Fellowships and $$

[GuP]

Anesthesia has a buncha fellowships including pain, regional, critical care, ob, peds, cardiothoracic, neuroanesthesia, perioperative, and ambulatory. From a strictly monetary point of view, will any of these fellowships allow you to make big bucks over your avergae gas passer w/o advanced training? I have read that pain in pp is an eat what you kill environment. Just wanted to get info from the powers that be. Holla.

 

[VentdependenT]

Anesthesia has a buncha fellowships including pain, regional, critical care, ob, peds, cardiothoracic, neuroanesthesia, perioperative, and ambulatory. From a strictly monetary point of view, will any of these fellowships allow you to make big bucks over your avergae gas passer w/o advanced training? I have read that pain in pp is an eat what you kill environment. Just wanted to get info from the powers that be. Holla.

Pain.

All the other stuff should be done because you have a desire for further learning.

The best way to make $$$ is find a solid group and become a useful, reliable, conscientious, team member who will break his/her back to get cases done in quantity (fast turn over, no loose ends at the end of the case to suck up PACU time, etc) and quality.

 

[AK_MD2BE]

Can anesthesiologists who do a pediatric fellowship or cardiac fellowship command a higher salary?

 

[jetproppilot]

Can anesthesiologists who do a pediatric fellowship or cardiac fellowship command a higher salary?

Generally no.

 

[dr doze]

.

 

[jetproppilot]

Pain.

Gotta buddy with his own office/micro "surgery center" where he does all his interventional stuff. Fluoro room that only he uses.

He has a (highly paid) P.A. who does mosta the leg work.

After leg work done, he meets with the patient, provides recommendations, does the procedures.

Minimal-to-no opiod stuff.

Deft with his judgement. Deft with his hands.

Highly respected/referred to in the medical community. Waiting list to get into his office.

Seven figures annually.

No weekends, holidays, nights.

He's created the ultimate pain gig.

 

[Leverage]

Pain.

Gotta buddy with his own office/micro "surgery center" where he does all his interventional stuff. Fluoro room that only he uses.

He has a (highly paid) P.A. who does mosta the leg work.

After leg work done, he meets with the patient, provides recommendations, does the procedures.

Minimal-to-no opiod stuff.

Deft with his judgement. Deft with his hands.

Highly respected/referred to in the medical community. Waiting list to get into his office.

Seven figures annually.

No weekends, holidays, nights.

He's created the ultimate pain gig.

sign me up

 

[jetproppilot]

Jet,

I would disagree with your response. IMO the cardiac fellow who graduates with strong TEE skills will be able to get the better job, i.e. the shorter partnership track, or the the job offer that he wouldn't otherwise get in the desirable city.

Agreed.

But the vast majority of groups arent like that. I'd say 90% don't require fellowship training.

Thats why I said "generally".

 

[GuP]

Pain.

Gotta buddy with his own office/micro "surgery center" where he does all his interventional stuff. Fluoro room that only he uses.

He has a (highly paid) P.A. who does mosta the leg work.

After leg work done, he meets with the patient, provides recommendations, does the procedures.

Minimal-to-no opiod stuff.

Deft with his judgement. Deft with his hands.

Highly respected/referred to in the medical community. Waiting list to get into his office.

Seven figures annually.

No weekends, holidays, nights.

He's created the ultimate pain gig.

Jet, would you say this is the norm? If a pain guy fresh outta indentured servitude decides to put up a shingle and open his own office, what is the likelihood that he will get where your buddy is?

Also what are some of the bread-butter procedures that these pain guys do that generate so much income?

 

[Disciple]

You don't make 7 figures just by doing procedures (Medicare epidurals reimburse less than $100 and the fluoro code is now bundled). You gotta own a surgery center and collect facility fees to make that kind of money (among other things). If you live in a "Certificate of Need" state, it's extremely difficult to get permission to open a new one.

The first generation pain guys were able to make that kind of money. I don't think this is possible anymore, especially in metropolitan areas where there are alot of interventionalists. The pioneer interventionalists who have big reps in their communities are probably the exception.

PCPs in these areas can pick and choose who they refer to. If you don't help them out with the opiates, they get pissed and refer to the guy down the street, or in the next suburb over, who may be a new grad. That's what they really care about, someone to help with the opiates. Other than that, you can do any procedure you see fit.

OTOH, you can work for a surgical group, and not worry about opiates, but make less, and not be offered partnership.

ASC rates for pain procedures were cut in 2007 and are going to be cut for the next 4 years (you can thank the AHA for that) and the Office of the Inspector General (OIG) is doing a review of interventional pain procedures this year. CMS knows that alot of money is being spent on these procedures.

You gotta diversify to make it in pain nowadays. Work comp, IMEs, report writing, dispensing meds out of the office, etc.

On the other hand, you can sign up with someone like Jet's friend and burn your hands off under the c-arm for a couple of years and then hopefully make partner.

Think he'd want to share some of that 7 figures with you?

 

[jetproppilot]

Jet, would you say this is the norm? If a pain guy fresh outta indentured servitude decides to put up a shingle and open his own office, what is the likelihood that he will get where your buddy is?

Also what are some of the bread-butter procedures that these pain guys do that generate so much income?

No.

Read disciples post above.

He's been in the game for over ten years, owns his own place (facility fees like disciple said) etc etc.

 

[GuP]

Hmmm I see. So pain is out too huh? I guess if you are strictly about the benjamins, then don't do a fellowship.

 

[LonghornJPS]

Gup, I thought you might find this thread interesting.

http://forums.studentdoctor.net/showthread.php?t=503152