Fears about Pain Fellowship

[Propofool123]

Hi all,

I’m currently a CA-1 and considering applying to pain. I’m also considering regional anesthesia. I don’t mind the Pain patient population, find the topic interesting, and think that The Interventional Pain procedures are cool and innovative. My problem is the following:

I’m at the ASRA pain conference and can’t help but think some of the people here come off as snake oil salesmen - especially the neuromodulation folks. Especially when those same people speaking are wearing Louis Vuitton or Gucci dress shoes or suits. My concern is - is this a common thing in pain? Is this the general personality of the people in this field?

Also, i know the evidence behind interventional procedures in pain is not great. What, then, makes interventional-heavy docs different from chiropractors who also don’t have great evidence behind the “procedures” they perform?

I really don’t mean to be offensive but it’s a genuine question.

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[lobelsteve]

They are ****** of industry. Look them up in dollars for doctors and you can know their conclusions before they talk. Skepticism is the greatest asset in a pain doctor. You are geared for the line of work. Kudos. Never stop learning.

 

[deleted993114]

Hi all,

I’m currently a CA-1 and considering applying to pain. I’m also considering regional anesthesia. I don’t mind the Pain patient population, find the topic interesting, and think that The Interventional Pain procedures are cool and innovative. My problem is the following:

I’m at the ASRA pain conference and can’t help but think some of the people here come off as snake oil salesmen - especially the neuromodulation folks. Especially when those same people speaking are wearing Louis Vuitton or Gucci dress shoes or suits. My concern is - is this a common thing in pain? Is this the general personality of the people in this field?

Also, i know the evidence behind interventional procedures in pain is not great. What, then, makes interventional-heavy docs different from chiropractors who also don’t have great evidence behind the “procedures” they perform?

I really don’t mean to be offensive but it’s a genuine question.

There are a lot of crooks in pain medicine. But there are A LOT of good, ethical docs. Just be one of the good guys. You can only control the world within your arms length.

Pain medicine is an interesting field and one can that continue to provide benefit and innovation to medicine. Try to be a doc that relies upon evidence based medicine and be one of the ones who helps the field.

 

[drusso]

Louis Vuitton and Gucci indicate that they are just poser/pretenders. Look for Hugo Boss and Versace. Those are the guys you want to hitch your wagon to...

 

[Agast]

I wear sketchers that my mom buys me and my patients compliment me on how comfortable my shoes look all the time. If living your best life means Gucci shoes, that’s great! You will also never be able to stop working.

 

[lobelsteve]

I have a New Balance fetish/problem/collection.

 

[dhcofc]

I have a New Balance fetish/problem/collection.

AKA “Dad shoes.” I know. I have them too.

 

[SommeRiver]

Mizuno

 

[deleted993114]

Louis Vuitton and Gucci indicate that they are just poser/pretenders. Look for Hugo Boss and Versace. Those are the guys you want to hitch your wagon to...

We have always been instructed to never wear expensive suits and just wear a white or blue shirt with khakis. The old way you could tell if someone was loaded was to look at the shoes and the watch, not the clothes. Now, that is not applicable, as many people wear comfortable commercial shoes and few young people wear watches anymore. For the watch wearers, the climbers wear Rolexes, while the real rich wear Pateks, VCs, or A Lange&Sohne in unassuming models (Calatrava, Patrimony, and Saxonia respectively- no Pour Le Merites).

I have divorced myself from consumerism and dress simply, drive an old pickup, and live in a relatively inexpensive ranch house. That stuff just doesn't "deliver", but it takes a while to figure that out.

As a shameless plug for handmade shoes, there is a shoe company in Maine called "Maine Sole", where they are working out of the old Dexter site and have employed those displaced workers making handmade shoes. The guy did it to help the local economy. Buy a few pairs- they are only $300-$400 and are some of the best shoes I have ever had- better than handmade overseas shoes that sell for over $1K. Try them- you are helping American workers and getting good shoes.

