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Pain fellowship

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  • Avatar John 
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    Status: Physician
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    Joined: 01/13/2016
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    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.

    #244041 Reply
    Avatar Peds 
    Moderator
    Status: Physician
    Posts: 4405
    Joined: 01/08/2016

    I think some IV Benadryl can cure that itch

    #244045 Reply
    SerrateAndDominate SerrateAndDominate 
    Participant
    Status: Physician
    Posts: 486
    Joined: 02/01/2018

    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

    Earn everything.

    #244049 Reply
    Avatar HikingDO 
    Participant
    Status: Physician
    Posts: 341
    Joined: 03/09/2017

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

    #244066 Reply
    Lordosis Lordosis 
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    Status: Physician
    Posts: 1806
    Joined: 02/11/2019

    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.

    “Never let your sense of morals prevent you from doing what is right.”

    #244304 Reply
    Liked by EndoRobert
    Avatar PainShrink 
    Participant
    Status: Other Professional, Small Business Owner
    Posts: 7
    Joined: 09/30/2018

     

    Personally, I couldn’t imagine more of a practice Hell 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!

    #244560 Reply
    Liked by Duckworth, Tim, Anne
    Avatar shantster 
    Participant
    Status: Physician
    Posts: 114
    Joined: 01/16/2016

    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)?

    #244662 Reply
    jfoxcpacfp jfoxcpacfp 
    Moderator
    Status: Financial Advisor, Accountant, Small Business Owner
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    Joined: 01/09/2016

    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?

    Johanna Fox Turner, CPA, CFP, Fox Wealth Mgmt & Fox CPAs ~
    http://www.fox-cpas.com/for-doctors-only ~ [email protected]

    #244670 Reply
    Lordosis Lordosis 
    Participant
    Status: Physician
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    Joined: 02/11/2019
    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 🙂

    “Never let your sense of morals prevent you from doing what is right.”

    #244936 Reply
    Avatar 8arclay 
    Participant
    Status: Physician
    Posts: 24
    Joined: 01/30/2019

    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.

    #244937 Reply
    Liked by Tim, MPMD, EndoRobert
    jfoxcpacfp jfoxcpacfp 
    Moderator
    Status: Financial Advisor, Accountant, Small Business Owner
    Posts: 8113
    Joined: 01/09/2016
    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!!!

    Johanna Fox Turner, CPA, CFP, Fox Wealth Mgmt & Fox CPAs ~
    http://www.fox-cpas.com/for-doctors-only ~ [email protected]

    #244981 Reply
    Liked by Lordosis
    Avatar akmd 
    Participant
    Status: Physician
    Posts: 48
    Joined: 10/01/2017

    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.

     

     

    #245416 Reply
    Liked by 8arclay
    Avatar 8arclay 
    Participant
    Status: Physician
    Posts: 24
    Joined: 01/30/2019

    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.

    #245428 Reply
    Avatar akmd 
    Participant
    Status: Physician
    Posts: 48
    Joined: 10/01/2017

    ^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.

     

    #245433 Reply
    Liked by 8arclay
    Avatar 8arclay 
    Participant
    Status: Physician
    Posts: 24
    Joined: 01/30/2019

    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

    #245440 Reply

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