pain jobs

[deleted697535]

Just looking on gasworks the pain jobs are way out in front in salary terms. What gives? Is this for real? How come these jobs aren't snapped up?
Would it be worth it to retrain for a year to bank that much for a 9 to 5?

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[Biohazard685]

Look at who is posting the ads.

If you see the names Vincent Kalra then it's all BS.

Also a lot of them have a range that includes base plus productivity bonus.

Some of these places are bad practices, go to the pain board and look up pills for pokes, urine mills, etc.

 

[Lecithin5]

Just looking on gasworks the pain jobs are way out in front in salary terms. What gives? Is this for real? How come these jobs aren't snapped up?
Would it be worth it to retrain for a year to bank that much for a 9 to 5?

My good friend, over the past few years, reimbursement for pain has gone way way down. So I would be very wary of any job that offers a “killing”- because all that means is that you have to work for that money, whether it’s seeing a tremendous amount of patients a day, or doing a tremendous amount of procedures per day. There’s no such thing as free money. So filtering those jobs out, more commonly, an average pain job is actually reimbursing on par with or even less than an anesthesiology job (ie starting 250-300k in the midwest).

 

[MiddleOfNowherrr]

If it sounds too good to be true it probably is. Those jobs probably involve pushing way too many opioids to drug addicts and being forced to do procedures on anyone with a pulse (subjecting oneself to a LOT of radiation). I make less than my anesthesia friends...
So does another pain friend of mine...

 

[zero0]

If it sounds too good to be true it probably is. Those jobs probably involve pushing way too many opioids to drug addicts and being forced to do procedures on anyone with a pulse (subjecting oneself to a LOT of radiation). I make less than my anesthesia friends...
So does another pain friend of mine...

Why are pain fellowships still even filling then? I know a few docs out there doing full-time pain straight out of anesthesia residency. They're rural but still, do you even need a pain fellowship?

 

[ryanjmy]

Why are pain fellowships still even filling then? I know a few docs out there doing full-time pain straight out of anesthesia residency. They're rural but still, do you even need a pain fellowship?

Besides the expertise, I know in some states if you want to open a clinic you must have a fellowship. In other words you’ll alway be an employee

 

[AdmiralChz]

I’m not in chronic pain but the same mantra for fellowship should apply to your practice if at all possible - your focus should be on PROCEDURES and not on medication management (with a tilt towards minimal to no narcotic scripts). Unfortunately, some particularly odious colleagues out there do both with procedures and then have essentially a pill mill on the side - slowly but surely, these leeches are getting exposed.

 

[GaseousClay]

From what I heard the Kaiser pain docs are really killing it. They have PM&R seeing the chronic pain people and managing narcotics and all they do is the interventional stuff. They can work in the OR as well and crush it with the overtime. They make well above the general anesthesiologists there.

 

[Aether2000]

It seems to be the opposite in Florida. I have been contacted by several different groups looking for pain physicians. Their starting pay is $250K- far lower than starting pay elsewhere.

 

[chocomorsel]

Why are pain fellowships still even filling then? I know a few docs out there doing full-time pain straight out of anesthesia residency. They're rural but still, do you even need a pain fellowship?

Because some people like having control of their schedules.
And maybe they get a kick out of taking care of manipulative drug seekers?

 

[Hoya11]

Just looking on gasworks the pain jobs are way out in front in salary terms. What gives? Is this for real? How come these jobs aren't snapped up?
Would it be worth it to retrain for a year to bank that much for a 9 to 5?

Pain docs do indeed make much more than anesthesiologists, typically.

When you do procedures, you can take your cases to a surgery center and become a partner in that surgery center - big money.

Also you can become a partner in an ortho group who feeds you referrals,. You keep the post-op patients happy with opiates, you do injections on some, you split a share of the ortho/neuro group profit - big money.

Problem is you have to be OK doing those things - I was not.

Since I have left I have had offers to come back to pain for "7 figures" - no thanks.

Also, the schedule in anesthesia IMO is better. Sure no overnights or in-house call in pain, but its every single day until 5-7pm by the time consults and paperwork are over. That daily grind can get old, especially when you mix in a couple dinner meetings during the week.

I remember sometimes I would have to go out to these networking dinners until 10-11pm. Then have to go home and sleep and wake up and work until 7pm the next day. Id rather sleep in the hospital and be off post call at that point.

 

[AdmiralChz]

When you do procedures, you can take your cases to a surgery center and become a partner in that surgery center - big money.

