carving your own practice

[tempperson]

I was wondering if anyone knew of PM&R docs currently integrating both an in-pt and out-pt practice. Like 2 days of out-pt clinic and then 3 days of in-pt, or is that nearly impossible since in-pt might require you to be at the hospital all the time. It there always a dichotomy as in pmr docs only do one or the other.

Also, for those who train in acupuncture, i assume you integrate into your outpt practice as one many treatment modalities? can anyone do it in-pt or would that not fly with most hospitals.

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[DigableCat]

I'm at a private hospital right now, and it can easily be done.

He has a inpatient service, and has clinic in the clinic area of the hospital 3 days a week which he rents from the hospital. He does outpatient f/u of his inpatients, EMG referrals, and new patient referrals ranging from musculoskeletal/sports injuries, spinal cord injury, worker's comp cases, etc. Needless to say, he does VERY WELL for himself.

 

[spinaldoc]

i am currently a chiropractor that has an interest in going to med school. i was wondering how pm&r doc/D.C. practice would go. do you think the both would compliment one another? asumming one can comment knowing what a D.C. does.

 

[axm397]

I think PM&R is so diverse and flexible - one can do whatever he/she wants to do with his/her practice. I personally do not know any D.C./PM&R practices - but I'm sure you can integrate your d.c. practice with an outpatient MSK type PM&R practice. I don't know if it makes financial sense to do that - but if you truly enjoy the chiropractic element of your career, then perhaps you would be happier doing that. There are many PM&R docs who use OMM, PT techniques, acupuncture, and other modalities in their practice. I don't know how the billing works - I know at least for acupuncture, the financial rewards are small compared to the time and energy you have to put into it. (I met several PM&R docs who used to do acupuncture but stopped because it was not the most efficient part of their practices.) I also know docs who just by-pass the reimbursement issue by charging cash-only for acupuncture. (both in-patient and out-patient)

spinaldoc, what makes you want to leave your established chiropractic practice (phew, a mouthful) to go back to med school? Seems like a lot of work...

 

[spinaldoc]

hey axm397, thanks for the info. not all DC's are interested in acupuncture and i am one of them. so many people associate chiro's with acupincture and it is not even taught atleast not at the school i went to. as for leaving my practice and going to med school it would be a business stand point simple as that. yes, i realize i would be allowed to do more as an MD but i would also get paid more for each treatment as well. i would still adjust my pt.s because it is such effective form of treatment. however, i would bill as a MD on that and get paid more. therapies i would get paid more as well. i am going to have to ask more silly ?'s on here and/or go and speak with a physiatrist (sp?).
for instance what is OMM and what is a fellowship. upon finishing med school which i am assuming is four years then 3 years in a residency in pm&r then what? thank you for your time.

 

[Seaglass]

what is OMM and what is a fellowship. upon finishing med school which i am assuming is four years then 3 years in a residency in pm&r then what?

OMM is osteo-manipulative medicine or something like that. It's what Osteopaths call adjustments/other physical msk treatment. I am not an osteopath so I can't tell you more than that.

A fellowship is post-residency training that usually leads to added qualifications for specialized practice in a subspecialty related to the residency specialty (eg. internal medicine -> Cardiology fellowship). In format it is very similar to residency. Lengths vary depending on area of subspecialty (1-3 years).

C

 

[axm397]

Hey C, nice to see you on this forum!!

spinaldoc, I didn't mean to relate acupuncture to chiropractic training. I was trying to address some of the other questions brought up in the forum.

I saw you on other forums asking about length of training, etc. Freida online is a good resource of residency programs - with lots of statistics on them. http://www.ama-assn.org/ama/pub/category/2997.html

The aamc also has a neat website summarizing different specialties - I think they also have lengths of training as well - http://www.aamc.org/students/cim/specialties.htm

In terms of OMM, you would have to go to an osteopathic medical school or try to seek out some courses to learn it properly and probably to bill for it. I don't know much about billing and I didn't know you could bill for chiropractic manipulation as an MD and get paid more.

Fellowship is training after residency - PM&R has several available - accredited and non-accredited. These are listed on the aapmr website - http://www.aapmr.org/resident/resource/fllwshp.htm

Hope this helps.

 

[Seaglass]

Yeah, got a little bored today so I ventured into the parts of the site I haven't seen in a while. All I have is humanities this month and for that all we had to do was one presentation which I've completed so now just cruising to May 16.

C

 

[spinaldoc]

thanks for all the info. axm397, i just want to answer all of my ?'s before i put my heart into it.