherty. Patrick is a fellow CAA. He is also the co-founder of bagmasscom. That is an anesthesia job board as well as educational resource site, and I'll have him explain more exactly about the vision and mission of bagmaskcom.

Speaker 1:

But Patrick popped into my mind when I was thinking who can I call that will know about really the moment-to-moment changes in the job market and really what circumstances brought CAAs to the salary that we are seeing and enjoying now in January 2025. So, patrick, thank you so much for saying yes and thank you so much for being the expert needed in the CAA job market. Do you mind sharing what bagmasscom is and how it has really put your finger on the pulse of the CAA job market, how it has really put your finger on the pulse of the CAA job market.

Speaker 3:

So really, to explain what bagmascom is, you sort of need to hear its origin story. And that really began with talking to students whether they're SAA students or CRNA students or residents about how to be a professional in the anesthesia job market, because the schools do an amazing job of teaching us how to be anesthesia providers. But when it came time to step out and start your career, I had no idea and most students don't have an idea of how you write a CV, how you apply for jobs, how you understand what a sign-on bonus is if you're lucky enough to get one. So it really began with trying to fill this gap of professional development for students. So I thought it'd be a great idea. Let's start writing these professional development articles. And on top of that, I want to be able to create a way for us to give back, and that was with the form of the anesthesia scholarship, because there really wasn't anything at that time.

Speaker 3:

But then the catch comes is how do you pay for that anesthesia scholarship? Do I pay for it out of pocket? I wish I could. I don't make that much money, but how can I get companies. How could I reach out to the anesthesia companies, the groups that we're going to be working for one day, to help sponsor this? And the more I thought about it, the more work I realized was going to be to constantly go out and ask these companies hey, please sponsor this anesthesia scholarship. I thought, well, why don't I start a job board to go along with this website? Let's just make one place where you can go, learn all the stuff you need to know about to be a professional, create a career, get a scholarship and then be able to find a job at the end of your student journey and then, even once you're past being a student, you know practicing, you can come back and find a job.

Speaker 1:

And the idea was, in fact, you get these companies, come on, post their jobs they could pay the website and then I could turn around and take that money and give it back to the community. And since its launch, I feel like you have expanded into different states, like the reach of it has really broadened. Can you speak on how your understanding of the CAA job market has deepened and where it is now in terms of even just seeing the trends over the what five years? How long has the job board been up?

Speaker 3:

No, so it's actually probably six years as of today or tomorrow, but I don't really count that first year. That was just really a lot of trial and error. But, holy cow, to be a CAA or SAA right now, it couldn't be any better. I've never seen the market the way it has been before and just the growth that we're seeing. So let's take why that is multiple reasons. One is we've had some great leadership start thinking about we need to open up more schools, so we're putting more providers out there and this comes to be a great question of like how many schools are too many when you start dumping out more providers? We can talk on life about that.

Speaker 3:

I've been on both sides of this use and I'm on the opposite side now, where I was 10 years ago, and that's where I think we do need more providers. We need people to get their voices out there and start knocking on doors and say the big turning point really was COVID. As horrible as COVID was for a lot of families, a lot of people individually, it shined a light on the anesthesia market. That was sort of it was always there, but they were able to sort of mask it. Now it's just how many providers were actually needed to fill positions. Oh, wow.

Speaker 3:

So it's COVID. Covid has been the big driving force. It's shown that they need more providers out there and what this has allowed is for more hospitals to open up. It's allowed for more states to open up and at the same time, we've seen this increase in salaries not only just for CAAs but for the CRNAs and anesthesiologists. Because when it comes down to this increase in salary, it comes down to market demand. This increase in salary, it just comes down to market demand. Okay, Before COVID, a lot of times the salary stayed stagnant for a very long time. There wasn't really anything pushing them up. The only time I ever saw an increase in my salary is when one anesthesia group left and another one came in and they wanted to keep the providers there.

Speaker 1:

Yes.

Speaker 3:

But what COVID did was it showed all. Right now we're really struggling trying to get providers in this hospital. We need to increase our salary. So I'm going to keep using DC as a great example, because it ended up becoming a market work there. One group would go up, next group go up and the next group go up and it's just a ladder into your system until they finally got to a. They're doing pretty well to the point where DC right now unfortunately unfortunately, depending on how you look at it if you're a person licensing part-time or PRN there's no spots in DC right now Really no hiring. So Washington Hospital Center might be hiring.

