Family Med Doctor With Pain Training Question

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FamilyDoc6554

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I am a family medicine doctor that has had a long-term interest in pain medicine who is currently applying this cycle. Several of my friends in anesthesiology have been telling me that I should not attempt to match since their practice groups would never hire a family medicine physician who is boarded in pain. I have been out working as an attending for several years and enjoy my current position but don't want to go back to training if there honestly would not be a place for me in the field. I wanted to reach out to the SDN community and get an honest opinion for those of us looking to enter the field coming from backgrounds such as family medicine and emergency medicine.
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its not whether you would be hired as a board certified pain doc.

its whether you can get in to an accredited pain or spine fellowship.

and remember you could always open up your own practice, so...
 
I don't think it would prevent you from getting a job at all. As long as you get into an accredited pain fellowship, take the boards and be board certified I don't think there would be a bias against you. Plus, I feel like pain jobs are increasing for some reason. Probably a lot of anesthesia pain providers switching back to anesthesia due to the market.
 
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its fine. you'll get a job.

it is better work than family practice, for sure.
 
FamilyDoc6554 said:
I am a family medicine doctor that has had a long-term interest in pain medicine who is currently applying this cycle. Several of my friends in anesthesiology have been telling me that I should not attempt to match since their practice groups would never hire a family medicine physician who is boarded in pain. I have been out working as an attending for several years and enjoy my current position but don't want to go back to training if there honestly would not be a place for me in the field. I wanted to reach out to the SDN community and get an honest opinion for those of us looking to enter the field coming from backgrounds such as family medicine and emergency medicine.
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I was one of the early EM-> pain folks.
I also encountered several naysayers.
If you work hard in fellowship, get BE/BC via ACGME, and have even a semi-normal social IQ, you will get a job.
What the job market will be like when it’s time for you to look and what/where your options will be then is anybody’s guess.
But if pain is what you really want to do, don’t be afraid to bet on yourself.
 
nobody else hiring you will know you were FP if you get into a pain fellowship. If you want to work with or for them, then you have a challenge, but they really shouldnt care.
 
Ducttape said:
its not whether you would be hired as a board certified pain doc.

its whether you can get in to an accredited pain or spine fellowship.

and remember you could always open up your own practice, so...
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Shouldnt be too hard. Pain fellowship is so incredibly not competitive right now, mainly cause the anesthesia folks are just doing general due to the market. In the pain discord there are several FM applicants with 15+ interviews
 
Good for you. 3 year residency, work a little bit, make some money in FM, 1 year ACGME fellowship. Sounds like a great plan. A big hospital hired two FM/sports/pain guys years ago and they are still here working, successful. Getting ACGME boards is all that matters for hospital jobs. There are some large private practice groups that have their own biases but they should be a minority.

The doctor that works with me is FM/unaccredited PM fellowship. We haven’t had major issues with billing. We have had some issues with hospital privileges so get that ACGME fellowship if it is an available. We swap patients back and forth and he is doing a great job and my long term patients are very happy with him.
 
FamilyDoc6554 said:
I am a family medicine doctor that has had a long-term interest in pain medicine who is currently applying this cycle. Several of my friends in anesthesiology have been telling me that I should not attempt to match since their practice groups would never hire a family medicine physician who is boarded in pain. I have been out working as an attending for several years and enjoy my current position but don't want to go back to training if there honestly would not be a place for me in the field. I wanted to reach out to the SDN community and get an honest opinion for those of us looking to enter the field coming from backgrounds such as family medicine and emergency medicine.
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First question is can you get into an agcme fellowship: answer is probably

Can you get a job: yes but it depends is the answer. In our practice it would not happen. But I/we are biased towards anesthesia based training. Honestly we would not hire a pmr trained guy either.

You can 100 % get a ortho based job and certainly some HOPD jobs will be available depending on location etc
 
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Some states have single specialty laws regarding who can do cases or have ownership in a single specialty ASC.
 
Ronin1 said:
First question is can you get into an agcme fellowship: answer is probably

Can you get a job: yes but it depends is the answer. In our practice it would not happen. But I/we are biased towards anesthesia based training. Honestly we would not hire a pmr trained guy either.

