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What are you treating?
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PRP and stem cells are great for this issue.
Love it. I am pretty sure the wallet is not under the ischial bursa when sitting. But the double meaning....you take their money out of the wallet with stem cells and prp and the thinning of the wallet cures them.
Centeno also says prolotherapy works better than steroids
SI Joint Syndrome
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reviewed some records today from University of Miami pain doc where they are still injecting bupivacaine into joints. wtf
Thanks for sharing, hadn't seen this one.
Furthermore, you a higher base salary may only be guaranteed for 1-2 years, after which, more of your compensation may be tied to production. Read the fine print.Having a great starting salary in a bad situation or getting overpaid early and having difficulty earning that salary in subsequent years will lead to great stress and problems. You will make a lot more than in fellowship regardless. Bet on yourself to be a producer and put yourself in a good situation to thrive. A guaranteed salary is either a way to suck someone in or bare minimum expectation that should be far surpassed. Don’t put much weight in it. I’d argue “fair” compensation is more tied to your production. A generous starting salary may be inversely proportional to how you will be treated.
Furthermore, you a higher base salary may only be guaranteed for 1-2 years, after which, more of your compensation may be tied to production. Read the fine print.
It depends. If your production is reasonably compensated and you produce, your guarantee will only be seen in the rearview mirror. If you are overpaid with your guarantee and/or have a bonus/production structure in which you don't meet your guarantee, you'll struggle to make payments on the boat and fancy house you bought in the previous 2 years when you THOUGHT you were a "balla."Is this a good package? That is to say 1 to 2 yrs of guaranteed salary, then moving to more production bonused structure?
Hard to define what is good. It has to fit your needs. You many not have an established patient base at the beginning and if you’re a new grad, you have loans to pay. Hence, the guaranteed base is appealing. The idea is your patient base will increase and more of you salary will come from RVU based production incentives so the hospital makes you share some of the financial burden of your salary. It really depends upon how long of a commitment you want to make to the hospital.Is this a good package? That is to say 1 to 2 yrs of guaranteed salary, then moving to more production bonused structure?
Hard to define what is good. It has to fit your needs. You many not have an established patient base at the beginning and if you’re a new grad, you have loans to pay. Hence, the guaranteed base is appealing. The idea is your patient base will increase and more of you salary will come from RVU based production incentives so the hospital makes you share some of the financial burden of your salary. It really depends upon how long of a commitment you want to make to the hospital.
Don’t work in an undesirable area for less than 50% mgma. That is standard. Ask for that guarantee for a year. After a year in an underserved undesired area you will be way above the average. And don’t feel bad.. they will be making multiples of your salary off of you. Ask for loan repayment, moving allowance and sign on bonus as well.
that is not necessarily true.Don’t work in an undesirable area for less than 50% mgma. That is standard. Ask for that guarantee for a year. After a year in an underserved undesired area you will be way above the average. And don’t feel bad.. they will be making multiples of your salary off of you. Ask for loan repayment, moving allowance and sign on bonus as well.
Could you expand on the political climate aspect? I am doing radiology but also had some interest in painDue to the extreme political climate and QOL I decided to go back to radiology. Specifically, ER rads. I work nights 9 on 11 off, but I see my kids all the time, go to every school event, daytime class, bday party, etc. I have a great life outside of medicine which I wasn't enjoying when I was practicing pain. I also despised prescribing opioids for patients when they didn't need it and was obligated in order to appease my larger practice. I no longer wanted to play that game and the practice refused to hire an NP or PA.
Now I make 25% more but work less than half the hours (from home) and I teach. I think there are great pain practices out there but I wasn't able to find the unicorn "procedure only, efficient, no opioids, well staffed/supported, great payer mix but completely ethical" practice.
I think the field is going to move more to cash only as time goes on. There will be a divide in pain care between the haves and have nots. It's how chiros have survived and it's how pain will survive.
Could you expand on the political climate aspect? I am doing radiology but also had some interest in pain
Pain has been taken over by special interest groups and groups with "competing commitments." The development of any kind of evidence-based approach to care is akin to this:
If you are doing a pain fellowship, anything is possible. If not, it's going to be like you said - hospital referrals mostly.Is it still possible to do from Radiology? Or more as an IR doing some occasional kyphoplasty/joint injections from the MSK people?
Thank you. But in general it is not radiology doing these procedures? If you wanted it to be a part of your practice is it realistic to match pain after IR? Or better off trying to do Neuroradiology which has some programs doing spinal interventions?If you are doing a pain fellowship, anything is possible. If not, it's going to be like you said - hospital referrals mostly.
But there are exceptions. It will depend on your area/competition. There's a radiology group in Guam that does almost exclusively pain and is the only game in town. I don't think they have any formal pain training but they have an extremely busy practice and are able to leverage radiology and pain to great success.
It's hard to generalize since it's so different everywhere.Thank you. But in general it is not radiology doing these procedures? If you wanted it to be a part of your practice is it realistic to match pain after IR? Or better off trying to do Neuroradiology which has some programs doing spinal interventions?
Okay thank you. Just curious, what doors would neurorads open? Do you know of radiologists doing pain fellowships? I kind of liked it as having an additional skill set/scope if one were an IR doc?It's hard to generalize since it's so different everywhere.
I think it's only worth doing a pain fellowship if you really want to follow patients, have clinic, etc. If that's the case, I think it's completely plausible to do a pain fellowship after IR. I mean, you have to compete of course. But you have advantages and disadvantages in your application.
But if you just want to do pain procedures while others manage the pt, I wouldn't do a pain fellowship. Neurorads is not worth doing just for pain procs but it will certainly open other doors for you.
If you are a radiologist on staff at a hospital, you can absolutely work with neurosurgeons and orthos who know what procedures they want. Your volume will depend on the competition both pain docs, fellow rads, etc.
I know a hospital that has a private rads group and the IR doc does most of the pain injections in the area. His referrals come from primary care, NS, etc, who are managing the pts, doing f/u's, etc. But if a reputable pain doc were to move in on that territory, they could probably take a lot of business away.
Sometines orthos, NS, etc who "know what they want" are reluctant to send to a pain doc because they don't want someone taking over the pt's care, don't want meds started, etc.