Speaker 3:

I've heard one to two people is coming here. That place could never get anybody to stay there. There was always a revolving door, but they've come around where the salary makes it worthwhile. For a long time they thought major city people want to live here. We can pay them less because they want to be here and it sort of worked but it didn't work. So DC is the only marketplace right now in the US where AAs would have a tough time finding a job. Wow, except outside of DC, and like the market's awesome, everywhere you go there's job opportunities. It's never been a better time for you to be able to go out there and really sort of cherry pick where you want to work okay and um uh.

Speaker 1:

One of the reasons I started this podcast is because CAAs can get really siloed in the reality of like the 20 mile radius around where we live, which is true for me in terms of the job market. I know fairly well the Kansas City job market. Share with us what it looks like in terms of the regions of the country and you can really speak to a CAA who understands the fact that we can't work in every state. Really speak directly to maybe even a practicing CAA, if you want to use that language, on why different regions of the country have different salaries and where you're seeing demand higher or lower. I mean, I don't even know what question to ask because I don't know the details. But talk on that, patrick.

Speaker 3:

Yes, all that stuff. It's a very complicated topic. Yes, because even within certain states you see regions where the pay is a lot higher versus other areas and I can't always answer to why that might be in certain states. But I'd tell you right now, the states with the three highest, most amount of job posts and it sort of makes sense, one per population of the thing is, and one just because we're A's has been for a long time. So Georgia, still one of the hottest spots Most amount of jobs you'll see on a job board right now are coming out of Georgia. Number two and three are going to be Texas and Florida, and part of that is land mass and the population there. There's a lot more places but there's still a lot more hospitals we could potentially be in in those locations. As far as salaries going, it's pretty much the same across the country right now.

Speaker 3:

A lot of things, at least for the top practicing CAs when I mean top practicing, I like the best CA, people with experience. A lot of the jobs are topping out now around $260,000, $250,000, $270,000, in some areas even a little bit higher. For a new grad, though you're going to be like well, I'm not making that, they're only showing me like $200,000. But that's the way a lot of these companies work is. There's a tier system. You come in, you start at a base level and then, based on your years of experience or sometimes it's even just being within the same group you get bumped up higher and higher. But even on that, 200,000 is very, very common nowadays for somebody to come out practicing, which is insane to think about. It's awesome. I mean, if you're an AA student right now, you don't really realize because you don't have the perspective of like. You have life, you've won. Basically, you've won lottery.

Speaker 1:

At this point in time, you have a job, you're coming out in your early 20s, especially if you went straight from college to A school. You're crushing it. You really are. Yeah, can you speak a little bit to whether the 260 is a straight salary or does that mean you're working overtime or call? Or is that with package, like when you see a salary can we assume that is not including benefits or is including benefits? Can you speak to that?

Speaker 3:

Yeah, don't assume anything. Okay, great, that's. One of the great things about what I've learned with bagmascom is I've had opportunities to talk to lots of recruiters, all from private practices to big groups is ask questions Anytime you go in for an interview. It's a two-way street, especially nowadays. Like the power is you. Nowadays we have the power of where we want to take a job. So ask all the questions you want.

Speaker 3:

You want to make sure you understand every single detail, because there's some deceptive practices out there where some group will put this huge number out there, like $300,000, but that's total compensation. And so to give you an idea of what total compensation is for salary, salary is what's going to be paid every two weeks. So multiply that by 26,. That's your salary. So maybe that's $250,000. Sometimes these groups, like I said, they'll give you total compensation so that other $50,000 is made up with taking call. Potentially it's a retention bonus, there's incentive bonuses. It might include your health insurance, your retirement package.

Speaker 3:

So you really need to ask those questions, like you know. All right, what is the salary? Now, going back to what you asked about originally okay, that salary does that include me taking call? The call nights is a weekend. Is my expected to work um holidays or is that just the base salary and then call is an additional top. That so I can you know I might be getting a 250, but I can take the accessory call. It might be cardiac call, just weekend call, trauma call and get an extra $20,000, $30,000. So it sort of gives you an idea of how that's broken down. Yes, please don't be afraid to ask questions. That's what you're there. You want to join a group that's going to be open and transparent with you. They're not. It might not want to be a place you want to be.