 

[Orin]

Hi all,

I’m currently a CA-1 and considering applying to pain. I’m also considering regional anesthesia. I don’t mind the Pain patient population, find the topic interesting, and think that The Interventional Pain procedures are cool and innovative. My problem is the following:

I’m at the ASRA pain conference and can’t help but think some of the people here come off as snake oil salesmen - especially the neuromodulation folks. Especially when those same people speaking are wearing Louis Vuitton or Gucci dress shoes or suits. My concern is - is this a common thing in pain? Is this the general personality of the people in this field?

Also, i know the evidence behind interventional procedures in pain is not great. What, then, makes interventional-heavy docs different from chiropractors who also don’t have great evidence behind the “procedures” they perform?

I really don’t mean to be offensive but it’s a genuine question.

The conferences are basically times for people to peacock, but in general pain medicine comes with a higher degree of salesmanship than regular anesthesia. You're selling yourself and your skillset to the patient's, referrers, etc. They're coming to have YOU specifically fix them, and aren't there for the surgeon who's doing whatever.

It's a different thing. The sliminess is a factor of the individual, but the ability to connect with the patient/build trust/give faith does require some showmanship. Think of it as similar to looking/being slick with an AFOI or a nerve block catheter, except it occurs all the time and it's for the benefit of the patient via the placebo response and your pocket instead of the OR/surgical teams.

With that said, ASRA and NANS are political conferences/trade shows disguised as an academic conference, so it's a prime location for those shenanigans.

 

[Baron Samedi]

If you thought ASRA was bad wait until NANS. 100x worse(better).

 

[Doctodd]

Stick to anesthesia.....geta wont get denied and you will probably never do a peer to peer

 

[TheLoneWolf]

 

[Timeoutofmind]

View attachment 286594

LOL!!!!!!!!!

 

[chudat]

radiology msk vs pain fellowship...which would you choose?

 

[dhcofc]

radiology msk vs pain fellowship...which would you choose?

Pathologist or pain fellowship... which would you choose?

 

[slippery_when_wet]

Pathologist or pain fellowship... which would you choose?

msk radiologists do almost everything (intervention wise) compared to pain docs, no?

 

[Baron Samedi]

msk radiologists do almost everything (intervention wise) compared to pain docs, no?

In the same way that celebrity chefs do almost everything that professional athletes do.

Are you a pre-med?

 

[BobBarker]

There are a lot of interventional msk radiologists. Doug Beall is a good example.

 

[chudat]

In the same way that celebrity chefs do almost everything that professional athletes do.

Are you a pre-med?

lol

 

[Agast]

Do interventional radiologists do a physical exam and consultation before their procedure? The few times a patient has come my way after a radiologist procedure it was clear it was done based on imaging and not actual complaint.

 

[lobelsteve]

I like my IR as technicians and not clinicians. I had my first failed attempt at a kypho last month. Called up my IR guy and he got it done no problem.
There are nearby guys that get referrals for ESI from surgeons. Never at possible location to do any good. Often at C4-5, C5-6, L3-4 for L5_s1 disc extrusions.

 

[paindoc007]

I like my IR as technicians and not clinicians. I had my first failed attempt at a kypho last month. Called up my IR guy and he got it done no problem.
There are nearby guys that get referrals for ESI from surgeons. Never at possible location to do any good. Often at C4-5, C5-6, L3-4 for L5_s1 disc extrusions.

If you talk to any IR doc, they also like being technicians and not clinicians. One of the perks of the job to them, do the procedures other people ask of them.

 

[cowboydoc]

msk radiologists do almost everything (intervention wise) compared to pain docs, no?

MSK rads not equivalent to IR. Lots of MSK rads never see or touch a patient. (They are in the MSK corner of the basement)

 

[chudat]

Do interventional radiologists do a physical exam and consultation before their procedure? The few times a patient has come my way after a radiologist procedure it was clear it was done based on imaging and not actual complaint.

They do whats the ordering doc ordered

 

[Baron Samedi]

Often at C4-5

You've got some gutsy IR docs!

 

[SSdoc33]

You've got some gutsy IR docs!

or some stupid ones. they probaby dont even know all the risks.

 

[Doctodd]

or some stupid ones. they probaby dont even know all the risks.

smh......why do you hate on everyone?