May 24, 2012
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I wanted to ask a few questions and wanted to be honest so that responses may help me decide if PM&R is the place for me.

I am a 4th year med student was interested in ortho until I realized that surgery just was not my thing, which was surprising because I love working with my hands.

My main worry with PM&R are first the patient population, I am concerned that I will be seeing a lot of pill seekers. I say this because it seemed like in IM and FM if we ran into a pill seeker we sent them to PM&R. However, from personal experience my sister who was in a terrible accident really had chronic pain and all her doctors thought she was a pill seeker, it was a PM&R doctor who said he believed her. Eventually he got her off the drugs so she could go back to school. She has always said the best treatment she ever recieved was being believed.

I know right now I jump to the pill seeker conclusion too fast and that it will be a challenge for me to admit I can be wrong and really help these people. I know thats probably not the mentality someone looking at PM&R should have, but it is also that challenge of changing my thinking that interest me in PM&R, a field that will mature me and make me a better doctor. Instead of one that will play on my stereotypes.

Another question is what should I read and how should I act as a student? Are pimp questions common and what questions are asked? I am used to being the super gunner for ortho knowing everything, running around constantly and never being seen relaxing. I dont know if this is exactly going to impress in a more relaxed enviroment.
 

RUOkie

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Mar 3, 2009
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OP:
As I have said in to other students, there is nothing wrong with being a gunner. I certainly was/am one. If you go into your career as somebody who is reliable, hard working, and smart, you will do well in any specialty.

My journey towards PM&R started when I realized I did not LOVE the OR, despite loving orthopedics. It did not stop me from working hard. I am now respected by my orthopedic and neurosurgical colleagues. Just today, a neurosurgeon asked me to look at an MRI because he did not agree with the radiologist, and wanted to know my opinion.

The issue about drug seekers is a little harder, and one which I struggle with to this day. I have come to the point that all I can do is take people at their words, but trust nobody. I don't Rx opiates for back pain, because the literature does not support their use. Every patient on controlled substances in my practice gets drug tested regularly and are checked for double dipping on the state database. I have no qualms about firing patients if they don't comply. Luckily, I am getting to the point that I will no longer have any chronic opiate patients within the next year.
 

SSdoc33

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Apr 23, 2007
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I wanted to ask a few questions and wanted to be honest so that responses may help me decide if PM&R is the place for me.

I am a 4th year med student was interested in ortho until I realized that surgery just was not my thing, which was surprising because I love working with my hands.

My main worry with PM&R are first the patient population, I am concerned that I will be seeing a lot of pill seekers. I say this because it seemed like in IM and FM if we ran into a pill seeker we sent them to PM&R. However, from personal experience my sister who was in a terrible accident really had chronic pain and all her doctors thought she was a pill seeker, it was a PM&R doctor who said he believed her. Eventually he got her off the drugs so she could go back to school. She has always said the best treatment she ever recieved was being believed.

I know right now I jump to the pill seeker conclusion too fast and that it will be a challenge for me to admit I can be wrong and really help these people. I know thats probably not the mentality someone looking at PM&R should have, but it is also that challenge of changing my thinking that interest me in PM&R, a field that will mature me and make me a better doctor. Instead of one that will play on my stereotypes.

Another question is what should I read and how should I act as a student? Are pimp questions common and what questions are asked? I am used to being the super gunner for ortho knowing everything, running around constantly and never being seen relaxing. I dont know if this is exactly going to impress in a more relaxed enviroment.

"My main worry with PM&R are first the patient population,"

that is a legitimate concern. there will be lots of patients looking for pills. whatever anobody tells you, it is exausting to fight / babysit these patients. there are fields within PMR that dont have much interaction with opioids, but that is rare. i would not change the choice that i have made, and i do really enjoy my work and the field of PM&R...... but the patients can be draining.
 

PMR 4 MSK

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Oct 1, 2007
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If you prescribe pain pills, pain pill seekers will seek you out.

Solution: Don't prescribe opiates for most chronic pain patients. It is controversial and typically causes more problems than it solves.