Speaker 1:

Yeah, and that transparency, like that shift to being transparent, is so new, I feel like in the job market, in the anesthesia job market and then specifically the CAA job market.

Speaker 3:

I encourage AAs being very open about what you're making. All right, that just helps us as a community in multiple ways. I mean individually your group you might barely have a pay bump, but two, it also opens up the doors, I think, for a lot of these groups and hospitals to realize no, we are getting the same amount CRNAs are getting. So if they do decide to open up, there's never this conversation of, hey, should CRNAs get paid more than NAA? Only caveat to that I will say there are circumstances where that should occur.

Speaker 1:

And that's where CRNAs are taken. Call by themselves, not a doctor all night and they'll be completely different circumstance. Yes, yes, when the anesthesia care team model is being utilized, a CRNA and an AA working in that model should be paid equally. Yes, that is a huge push in our legislation and in our education. Like to understand that there is no difference thing that seems to be happening. That happened after I graduated. These like enormous sign-on bonuses and how those are usually structured. Are there any pitfalls that we need to be watching out for? If we see this like really eye-catching number, are we like selling our soul to that hospital for the rest of our lives?

Speaker 3:

Oh, so you're in the same boat as me. It's like I remember when I was graduating I think there might've been like maybe one or two practices that were offering sign-on bonuses. It's like, what is that? And to go back to your point, you know, am I selling your soul? I think that is part of the respect of us being people have been practicing for a while, because for quite a while there sign sign-on bonuses were only given out to places where they were desperate for people. Today it's the main street, like but if you're not giving a sign-on bonus, almost like, why aren't you giving a sign-on bonus? Type of deal. Really, lots of groups have signed with I'm the same boat.

Speaker 3:

I never had a sign-on bonus, um, just when I was switching jobs I'm on to my third job now um, just never had the opportunity they weren weren't offering them. So completely jealous, completely fascinated by sign-on bonus. I'm hoping to one day get a sign-on bonus, but the way things are going, I doubt it. Sort of going like you want to work less part-time, all that jazz. So sign-on bonuses, how they're structured, should you take them? What do they mean? You're going to have different thoughts if you hop online to talk about this. We did a little bit of a deep dive on it last year to really run the numbers, if it makes sense. We have two articles up there right now. I highly suggest you take a look at them, just so you understand what you're getting into.

Speaker 1:

We'll link them. I did not come across those, so send them to me and I'll put them in the show notes.

Speaker 3:

I got too well hidden. I got to get them out there. My thoughts on sign-on bonus this is myself If you're offering a sign-on bonus, take it, absolutely, take it, 100%. Take it, even if you think you're going to be leaving within a year. Take that money. That's money you would not get otherwise. And I say that with the caveat of you need to understand what you're signing on for though, okay. And second thing is, if you're not a financially responsible person, anything might be a, believe me. Really don't take it then. Okay. The reason I say this let's it's a lot easier if I write this out or try saying this verbally. Let's say we'll back it up.

Speaker 3:

Most sign-on bonuses right now are anywhere from 15 to 25000 per year. They can be sometimes multiples, where it's like $25,000 every single year. So you might see sign-on bonuses for $75,000. They're going to be paid off the course of three years. Each group does it a little bit differently. Some might give you that $75,000 off front. Some do it as a sign-on bonus as soon as you sign, you get $25,000. Others do it as your first day you get that $25,000. And then, at the beginning of your second year you get $25,000. And the third year you get $25,000. So once again, it goes back to salaries.

Speaker 3:

Make sure you really understand what you're signing up for and what you'd have to pay back if you were to leave early. Leaving early I'm going to get back to why you should always take it here, but I want to keep with the strain of thought. Leaving early. Paying back is done differently by groups. So you take a larger group like, let's say, envision. I know for a fact uh, I should say for a fact I know that they've worked with people this way in the past is that, say, you take a sign-on bonus, you owe them two years, you're going to be leaving after a year, but they've already given you the full, let's say, $50,000. What they'll do is they'll have you pay that back in increments over your final remaining checks. So it's not like you have to dig into your bank account, pull out $25,000 and get it back to you, which is a very nice way to do it. Other groups might require you to pay it back right away.

