For you guys practicing out in the real world, I was looking for some advice on what you think is the best mix of procedures from both a financial and headache point of view. Im interviewing for a pain fellowship spot right now and trying to figure out which spot is best. It seems a lot of applicants focus on how many pumps/stimulators the fellows are doing during the year. For those of you doing stims out in private practice, is it worth it? Do you need to have a practice that is primarily geared towards doing just stims or can you do both bread and butter procedures and stims? Is it a better game plan to just avoid doing stimulators all together? A couple of programs that I've interviewed at do a ton of pumps/stimulators. Should these procedures really be focused on during fellowship or are they more of a pain in the ass out in private practice? Thanks in advance for any advice.
Best Procedural Mix in Private Practice...
- Thread starter V-SWAG
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I have a 40 hr per week office-only practice with no real call and zero hospital work. It's very sweet.
What works best for me is doing the occasional stim trial in office as indicated, and referring the implants out to a surgeon. Some may say that's heresy, but I did a lot of implants in fellowship, and it just works out better to have someone already in the OR all do the surgical part, rather than shut down clinic for a day to do an implant. In community Pain medicine/private practice I don't think there's enough appropriate stim candidates in most locations to do only stimulators. Even in academic medicine I think it would be tough to find enough appropriate candidates to do just stim.
Pumps are a whole different animal. In my opinion, you should not do pumps as a community Pain physician unless you want your life to be horrible. If you're an attending at a fellowship with an army of fellows and resident to do the misery-scut involving pumps, or with access to PAs/NPs, then it's a different story.
It's definitely good to learn how to trial and implant, but you need to learn bread and butter procedures, other advanced such as kypho, and clinical Pain medicine, too. Unfortunately, 1 year is a very short period of time to cram it all in.
Basically, you need to learn everything so you can then tailor your practice as indicated based on your job setting, desire and interest after fellowship.
What works best for me is doing the occasional stim trial in office as indicated, and referring the implants out to a surgeon. Some may say that's heresy, but I did a lot of implants in fellowship, and it just works out better to have someone already in the OR all do the surgical part, rather than shut down clinic for a day to do an implant. In community Pain medicine/private practice I don't think there's enough appropriate stim candidates in most locations to do only stimulators. Even in academic medicine I think it would be tough to find enough appropriate candidates to do just stim.
Pumps are a whole different animal. In my opinion, you should not do pumps as a community Pain physician unless you want your life to be horrible. If you're an attending at a fellowship with an army of fellows and resident to do the misery-scut involving pumps, or with access to PAs/NPs, then it's a different story.
It's definitely good to learn how to trial and implant, but you need to learn bread and butter procedures, other advanced such as kypho, and clinical Pain medicine, too. Unfortunately, 1 year is a very short period of time to cram it all in.
Basically, you need to learn everything so you can then tailor your practice as indicated based on your job setting, desire and interest after fellowship.
