Pain Clinics a viable career goal?

[WVmed]

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I am interested in critical care anesthesia but also like the idea of being in a shared-practice or solo pain clinic. I understand most anesthetists work as hospital employees and thus don't have some of the freedoms which may (or may not) come with a "private" pain clinic. Do many anesthetists work in this high level of care? I assume anesthetists could also be valuable in sleep centers. Any insight into this exciting field ?

 

[Furious_D]

I am interested in critical care anesthesia but also like the idea of being in a shared-practice or solo pain clinic. I understand most anesthetists work as hospital employees and thus don't have some of the freedoms which may (or may not) come with a "private" pain clinic. Do many anesthetists work in this high level of care? I assume anesthetists could also be valuable in sleep centers. Any insight into this exciting field ?

First of all, its not anesthetists (unless you are in England) its ANESTHESIOLOGISTS. The former are nurses, the latter are physicians - big difference. Do us all a favor and educate yourself before posting such a seemingly contradictory post. 😍

 

[jetproppilot]

First of all, its not anesthetists (unless you are in England) its ANESTHESIOLOGISTS. The former are nurses, the latter are physicians - big difference. Do us all a favor and educate yourself before posting such a seemingly contradictory post. 😍

Whoa. Don't mess with da man.

 

[WVmed]

First of all, its not anesthetists (unless you are in England) its ANESTHESIOLOGISTS. The former are nurses, the latter are physicians - big difference. Do us all a favor and educate yourself before posting such a seemingly contradictory post. 😍

My thread should have had a disclaimer: no flames! This is a professional forum not some pre-med flame pit. So I made a mistake, give me a break. Or you can just call the dogs on me. I wonder if this is how you deal with your patients in your own head? I hope you can find a better way of dealing with people that have "less" knowledge than yourself.

 

[Skip Intro]

I am interested in critical care anesthesia but also like the idea of being in a shared-practice or solo pain clinic. I understand most anesthetists work as hospital employees and thus don't have some of the freedoms which may (or may not) come with a "private" pain clinic. Do many anesthetists work in this high level of care? I assume anesthetists could also be valuable in sleep centers. Any insight into this exciting field ?

Well, first off, Critical Care is a one-year fellowship following four years of anesthesiology, and Pain is a one-year fellowship following four years of anesthesiology. If you want to get certified in both, you'd have to do two separate fellowships, unless there are combined programs I don't know about (anyone?). If you were suggesting an either/or scenario, then I think you could do pain fellowship and then set-up in an outside clinic and not be a "hospitalist" if you wanted to go that route. There is a big demand for pain specialists right now with commensurate compensation. Whether that continues will depend on how many enter the field over the next 5-10 years.

The pain guy I worked with actually had a sweet deal. The hospital he was working at was very interested in setting-up a pain service. So, they basically gave him an off-site clinic where he could see patients provided that he did all of his procedures in their ambulatory center. So, essentially, he gets to see patients in his office (that they pay for) but does all the procedures in their facility. This is win-win for both because he gets a free office and the hospital gets him to bring patients into their ambulatory center, which they get to bill for. The only downside, as I could see it, is that they required him to manage the in-hospital pain service (i.e., he had to round on all of the patients on PCA). Although, he usually just got a resident to do this part for him, collect the notes, review and sign-off, and then have a resident or student re-insert the notes in the chart. So, it wasn't that "painful" for him (pun intended ). Also, part of the deal was he covered the OR on Fridays if they needed an extra anesthesiologist.

-Skip

 

[prefontaine]

If PSUSOM is Penn State in Hershey, spend some time with Vitaly Gordin in the pain department.

I am interested in critical care anesthesia but also like the idea of being in a shared-practice or solo pain clinic. I understand most anesthetists work as hospital employees and thus don't have some of the freedoms which may (or may not) come with a "private" pain clinic. Do many anesthetists work in this high level of care? I assume anesthetists could also be valuable in sleep centers. Any insight into this exciting field ?

 

[florisio]

First of all, its not anesthetists (unless you are in England) its ANESTHESIOLOGISTS. The former are nurses, the latter are physicians - big difference. Do us all a favor and educate yourself before posting such a seemingly contradictory post. 😍

Easy killer. The chairman of the department of Anesthesiology and Critical Care at MGH is the Anesthetist-in-Chief.

 

[rn29306]

Easy killer. The chairman of the department of Anesthesiology and Critical Care at MGH is the Anesthetist-in-Chief.

Very nice.

 

[GasEmDee]

Easy killer. The chairman of the department of Anesthesiology and Critical Care at MGH is the Anesthetist-in-Chief.

Haha.

