haha yea most of the things said about IP work is true. That being said, we actually provide 24/7 inpatient coverage at 2 hospitals. Our outpatient work is busy, but we do the inpatient stuff for few reasons. One, it brings you to the hospital and forces you to interact with the primaries/orthos/neurosurg on a regular basis. I probably spend half my time there just BS'ing with docs that I run into. Second, hospital admins LOVE having inpatient pain service. It's a service that adds value in their eyes, and can help improve inpatient outcomes on metrics tracked by ACO's (don't get me started on ACO's...not good). Being in good favor with the admins/hospitals is always a plus. Lastly, the money's not that bad. We're lucky in that the hospitals we work at see very little public aid. A level 3 IP consult pays about $200, and follow ups $100. Even the moderate levels pay about $140/70. For about 5-15 mins of work its not bad. That being said, we've had failed forays into hospitals as far as setting up IP services, mostly for the reasons you initaly mentioned. Also if the primaries tend to admit through the hospitalist service, then it prob won't help your OP referrals much.