More and more, this isn’t the case. Many independent, free-standing ASCs are closing or getting fully or partially taken over by hospitals. Nearly all hospital employees have a covenant in their contract preventing them from owning a stake in an independent surgery center, and as more and more surgeons/proceduralists become hospital employees there is a smaller pool of folks to buy into a given ASC.

We staff 2 50% independent ASCs, traditionally in the 90s and 2000s they performed well but now as surgeons are retiring and the facility ages it is becoming somewhat of a downer. I anticipate at least 1 will close within 5 years or will be fully integrated into the hospital.

You add in new grads typically with major debt, even those who join a PP or maybe even go out on their own will be hesitant to spend a bunch of money they don’t have (e.g. borrow more) to buy into an ASC that is underperforming. I almost certainly wouldn’t at the 2 we have if I was on that side.

 

[chocomorsel]

Pain docs do indeed make much more than anesthesiologists, typically.

When you do procedures, you can take your cases to a surgery center and become a partner in that surgery center - big money.

Also you can become a partner in an ortho group who feeds you referrals,. You keep the post-op patients happy with opiates, you do injections on some, you split a share of the ortho/neuro group profit - big money.

Problem is you have to be OK doing those things - I was not.

Since I have left I have had offers to come back to pain for "7 figures" - no thanks.

Also, the schedule in anesthesia IMO is better. Sure no overnights or in-house call in pain, but its every single day until 5-7pm by the time consults and paperwork are over. That daily grind can get old, especially when you mix in a couple dinner meetings during the week.

I remember sometimes I would have to go out to these networking dinners until 10-11pm. Then have to go home and sleep and wake up and work until 7pm the next day. Id rather sleep in the hospital and be off post call at that point.

So in other words, you have to sell your soul to the devil for big money.
Glad you have a moral compass. It can't always be about the money.

 

[244913]

Pain can be better than anesthesia (not $$$ wise) if you have a non-opioid practice. You can do it ethically but many PP setups are midlevel doling out narcs, MD needling all comers and side hustles involving work comp, marketing meetings.

 

[deleted697535]

Thanks for your responses guys.

 

[MiddleOfNowherrr]

Why are pain fellowships still even filling then? I know a few docs out there doing full-time pain straight out of anesthesia residency. They're rural but still, do you even need a pain fellowship?

Insurance and hospital credentialing are beginning to become more difficult w/o a board cert in Pain. Because what else is there to do besides make more hoops for us to jump thru? When I began working after fellowship (but before taking Pain Boards) one insurance company sent me a letter stating something along the lines of “We see you arent yet pain board certified....we will give you x amount of time before we may reconsider the terms of remaining credentialed with us if you do not become board certified...”
one partner in our group gave up training on our procedures (was going to join the team and learn from the other senior partner) bc he kept hitting road blocks to getting hospital credentialed for pain procedures w/o a fellowship, so he headed back to anesthesia. All this probably depends on location, saturation of similar docs in your area, etc etc.

 

[zero0]

Insurance and hospital credentialing are beginning to become more difficult w/o a board cert in Pain. Because what else is there to do besides make more hoops for us to jump thru? When I began working after fellowship (but before taking Pain Boards) one insurance company sent me a letter stating something along the lines of “We see you arent yet pain board certified....we will give you x amount of time before we may reconsider the terms of remaining credentialed with us if you do not become board certified...”
one partner in our group gave up training on our procedures (was going to join the team and learn from the other senior partner) bc he kept hitting road blocks to getting hospital credentialed for pain procedures w/o a fellowship, so he headed back to anesthesia. All this probably depends on location, saturation of similar docs in your area, etc etc.

Makes sense, like I said the only docs I know personally doing pain without fellowship are way out in the wild wild underserved west. Insurance will undoubtedly find a way to not pay out anywhere else, regardless of a physician's actual capability

 

[ToKingdomCome]

My good friend, over the past few years, reimbursement for pain has gone way way down. So I would be very wary of any job that offers a “killing”- because all that means is that you have to work for that money, whether it’s seeing a tremendous amount of patients a day, or doing a tremendous amount of procedures per day. There’s no such thing as free money. So filtering those jobs out, more commonly, an average pain job is actually reimbursing on par with or even less than an anesthesiology job (ie starting 250-300k in the midwest).

Gtfo, starting anesthesia jobs are 250k in the Midwest?

 

[dabears505]

Lol who is Vincent Kalra? I've actually responded to his ads because they are all great looking jobs, but never got a reaponse

 

[Arch Guillotti]

Lol who is Vincent Kalra? I've actually responded to his ads because they are all great looking jobs, but never got a reaponse

I have gotten emails from that guy too. I would just ignore them. 99.9% chance the jobs he is selling are junk that nobody else wants.