Speaker 3:

This goes back to where I say you have to be financially responsible when you take a sign-on bonus unless you know you're going to absolutely be there for two or three years, whatever the duration is for that, my suggestion is take the money out. They're going to take a whole bunch of taxes out of your sign-on bonus, and that's fine. Because if you think about it this way, if I were to give you $100 and you had to give 50% to the government, you're still walking away with an extra $50 in your pocket you wouldn't normally have. You're ahead of the game. So people get worried about all right. So what if I have to pay this back? So let's take the idea for simple numbers. Say you're given $24,000 sign-on bonus. You're going to be paid $12,000 at the very first day of your job and you're going to be paid another $12,000 at the start of your second year. So basically, during that first year, if you were to leave at any of those months let's say you leave at the six-month mark period. So you've been given $12,000, you haven't been given that second 12 yet you'd only owe 50%. Right? Easy math. You're halfway through the year and you'd owe $6,000. So basically, what happened is you got $12,000. Taxes were taken out, you put it in your bank account. You should have that money ready to pay back if you need it. Okay, that's what I said.

Speaker 3:

If you're not very sure about this, what's interesting with the math on the second year? I love this fact and I didn't know this was. This was the way it worked. So you already got the twelve thousand dollars. You made it through the first year. They give you that second twelve thousand dollars. Now, if you were to leave six months into that second year, you're not paying fifty percent of that back because your contract is based now on it's been based on 24 months. You're being you're basing it off of 18 months of already in service. So you're actually paying a quarter back of that $12,000, that second one. So you're not paying $6,000 back, whatever. What's quarter for that $3,000? So you're only paying $3,000 back at that point in time.

Speaker 1:

So the longer you stay within that contract, the less and less you're paying. That applies to even if they give it to you off-front. Wow, okay, yes, I followed that math. But basically you're rewarded for the longer you stay and fulfill your contract, you have to pay back less and less. So the longer you stay, you're incentivized to stay. Basically, yes.

Speaker 3:

I mean as simple as that sounds, but sometimes it gets a little tricky with how they're paying it out.

Speaker 1:

Yeah.

Speaker 3:

And there was one other thing I want to mention with that, but I'm sure it'll come to me with your next question.

Speaker 1:

Yeah Well, I was just thinking this. Of course, for everyone, listening is not a standard. It is what the trends that Patrick is seeing. So you know it's all very nuanced. But what Patrick is saying is that you have to be asking all these questions before taking the sign-on bonus. You want to be really understanding what you would have to pay back if you end up unexpectedly or expectedly moving, and you always want you know it's just really smart to have a little nest egg that you can dip into, if something like this, like a little emergency fund, that could then also double as your payback sign-on bonus if you were to take one. What else do we want to say, patrick?

Speaker 3:

So what I remember was, if you feel really uncomfortable with taking an upfront sign-on bonus just because you're not too sure this is the right place for me, you know life happens Ask them if they can make it a retention bonus instead. So instead of getting paid upfront after I complete my first year, I get that $12,000, because then you're not on the hook for leaving early and you can continue to do that after the second and the third year.

Speaker 1:

Oh, that is a really great suggestion because that behooves them, that makes it feel like this person is going to want to stay, as opposed to giving them the money up front. Oh, that is a wonderful suggestion. Yeah, people out there don't, you know, don't want to worry about it. Wonderful, great. I wish I had that suggestion. My last negotiation it's time to switch jobs. Okay, I think this might be my last question. We've covered so much but I'm wondering. We touched on the transparency a little bit, but I'm wondering when is the right time to bring up salary? When you are looking for a new job, like you're entertaining maybe several offers, or you're just doing your first inquiry into a posting on bagmaskcom, when is it appropriate to ask how much I will be getting paid?

Speaker 3:

don't lead with that question.

Speaker 3:

If you want to turn a group off. It shouldn't be within the first 10, 15 minutes, but it needs to be addressed and it's not something you should be afraid to address because you're about to commit a lot of time to these people. Generally, I would recommend it. Once again, it depends on what type of group you're talking to. Are you talking to a national group? Are you talking to a private group? But either way, I would bring it up towards the end of the conversation. I would sort of say like all right, so we covered X, y and Z out of curiosity, just so I can start planning my future. I want to make sure I'm financially sound. What is the pay modeled here? What is expected? Shifts, bonuses, all that jazz. They're expecting that, especially in today's market. They know once again it goes back to we're in control. They should feel comfortable with that.

