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  • Pain fellowship

    I’m a private practice anesthesiologist that has been in practice for four years. I have a pretty good job and feel like I’m compensated fairly well. However I’ve had this itch to go back and do a pain fellowship. I have quite a few connections with pain docs in my area and I could more than likely secure a job before I even started the fellowship. Does anyone have any input/thoughts on changing career directions so soon? Obviously it would be a huge pay cut for one year but the earning potential for pain doc is much higher than general anesthesia where I live.

  • #2
    I think some IV Benadryl can cure that itch

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    • #3
      I'm not in anesthesia but did meet a guy at fellowship orientation. He was in a very similar boat and seemed really excited about the transition. I don't know the guy well but would gladly help you reach out to him

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      • #4
        Personally, I couldn’t imagine more of a practice ************************ than a day full of pain patients, but I’m glad there are docs out there that want to do it!

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        • #5
          Is your current lifestyle more of an anesthesiologist or a resident?  If the former then becoming a fellow will not hurt so bad.  If the latter then the salary reduction might suck.

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          • #6
             




            Personally, I couldn’t imagine more of a practice ************************ than a day full of pain patients, but I’m glad there are docs out there that want to do it!
            Click to expand...


            I absolutely love working with chronic pain patients!  I’ve worked with many populations and this is by far my favorite.  The funny part is that the pain docs always send me their most challenging patients and I still love it after 26 years. It is very rewarding!

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            • #7




              Is your current lifestyle more of an anesthesiologist or a resident?  If the former then becoming a fellow will not hurt so bad.  If the latter then the salary reduction might suck.
              Click to expand...


              Do you mean this the other way around (former = anesthesiologist, latter = resident)?

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              • #8




                Is your current lifestyle more of an anesthesiologist or a resident?  If the former then becoming a fellow will not hurt so bad.  If the latter then the salary reduction might suck.
                Click to expand...


                Did you mean the opposite or have I just not had enough coffee yet?
                Financial planning, investment management and CPA services for physicians, dentists, and medical professionals | 270-247-6087

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                • #9


                  Do you mean this the other way around (former = anesthesiologist, latter = resident)?
                  Click to expand...




                  Did you mean the opposite or have I just not had enough coffee yet?
                  Click to expand...


                  I think I was the one with the lack of coffee

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                  • #10
                    I do interventional pain, have an anesthesia training background. My reasoning for the fellowship was twofold: 1) Broadened skill set. I dont know what anesthesia is going to look like down the road (increased CRNA autonomy always threatening), so having other options with regards to employment can only help. 2) Lifestyle. While there are a lot of things I really miss about anesthesia and the OR, I certainly dont miss the inconsistent hours, nights, call, or weekends/holidays.

                    Of course there are patients that can suck the life out of you (as with any specialty), but I honestly think pain patients get a bad rap. By and large, the vast majority are simply looking for ways to be more functional and are fairly reasonable about it. Overall, Ive been very happy with my decision and dont regret it a bit.

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                    • #11





                      Do you mean this the other way around (former = anesthesiologist, latter = resident)? 
                      Click to expand…




                      Did you mean the opposite or have I just not had enough coffee yet?
                      Click to expand…


                      I think I was the one with the lack of coffee
                      Click to expand...


                      I’m glad I’m not the only one!!!
                      Financial planning, investment management and CPA services for physicians, dentists, and medical professionals | 270-247-6087

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                      • #12




                        I’m a private practice anesthesiologist that has been in practice for four years. I have a pretty good job and feel like I’m compensated fairly well. However I’ve had this itch to go back and do a pain fellowship. I have quite a few connections with pain docs in my area and I could more than likely secure a job before I even started the fellowship. Does anyone have any input/thoughts on changing career directions so soon? Obviously it would be a huge pay cut for one year but the earning potential for pain doc is much higher than general anesthesia where I live.
                        Click to expand...


                        which area is this???? are you sure? im sincerely curious about this because pain salaries are declining.

                        as a fellowship trained pain physician who went back to anesthesia, i can tell you pain salaries are wayyyy down and will continue to go down because your practice will be managing a lot of patients on opioids, or dumps from PCPs. its hard work to squeeze out procedures.

                        The re imbursements for procedures are down and pre - approval through insurances is getting very tough. and you can thank multiple unethical pain physicians who treated patients as pin cushions and/or currently run a 'injections for pills' type of practice.

                        PP guys are surviving on ancillary income services, like UDS, testing.

                        Life as an anesthesiologist involves more hours, but quality of life is better overall since there are no notes, no responsibility after pager is off and much more vacation than youll get in pain.

                         

                         

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                        • #13
                          Agree with the decrease in reimbursements and salaries, but even taking this into account I make more in pain than I would have doing anesthesia.

                          Obviously everyone will have their own stance, but I disagree on the lifestyle being better for anesthesia. In pain, my hours are set, I'm able to go to the gym before work and have dinner with my family every evening. I get an after hours call maybe once a quarter, so that's a non issue. The work itself is fast paced and busy, notes don't take much but a scribe solves that if needed. Definitely more vacation in anesthesia though, pain obviously more production based with reimbursement.

                          We've absolutely seen an increase in med mgt dumps too. The amount of med mgt referrals I get for patients on less than 40mme/day for chronic OA can get rough, but I usually delegate these to mid levels.

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                          • #14
                            ^most days i finish at 1 pm. pain, I would finish my day at 5:30-6 pm, then finish notes.

                            to each his own i guess.

                             

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                            • #15
                              That's fair. I'm done with patients and charting by 430 99% of the time. To me that's worth the trade off of not having to work any nights/weekends/holidays. Hoping to drop to 4 days/week over the next year or so as well, although anesthesia usually has that built in with post call days

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