 

[IMGASMD]

Lol who is Vincent Kalra? I've actually responded to his ads because they are all great looking jobs, but never got a reaponse

All he wanted was my cv, before he would even tell me anything about the job.....

Not pain.

 

[deleted697127]

All he wanted was my cv, before he would even tell me anything about the job.....

Not pain.

This is not specific to medicine but...recruiters want CVs as proof for finders fee so if you try to get hired at somewhere they have been in contact with they can claim they are owed a fee.

Stop supporting the middle man.

 

[IMGASMD]

This is not specific to medicine but...recruiters want CVs as proof for finders fee so if you try to get hired at somewhere they have been in contact with they can claim they are owed a fee.

Stop supporting the middle man.

I am sure he got burned before. But without saying anything about his job listings? His only opening line is give me your cv, or I won’t talk. I hope most of people in medicine aren’t like that.

Get more bees with honey, don’t be a douche.

 

[Status Sciaticus]

I am sure he got burned before. But without saying anything about his job listings? His only opening line is give me your cv, or I won’t talk. I hope most of people in medicine aren’t like that.

Get more bees with honey, don’t be a douche.

This is also party the hospital's fault.
Most hospitals wont match or beat recruiter/AMC rates, which provides no incentive for us to seek them out directly. They may offer you 350k while they will offer 400k to an AMC for the same position.

 

[IMGASMD]

This is also party the hospital's fault.
Most hospitals wont match or beat recruiter/AMC rates, which provides no incentive for us to seek them out directly. They may offer you 350k while they will offer 400k to an AMC for the same position.

They’re also too cheap/resource poor to have in-house recruiting. Or private practice just don’t have the Human Resources to deal with listing, interviewing or credentialing. It’s a catch 22, I understand.

I tried to negotiate with a hospital directly, at the end they just ghosted me. Guess they’re not desperate enough or I was asking too high of a price.

Have you seen this guys’ listing though. I think there was one as high as 600k+ a year. If there was a job that can make that number, I really don’t think they need recruiters; or I am just not qualified/stupid.

 

[TheGift]

Dad is a pain doc in an interventional only practice and makes 350k - 450k a year. Expect to be in that range if you want to actually practice ethically and do what is best for the patient. Reimbursement keeps declining because the data is very poor for the procedure efficacy. You will also be exposed to alot of radiation so something to keep in mind. Lastly, this is probably the most shady subspecialty in all of medicine and if you play with your tail expect the DEA to come knocking at your door.

 

[chocomorsel]

Dad is a pain doc in an interventional only practice and makes 350k - 450k a year. Expect to be in that range if you want to actually practice ethically and do what is best for the patient. Reimbursement keeps declining because the data is very poor for the procedure efficacy. You will also be exposed to alot of radiation so something to keep in mind. Lastly, this is probably the most shady subspecialty in all of medicine and if you play with your tail expect the DEA to come knocking at your door.

I think $20,000 spinal fusions on whales is right up there with injecting and doping them up.
Spine surgeons are the absolute worst.

 

[chocomorsel]

They’re also too cheap/resource poor to have in-house recruiting. Or private practice just don’t have the Human Resources to deal with listing, interviewing or credentialing. It’s a catch 22, I understand.

I tried to negotiate with a hospital directly, at the end they just ghosted me. Guess they’re not desperate enough or I was asking too high of a price.

Have you seen this guys’ listing though. I think there was one as high as 600k+ a year. If there was a job that can make that number, I really don’t think they need recruiters; or I am just not qualified/stupid.

He fishes other people’s ads, inflates the rates and then tries to make it his own ad. You can usually find out who’s ad it is to start by subtracting about 50-100k.
He’s just a fast talking snake oil salesman.

 

[chocomorsel]

Lol who is Vincent Kalra? I've actually responded to his ads because they are all great looking jobs, but never got a reaponse

A lying, thieving, fast-talking, snake oil salesman. His ads are American Healthcare.

 

[IMGASMD]

A lying, thieving, snake oil salesman. His ads are American Anesthesiology I believe.

I think dabear was going for a Jeopardy-styled answer.....

That’s how I read it.

 

[TheGift]

I think $20,000 spinal fusions on whales is right up there with injecting and doping them up.
Spine surgeons are the absolute worst.

Agreed. I believe heavy cuts are coming their way, rightfully so. I decided to go an entirely different way with my career. Didn't want to deal with any of it.