EM to pain management

[Strider_91]

Does anyone know what the career of someone who does an EM residency and then a pain management fellowship looks like?

Are you basically just a pain management doctor at that point doing what someone who does pain from PMR or Anes would be or are you working in an ED part time and doing injections part time?

Would being specialized in pain management make you any more desirable/ useful in an ED especially now that managing pt pain is so tied to money?

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[Fox800]

Paging Birdstrike...

 

[NRAI2001]

I ve never heard of anyone going into pain management from EM... but I guess its possible?

 

[GeneralVeers]

One of the guys I went to residency with went into pain management. He's in jail now. http://www.news4jax.com/news/local/doctor-gets-20-years-for-operating-pill-mill-clinics

 

[Apollyon]

There's a guy on the pain med forum that did EM to pain. And, as mentioned, @Birdstrike did it. However, of these two, both left the pit in the rear view mirror.

If all you think of pain medicine is "pill mills", that has about as much nuance as saying Scottish people are cheap, or people from Poland are dumb. In other words, look more into it before you **** on it. After you do your research, then, you can vilify it all you want.

 

[Strider_91]

@Apollyon Thanks for the response. I did not get the impression that @GeneralVeers was insinuating that all pain management docs are running pill mills, just kinda stating a fun fact.

That being said, I work in pain management currently and all of the docs I work with go to great lengths to prevent that. Urine test, drug monitoring programs, not treating pt's that arent willing to try therapy or injections and only want narcs etc. Pain management is a cool field when doing procedures but my major issue with it is that it can be painfully boring and mundane.

 

[Birdstrike]

One of the guys I went to residency with went into pain management. He's in jail now. http://www.news4jax.com/news/local/doctor-gets-20-years-for-operating-pill-mill-clinics

Someone that hangs a shingle and calls themselves "Pain management" and deals drugs for cash for no legitimate medical purpose, isn't practicing Pain Medicine, Pain "management" or any forms of Medicine, at all. They're a drug dealer.

If you actually want to help people, are committed enough do an ACGME Pain fellowship, get board certified (like I did) and practice good medicine along with committing to aggressive opiate-risk reduction, then that's a "Pain Management" doctor, now and into the future. With the pendulum swinging away from using opiates currently, it's my opinion that doing a Pain fellowship right now, is a much better idea than it would have been 20 or even 10 years ago.

I did a Kyphoplasty last week. I'm doing a spinal cord stimulator later today. It's cool stuff. And I'm well rested, every day, unlike the chronic circadian-rhythm dysphoria that plagued me when working rotating shift work . Sure, some of the patients can be challenging. (But you'll see them in the ER at 3 am anyways, and I can pick and choose my patients, now. In the ED I couldn't). Admittedly, it's not for everyone. But if you want a normal life, to sleep at night, like doing cool procedures and want to still be a doctor, it might be. If you're ethically challenged or looking to make $1 million per year, I'd recommend steering clear.

Cc @Strider_91