lobelsteve said:
PMR-Pain fellows can do anything that any ANES-Pain fellow can do. Pluses and minuses to both. My biased opinion as a PMR-Pain guy is that I am a much better diagnostician than my ANES counterpart, we have the same interventional skills (varies widely based on training- not on background, and personal abilities/aptiutude), and if a difficult patient loses an airway on the table- I call 911 and try my best to secure the airway, the ANES doc does what they do with much more aplomb.
PMR-Pain is not going away, it is growing by leaps and bounds. The future will be one of political contention, run by small minded people who care little about the patients and lots about protecting "their turf".
My 2cents.
Let me start by acknowledging that I am a gadfly, and always seem to do this with minimal tact. That said, let me take issue with my colleague -
PM&R is a little field in terms of number of practitioners, but encompasses a huge array of foci (EMG, TBI, SCI, stroke, pain, spine, sports, etc, etc, etc). Anesthesia is similarly broad in its scope. In the main (yes Steve, I know you were a pain doc from your nascent development on, but for most of us) most or us garner the vast majority of our knowledge base and skill sets during our fellowships. How you got to your fellowship is less important than that you are interested enough to actively acquire the knowledge to be a highly skilled diagnostician, clinician, and interventionalist.
I know lots of incredibly smart interventionists who are anesthesia trained, and lots who are PM&R trained. I know an equal number of each I would not trust to an injection on a dead cat. The PM&R myth that we are better suited to be good at this line of work stems from out need to puff ourselves up as no one knows what the heck a physiatrist is, or what we do. Rather than making overly broad generalizations regarding interventionists as a whole, lets look at the individual practitioner, and focus on his knowledge and skills. Belittling our colleagues and their training lowers us, and makes for a fractious, rather than integrated field.
Pain docs snipe at each other all the time. Some folks on this board profess to want to work together, and then in the next breath belittle whole classes of others in the field.
I see no reason why you can't be a good pain doc, whether you do an anesthesia, PM&R, or other residency, so long as, at the end of the day, you care about doing quality work.
Rodney King said:
