Is it possible to perform spinal procedures like ESIs or RFAs without doing a spine fellowship? It is my understanding that insurance companies want evidence you know what you are doing such as a case log before they will pay you. If I was able to perform enough of these procedures in residency would that suffice? Thanks for any responses. I am trying to learn more about billing and the business side of medicine.
Is fellowship required for spine procedures?
- Thread starter MavFab
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Depends. I've had a handful of classmates do this, but mostly in non-super competitive areas in the country. In high competitive areas unlikely. Most groups won't hire you and good luck if you get sued. If you get sued without a fellowship good luck winning the lawsuit. Wouldn't recommend it. I don't think for the most part that it's a good idea. And more and more pain requires ACGME fellowship. Credentialing at hospitals also requires fellowship and a log. Makes no sense to not do a fellowship. It's a year.
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It depends on your training program, employer, and state.
Certain programs (i.e. LSU) you would probably have enough hands on experience to do lumbar ESIs, MBB/RFA, and SI joints. For an individual right out of training I would not sign off at our facility unless you performed at least 50 supervised independent performed ESIs and MBBs/RFAs with evidence that you did them correctly and/or could identify vascular/dangerous flow and do the appropriate correction. Plus your residency director would need to sign off that you are competent through this request for procedure form and most seem hesitant to do that for a resident without fellowship training. Personally I would not sign off on someone to do cervical injections right out of training unless they are fellowship trained.
If you/your practice had an in office fluoro suite then you could do whatever you wanted to do if you got approved for payment by your insurance payors or just did it cash based with appropriate disclosure.
Doing a pain or spine fellowship (or PM&R sports that offers spine training) will be a huge benefit for your future if you want to do spine procedures.
Certain programs (i.e. LSU) you would probably have enough hands on experience to do lumbar ESIs, MBB/RFA, and SI joints. For an individual right out of training I would not sign off at our facility unless you performed at least 50 supervised independent performed ESIs and MBBs/RFAs with evidence that you did them correctly and/or could identify vascular/dangerous flow and do the appropriate correction. Plus your residency director would need to sign off that you are competent through this request for procedure form and most seem hesitant to do that for a resident without fellowship training. Personally I would not sign off on someone to do cervical injections right out of training unless they are fellowship trained.
If you/your practice had an in office fluoro suite then you could do whatever you wanted to do if you got approved for payment by your insurance payors or just did it cash based with appropriate disclosure.
Doing a pain or spine fellowship (or PM&R sports that offers spine training) will be a huge benefit for your future if you want to do spine procedures.
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It's a liability thing, not necessarily how good you are doing something. If you are only board certified in PM&R then I wouldn't want to get sued for something that has separate ACGME training and fellowships for.
But, yes it is possible to do those injections without fellowship. There are job positions out there that don't care if you are fellowship trained or not.
But, yes it is possible to do those injections without fellowship. There are job positions out there that don't care if you are fellowship trained or not.
