Medical Spine Fellowship for non-PM&R/non-Anesthesia

This is absolutely amazing. The amount of "fellowships" devoted to the spine. I guess the economic windfall that is showering pain management will be further diluted.

i don't know anything about what is going on at Cleveland Clinic - but Nagy Mekhail must be going nuts with this!!!

basically this is a way for the spine surgeons to have complete control of spine injections/procedures thus bypassing the pain department - i wonder if there is a rift that led to this or what the underlying issues are

i know that at a few large teaching facilities the spine surgeons got tired of requesting ESIs from anesthesia/pain because of the 2-4 month delay to be seen for consultation with the then obligatory delay in getting the procedure the surgeon thought was needed..... instead they increasingly turned to interventional radiology to do their bidding - but found out the hard way that IR just does the injections and doesn't really take the patients phone calls/complaints etc/med prescriptions - so this must sound like the perfect deal for the spine surgeons ----

unbelievable... it just goes to show that spine surgeons can wield a lot of control --- unless of course you bypass them and convince the PCPs to send all spine patients to you first, and that you will decide whether spine surgery eval is indicated...

that is what i did with my PCPs and the spine surgeons are coming to me instead of the other way around.

Not to be a cynic, but this differs from what Anesthesia is trying to do to PM&R how?

*duck and cover*

This is the CC's Spine Departments way of sticking it to the pain management department. The Cleveland Clinic is a highly political place and this is just another power struggle that is going on within the institution.
When I was a fellow the main guy who did injections for the PMR spine department was allowed to come into one of the pain fluoro rooms and do procedures 1/2 day a week. He would do 5 transforaminals a morning at 45min a pop, while the 3 pain procedure rooms would be churning out 15-20 more complex procedures each. The PMR residents used to rotate through the pain department and one complained because she thought she didn't have to see patients and only do procedures and it started an arguement between Mazanec and Mekhail and Nagy kicked the PMR fellows and the PMR attending out of the pain department.
I do not think that this place is accredited but I do think it would be an good PMR interventional spine program, especially compared to what is out there. You will get good exposure to interventional spine procedures.

lobelsteve said:

Is Rus DeMico still there? I'm pretty sure he went to the fellowship there before PMR had accredited fellowships (2003). Then I thought he was sticking around as faculty... Good guy, haven't heard from him in a while, but he'd have the right input on the situation....

Click to expand...

Yes, he's the associate program director.