seeing the amazing response, perhaps i need to shed some light here 🙂
me: new attending. anesthesia trained. pain fellowship trained. finished training in summer of 2015. was in PP for 7 months (was employed by them) but didnt like it, took a hospital job...much happier. still ups and downs like tremendous beuracracy, inefficiencies, fighting for fluoro time, types of patients and case load since FP/PCP are ridiculous and wont even examine the patient or evaluate or order basic imaging for work ups. >50% of my population is medicaid. im the only pain doc catering to 20 pcps, spine surgeons, a huge cancer department...plus i do anesthesia 1 day a week.
it is busy, but so far so good.
its a 2 year contract. basically my goal is to get my procedures in and slowly build my skill then go independent in an area where i will settle.
i have realized i really want my independent practice. its not so much about the money - its the fact that i want my own brand. i want to primarily do cancer pain, spinal pain and possibly addiction medicine (not suboxone) - essentially multidisciplinary with emphasis on things i like. plus possible ketamine infusions, CBT, etc. all under one roof. i think having a neurologist in my practice will be useful, they can do EMGs and offer neurological view point...maybe my own imaging center..not a big fan of ASC since more staff = more headache. ofcourse fluoro/ RFA stuff.. i am not sure what is the limit - seems limitless given the huge shortage of quality pain docs and PCPs not wanting to manage pain.
not a big fan of PA's as i like to do everything myself. atleast initially. i will obviously need MA's. so i probably will cap out at 700-1000 patients total...esp. if i have them on opiates, and if they meet the criteria for long term opiate therapy for chronic non malignant pain...
a practice of that nature is my dream.
i have been researching all this very heavily. they say one should start preparing 18-20 months before.
what can i do at this time?
is this kind of a practice sustainable? what are the start up costs of this practice? will it be profitable? if i am seeing 20 patients in clinic and doing 10 procedures a day? (bread and butter stuff).
how do i get the patient volume in? i mean high quality patients.
Do i get them from providing inpatient pain consults or staffing the ER? (someone mentioned this to me, but i cant imagine the quality of ER pain patients being very good).
advice welcome. if you can share any stories and resources, that will be helpful