Speaker 1:

So true, I personally, and I'm sure you personally, have lived through that where it was like a hush-hush, don't talk about it and people are getting paid differently at the same amount of experience and then all of a sudden that busted open after COVID. Are getting paid differently at the same amount of experience and then all of a sudden that busted open after COVID. Anything else we need to know, patrick, that's inside your brain, that needs to be recorded on this mic so we can all sort of understand the money behind the CAA profession and how best, to you know, make our decision on whether this profession is right for us or a job move is right for us. So let's talk to about, you know, is this profession is right for us or?

Speaker 3:

a job move is right for us. So let's talk about. You know, is this profession right for you? That's a very tough question. You cannot let the money decide. You know, is this the right job for you? You're going to hear that with everything.

Speaker 3:

But this is a much different career. It's one of the conversations I have with brand new students is you're no longer studying to pass a test, you're studying to keep a test. You're studying to keep somebody alive. You're studying to keep somebody from getting hurt. You're studying to make sure, 30 years down the line, you can pull some random fact out of the back of your brain to help save a person's life. I may not have to save a life, but just make sure nothing bad goes on. So the responsibility that comes along with this number is a lot different than potentially any other job. So that's something you really have to think about.

Speaker 3:

The dedication, the sacrifices you're going to have to make at school are unbelievable. You don't really realize how much you have to sort of cut yourself off from the rest of the world, like your world becomes your cohort of classmates going in there. I mean, I still made every opportunity to call my parents, check on my brother and sister, but I had a lot of great friends who are that's why they're my great friends. Like they knew I was going to be dropping off the nap for a little while just to study. I had to miss some funerals for some of my buddies, which still haunts me to this day, but they understood, like I was in school, this is nonstop. So when you think about getting into this career, you got to think about the sacrifices just to get to that point.

Speaker 3:

Now the good news is you have an amazing community that wants to see you succeed. You got your preceptors, you got your teachers, you got your classmates. You're going to make some great friends throughout the program. The doctors are going to meet the CRNAs and nurses. I mean, the healthcare community is amazing. I mean, it's one of my favorite things about it. The people in healthcare are outstanding. But then once you start practicing too, you're going to have to start. Maybe, depending on your practice, you're going to have to sacrifice nights. You're going to have to sacrifice holidays, weekends, you're going to miss birthdays. So that number comes with the price. So that number comes with the price. You just have to figure out whether or not you feel comfortable with it. For the practicing CA. You had a question about that Sort of lost track of my career spot there.

Speaker 1:

Yeah, just about making a career shift. Like, gee, I feel like I've been at a job for 10 years and everyone else is getting these huge sign-on bonuses and should I, you know, maybe negotiate or look for a different job because I'm not getting the best deal I can be.

Speaker 3:

Being in a job, same place for 10 years. Sometimes you just need to change the pace. I mean honestly maybe it's just picking up PR and shift someplace else, just to sort of we're very smart people in anesthesia, Like our minds need to be stimulated, and I think sometimes you get in sort of the same rut where you can just walk into the OR like five minutes beforehand, like I've got this, like not a problem.

Speaker 3:

But when it comes down to when you start seeing, you know the salaries going up in other places, you have to determine, you know, is that extra $10,000 a year really worth it? Like to make a big change. Maybe, maybe not $10,000, it seems like a big number. It can make. It can be a big difference, like my kids started going to private school, that extra $10,000 a year right back out the door but well needed.

Speaker 3:

So you sort of have to think you know how much of a jump, how much is this actually going to improve your life? Type of deal. That's going to be a really decision you have to sit down and think about.

Speaker 1:

Yeah, totally. Thank you so much, Patrick. I learned a ton and I just really know that our community is going to be better from hearing your expertise and your insider knowledge. So I just wanted to really share my gratitude for you being on the podcast.

