Imagine after some peer pressure and bad choices, you find yourself dealt into a card game at a high-roller casino in Las Vegas. The other players are calm and confident, and the buy-in is more money than you’ve ever had. As you look at your hand, you start sweating, because the truth is, you don’t even know how to play. Sound crazy? That’s because it is. But if you finish your residency and try to negotiate the contract for your first job, we might as well deal you in at the table. Don’t believe me? That’s O.K. Give me a moment to scare the #@%!$ out of you and help you play the game.

One of the trends in the business of anesthesia over the past few decades has been consolidation. My grandfather was an anesthesiologist in the...

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