The boards in UCSF operating rooms also use the term "anesthetist", and they dont use CRNAs

 

[WVmed]

Well, first off, Critical Care is a one-year fellowship following four years of anesthesiology, and Pain is a one-year fellowship following four years of anesthesiology. If you want to get certified in both, you'd have to do two separate fellowships, unless there are combined programs I don't know about (anyone?). If you were suggesting an either/or scenario, then I think you could do pain fellowship and then set-up in an outside clinic and not be a "hospitalist" if you wanted to go that route. There is a big demand for pain specialists right now with commensurate compensation. Whether that continues will depend on how many enter the field over the next 5-10 years.

The pain guy I worked with actually had a sweet deal. The hospital he was working at was very interested in setting-up a pain service. So, they basically gave him an off-site clinic where he could see patients provided that he did all of his procedures in their ambulatory center. So, essentially, he gets to see patients in his office (that they pay for) but does all the procedures in their facility. This is win-win for both because he gets a free office and the hospital gets him to bring patients into their ambulatory center, which they get to bill for. The only downside, as I could see it, is that they required him to manage the in-hospital pain service (i.e., he had to round on all of the patients on PCA). Although, he usually just got a resident to do this part for him, collect the notes, review and sign-off, and then have a resident or student re-insert the notes in the chart. So, it wasn't that "painful" for him (pun intended ). Also, part of the deal was he covered the OR on Fridays if they needed an extra anesthesiologist.

-Skip

Sounds like it is a viable and realistic goal, but I am only MS1 this coming fall. What that means is my plans are still wet cement (I have not even opened the bag of QUIKCRETE yet). I hope to learn more about pain as my clinical years approach. Thanks for your insights!

 

[skypilot]

I am interested in critical care anesthesia but also like the idea of being in a shared-practice or solo pain clinic. I understand most anesthetists work as hospital employees and thus don't have some of the freedoms which may (or may not) come with a "private" pain clinic. Do many anesthetists work in this high level of care? I assume anesthetists could also be valuable in sleep centers. Any insight into this exciting field ?

I thought Anesthesiologists were usually partners or owners in group practices that contracted their services to hospitals and not employees of the hospitals?

 

[Skip Intro]

Sounds like it is a viable and realistic goal, but I am only MS1 this coming fall. What that means is my plans are still wet cement (I have not even opened the bag of QUIKCRETE yet). I hope to learn more about pain as my clinical years approach. Thanks for your insights!

Well, if you're starting at Penn St (as was suggested above), then you should make yourself known and definitely stop by their program and get to know the residents, the chair and the PD (if/when you have time). In a couple of years when it comes time for electives, do a rotation (or two) in the department. It's a really strong program from all accounts on this forum, and I think - at the very least - a letter coming from them will help you out a lot... you may even decide to stay there.

However and whenever your concrete dries, good luck to you. 😉

-Skip

 

[Murdawg]

Hi everyone,
I'm wrapping up my first year in med school, and I am strongly considering anesthesiology as a career path. Particularly, I am interested in pain. My undergrad major was neuroscience, and i've always been fascinated with all things neuro. Basically, I want to know how competitive it is to get into a good pain medicine fellowship. What is the applicant pool like? Any info, help, advice, or insight would be greatly appreciated.

 

[Goose...Fraba]

if you can run through hot burning coals while fat people throw ham sandwiches at you then your in 👍

trust me, this is what one must do to obtain the ever coveted "pain" fellowship.

since your a first year, you can start by going up to your anatomy professor and kick him in the balls then scream "I LOVE PAIN BABY" 😍

Goose

ps just kidding by the way, except the part about fat people

 

[Goose...Fraba]

man this is fun, kinda like being in high school again...... 😉
Goose

 

[edinOH]

I hope to learn more about pain as my clinical years approach. Thanks for your insights!

Pardon the EM guy for posting on the gas forum, but how can you all let this one get by you? 😉

You will definitely learn more about pain during your clinical years. Especially while rounding all day on medicine or writing notes at 5 a.m. on surgery.

 

[WVmed]

Pardon the EM guy for posting on the gas forum, but how can you all let this one get by you? 😉

You will definitely learn more about pain during your clinical years. Especially while rounding all day on medicine or writing notes at 5 a.m. on surgery.

At my college there are fourth yr rotations available in pain clinics as well as critical care anesthesia. I will do one of each, however, I think the pain will be enduring the two years of basic sciences leading up to clinical rotations.
And you say rounding all day on medicine as if it's something of a suprise. I am pretty much hanging up the coat of my old life at the door and trying to immerse into the hospital for the next 10 years. After that, we will see what the physicians office centers and clinics can provide.

 

[MechE]

Does anyone know how much a pain doc can make starting out? I know it varies with location and how many cases you do, but if anyone could give me a general idea, that would be great.

Thanks.

 

[NRAI2001]

How difficult is it for FMG's to get a pain fellowship?