Speaker 3:

Oh well, first of all, I really want to thank you Just what you've done the past couple of years. I think the CAA community is in a great place where we've had people sort of stepping outside the OR. So, like yourself, like Jabeli's doing on social media awesome stuff, getting that transparency out there. Rad and Sasi from Harmony Anesthesia they started up the first CA locums company. It's spectacular. We see people that are starting to really work with students trying to get into school, like Aspiring CA Anesthesia One Resource.

Speaker 3:

So I just want to thank you and for everybody else out there, sort of letting our voices be heard, because this is what really moves our community to become bigger, become stronger. I don't want to say well accepted, but yeah, I mean we've become more accepted because people are now just like oh yeah, I've heard of you guys, as opposed to what's a CAA. So thank you very much for what you're doing for everybody else out there In case I forgot you, you're doing a great job. I encourage people to really, you know, use your voice, share who you are, share the community.

Speaker 1:

Awesome. Well, Patrick, until I SOS text you again, thanks for being here.

Speaker 3:

I'm looking forward to doing it again at some point.

Speaker 1:

Okay, so that was my conversation with Patrick Flaherty from bagmaskcom. I'll put a link in the show notes for the resources he mentioned, as well as just a link to the website, in case you want to access those educational resources. And, you know, search on the job board. So, thank you, patrick. Again, thank you for your kind words, and he's right. As we all use our voice as CAAs, our community keeps growing and people who never knew about CAAs are learning who we are and what we are and what we stand for, and so it really matters to put yourself out there and to tell people why you love this profession and why it's more than just you know giving anesthesia and making money. There's just so much more to it. So I hope this episode was really helpful.

Speaker 1:

Again, as you heard, there is so much nuance to making money as a CAA. There are so many particulars in the individual jobs of what you have to do to make that money, in terms of when you're working and in what specialty you're working and what days of the week you're working, and, of course, then those differences between salary and compensation and how these jobs are being marketed or how they're marketing themselves. Sometimes they're talking about total compensation versus your actual take-home salary, and so, as we've said over and over again in this episode, the best thing for you is to be your own advocate as an AA student, prospective AA or practicing CAA at all levels. This is a dynamic job market that is really unprecedented, and you know just healthcare in general in the United States is changing so much and laws pass and things change and you know it's hard to keep track of everything. So I do hope this is a good representation of what's going on right now, january 2025.

Speaker 1:

If you have anything to add or any questions or maybe something you feel like I didn't get quite right, please feel free to text me. There's a link in the show notes that goes directly to me and we can start a conversation. I learn from you all. I only know what I know, and one of the things I love doing is finding people who know more than me and just letting them teach me. It's truly one of my passions to talk to people who are an expert in their field and, yeah, I learned so much from you all. So thank you everyone who I SOS texted Patrick Flaherty from bagmascom, jen from Anesthesia OneSource, sarah Whitfield from AspiringCAAcom and Chabeli Rodriguez from CAA Lifestyle Speaking of which I am curating, in the show notes as well, some links to social media posts that offer just really quick glimpses into salary, some people's personal journeys with salary, some CAA content creators, so that you can have access to the larger conversation.

Speaker 1:

If this is your first foray into talking about money and CAAs, okay, I think that wraps up this conversation about how much money do CAAs make in your Complete Guide to Understanding Certified Anesthesiologist Assistance. So the good news is there is one more episode that I have planned on the agenda for this series to completely understand everything you need to know about a CAA, or everything I can tell you in five episodes and I'm kind of at a crossroads. There are two topics that I really want to speak on. One intimidates me more than the other, and I feel like that's probably a sign I should do the one that's scarier for me, but I have some opinions on the two topics and I think I'm going to go to my Instagram and let you all decide. So if you are not following me on Instagram, it's really the only social media platform I have.

Speaker 1:

It's the only one I show up on semi-regularly, and when this episode launches, I am going to poll the audience to see what you guys want as the fifth and final installment in this complete guide to understanding certified anesthesiologist assistance. So follow me on Instagram at awakenedanesthetist. If you have any other questions or want to contact me, I'm available by email at awakenedanesthetist, at gmailcom. And let's see what else do I like to tell you at the end of these episodes. You can sign up for the Awakened Anesthetist newsletter in the show notes, as well as receive a free link to a 30-minute webinar how to start meditation as a CAA. Free for you for signing up. So, yeah, that's all in the show notes. Go there and let's talk soon, y'all.

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Mary Jeanne Roberts, CAA

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