You can 100 % get a ortho based job and certainly some HOPD jobs will be available depending on location etc
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Why not Pmr?
 
I know a few. They tend to lean more towards med mgt.

It’s ok.

Beauty of pain mgt is that you can choose what you’re willing to do and comfortable with and as long as it’s within standard of care.

There is no perfect practice for everyone. It’s individualized to you.

I’m just wary of FP trained docs trying to implant pumps and stims and how comfortable they’d be with that.
 
sloh said:
Why not pmr
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Personally I’m more comfortable with someone that followed the same training path. A lot of our older surgeons kind of look down on pmr as one of the weaker specialists as well. We have a few pmr/fm/ sports in the greater group though. They are minimally interventional.
 
It is what it is. When I’m looking for a partner I want to have many things in common including training path.
The OP asked for opinions. I wouldn’t even interview a fm/er/psych/ neuro pain doc. Unless I had personal knowledge about them.

Go ahead and roast me ☠️
 
Ronin1 said:
It is what it is. When I’m looking for a partner I want to have many things in common including training path.
The OP asked for opinions. I wouldn’t even interview a fm/er/psych/ neuro pain doc. Unless I had personal knowledge about them.

Go ahead and roast me ☠️
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You are mistaken. When looking for a partner, you want someone who compliments your skills with their own. Otherwise you’re in a circle jerk situation.
 
Adding a neuro trained pain physician to our practice has been awesome. The anesthesia trained applicants seemed terrible, but I don't let those few data points elevate or tank all physicians from a given training path.

OP-If you can get into a fellowship, I think you'd have minimal issues (outlined above) that would be region dependent. It's a great time to have an improved chance of matching. It would almost certainly be a great lifestyle move.
 
lobelsteve said:
You are mistaken. When looking for a partner, you want someone who compliments your skills with their own. Otherwise you’re in a circle jerk situation.
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That describes pretty well a subset of anesthesiologists tbh. My first thought from above was that older surgeons want people who are trained to obey. Those are the "better docs"...
 
Ronin1 said:
It is what it is. When I’m looking for a partner I want to have many things in common including training path.
The OP asked for opinions. I wouldn’t even interview a fm/er/psych/ neuro pain doc. Unless I had personal knowledge about them.

Go ahead and roast me ☠️
Click to expand...

Lol well it is your practice you can do what you want but your an idiot if you think that makes logical sense to anyone else but you. The only way I could see this making sense is if you guys split your time and also covered anesthesia at an ASC or something. But for 100% chronic pain pshhh - ACGME fellowship + board certification is all that matters. Anesthesia or not there are crappy pain docs out there - just like essentially any other field. If anything there probably are more crappy anesthesia/pain docs then not just by sheer number of physicians that are dual boarded in that pathway.
 
FamilyDoc6554 said:
I am a family medicine doctor that has had a long-term interest in pain medicine who is currently applying this cycle. Several of my friends in anesthesiology have been telling me that I should not attempt to match since their practice groups would never hire a family medicine physician who is boarded in pain. I have been out working as an attending for several years and enjoy my current position but don't want to go back to training if there honestly would not be a place for me in the field. I wanted to reach out to the SDN community and get an honest opinion for those of us looking to enter the field coming from backgrounds such as family medicine and emergency medicine.
Click to expand...
I'm in my own solo practice. I'd actually prefer hiring you over anesthesiology. First, you'd probably come in a bit lower than anesthesia would since your primary residency likely pays a bit less. Second, I could cash in on you doing a bit of primary care if necessary, which is in such high demand. I could profit from it and in turn be fed patients for my pain clinic. So tell your friends to shove it, lol

Where are you looking to practice? Get in touch in the future post fellowship. Maybe we could work something out.
 
Pain Applicant1 said:
I'm in my own solo practice. I'd actually prefer hiring you over anesthesiology. First, you'd probably come in a bit lower than anesthesia would since your primary residency likely pays a bit less. Second, I could cash in on you doing a bit of primary care if necessary, which is in such high demand. I could profit from it and in turn be fed patients for my pain clinic. So tell your friends to shove it, lol

Where are you looking to practice? Get in touch in the future post fellowship. Maybe we could work something out.
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It would be great if this could be answered once and for all with some semblance of an explanation because everyone I’ve talked to has said idk? Which is wtf to me. Is it a violation of Stark’s law for a primary care or hospital based physician to see a patient for one thing, then self refer them or to another pain physician in their group for pain eval and treatmenf?
 
hopefulgasman said:
It would be great if this could be answered once and for all with some semblance of an explanation because everyone I’ve talked to has said idk? Which is wtf to me. Is it a violation of Stark’s law for a primary care or hospital based physician to see a patient for one thing, then self refer them or to another pain physician in their group for pain eval and treatmenf?
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No attorney here but it shouldn't be an issue as long as there's no incentive to refer in house, etc.
 
Hello,
I am also a FM doctor planning to do fellowship in Pain medicine and my main target cities are Houston or Dallas, Texas.

Can you please post platforms other then Freida where I can look for pain medicine fellowships?

Also please share the discord group link where I can look for pain fellowships.
 
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SgtThunderfistMD said:
Houston and Dallas are 2 of the most saturated cities for PM. Very unlikely to find a half-decent job even with Anesthesia background.
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What would you recommend then, I can't change the cities due to family ties.

I don't wanna do more then 1 year fellowship so which specialities are most in demand in Texas? Especially from opening a clinic point of view and less competitive.

Lot of people are recommending me geriatrics but I don't wanna do home visits.
 
Numerator said:
What would you recommend then, I can't change the cities due to family ties.

I don't wanna do more then 1 year fellowship so which specialities are most in demand in Texas? Especially from opening a clinic point of view and less competitive.

Lot of people are recommending me geriatrics but I don't wanna do home visits.
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You should only pursue a fellowship that you are sincerely passionate about otherwise you are absolutely wasting your time, efforts, and opportunities.
 
Palliative care and wound care actually do quite well, I hear. I think it’s because hospice and wound care lead to a lot of RN visits you can bill for. Those may be better fellowships.
 
hopefulgasman said:
You should only pursue a fellowship that you are sincerely passionate about otherwise you are absolutely wasting your time, efforts, and opportunities.
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I am looking for specialities that can benefits me in running a successful family clinic and also boost my income potential as a family physician.
 
Agast said:
Palliative care and wound care actually do quite well, I hear. I think it’s because hospice and wound care lead to a lot of RN visits you can bill for. Those may be better fellowships.
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Thanks for your response and suggestions .
Honestly I am in the process of gathering data, as I am confused which specialities can potentially increase my earnings as a solo practitioner and can potentially be completed within a year.

Also although I am more interested in pain medicine but I don't want to waste time if i dont get selected so looking for more specialities to put in my selections that are rightly aligned with my career goals in Texas state.

I really appreciate if you can share more lesser known platforms through which I can apply for fellowships. E.g perhaps some discord channels etc
 
bedrock said:
What is a discord channel? You’ve used that term twice already
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Discord is an online messaging platform (think chat room). There are several pain management discord servers out there, one for current fellows to discuss fellowship/job hunt/board studying etc etc, one for applicants to discuss application strategy/program reviews etc etc. This person is likely asking for an invite to the applicant discord channel.
 
Numerator said:
I am looking for specialities that can benefits me in running a successful family clinic and also boost my income potential as a family physician.
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You can't do family clinic with a little pain on the side. Go all-in with pain only or just stick with concierge family.
 
I’m Anesthesiology trained.

The field doesn’t need people who can just steer a needle. It needs physicians who know how to diagnose, coordinate care, and can steer a needle to the correct location.

I think the sooner the field becomes less Anesthesiology dominant the better.
 
lobelsteve said:
Hoping to keep discord stuff off of our SDN forums. Unsure if competing platform, but good things do not happen on discord.
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Discord is just a forum/chat vehicle with less formatting. It's sort of like Reddit and whether it's good or bad is based on the participants. I highly doubt a doctor discord is anything to be worried about.
 
Just do family and set up a DPC practice or do a sports med fellowship and then DPC so you can add in some MSK stuff.
 
I don’t see how DPC would work with sports med. You would give away all of your easy big pay days (non displaced fracture care) and keep your time/expense sucks (us guided injections). The math doesn’t work.
 
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