Pain medicine in msk practice

[Firelambo]

Are there job opportunities out there for pm&r with pain fellowship training to work mostly in msk/interventional spine practices without needing to deal with the true pain population (opioids dependence, crps,cancer pain, pill mill?) thanks

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[VA Hopeful Dr]

Are there job opportunities out there for pm&r with pain fellowship training to work mostly in msk/interventional spine practices without needing to deal with the true pain population (opioids dependence, crps,cancer pain, pill mill?) thanks

One large ortho group and two large spine groups in my city have pain management physicians on staff to do exactly that.

 

[Taus]

Yes. Agreed- with an Ortho group. That is what I do, but you still need comprehensive training to understand how to recognize that "other stuff" and how it plays into what you are treating.


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[Dr. Ice]

Yes. Agreed- with an Ortho group. That is what I do, but you still need comprehensive training to understand how to recognize that "other stuff" and how it plays into what you are treating.


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Nice..although I'm sure you get the referrals for "rehab guidance" from your friendly el heffe ortho spine surgeon and we all know what that means

 

[drpainfree]

funny post. what do you think pain management fellowship prepare you if not for PAIN MANAGEMENT?

 

[lobelsteve]

Try IR.

 

[Firelambo]

Thank you for all the response. In response to drpainfree, I guess I should have clarified whether a PM&R pain medicine doctor could work in a hybrid practice setting of (sports med+pain)where they evaluate knees,shoulder, foot,etc with ultrasound injection, reduce fractures dislocations, as well as doing spine injections/spine procedures. Thanks

 

[Gauss]

Thank you for all the response. In response to drpainfree, I guess I should have clarified whether a PM&R pain medicine doctor could work in a hybrid practice setting of (sports med+pain)where they evaluate knees,shoulder, foot,etc with ultrasound injection, reduce fractures dislocations, as well as doing spine injections/spine procedures. Thanks

sports med and pain med are different specialties. There may be crossover in some procedures, but I've never heard of pain med training adequately preparing someone for reducing fractures and dislocations

 

[cbest]

Thank you for all the response. In response to drpainfree, I guess I should have clarified whether a PM&R pain medicine doctor could work in a hybrid practice setting of (sports med+pain)where they evaluate knees,shoulder, foot,etc with ultrasound injection, reduce fractures dislocations, as well as doing spine injections/spine procedures. Thanks

Firelambo, this is pretty much my practice (minus the fracture reductions). I'm double boarded in PM&R and pain and work with an ortho group. I see mainly spine with a mix of msk/sports medicine and EMG. I really enjoy my job and role within the group as well as the patient population. Contrary to the belief of some of the members on this forum, you don't have to end up being "just a needle jockey" in this setting. The other members in my group appreciate the knowledge base and skill set I've brought to the table. There is no ordering of injections. They refer me patients and I provide comprehensive treatment plans that sometimes include injections but may also include medications, PT/OT/SLP, OMM, pain psych, etc. I got crushed on a different thread about marketing myself as an interventional spine and sports medicine doc and not pain so just beware that this forum can be opinionated


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[SeniorWrangler]

There are plenty of pain doctors who do nothing but injections, and I suppose they do some good as well.

 

[drpainfree]

Firelambo, this is pretty much my practice (minus the fracture reductions). I'm double boarded in PM&R and pain and work with an ortho group. I see mainly spine with a mix of msk/sports medicine and EMG. I really enjoy my job and role within the group as well as the patient population. Contrary to the belief of some of the members on this forum, you don't have to end up being "just a needle jockey" in this setting. The other members in my group appreciate the knowledge base and skill set I've brought to the table. There is no ordering of injections. They refer me patients and I provide comprehensive treatment plans that sometimes include injections but may also include medications, PT/OT/SLP, OMM, pain psych, etc. I got crushed on a different thread about marketing myself as an interventional spine and sports medicine doc and not pain so just beware that this forum can be opinionated


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just curious, who actually writes opioid meds in your group? orthopods or you? or some PA/NP?

 

[cbest]

just curious, who actually writes opioid meds in your group? orthopods or you? or some PA/NP?

Some of the surgeons and their midlevels write opioids. I haven't written for anything stronger than tramadol so far. Ortho practices capture patients in more an acute or subacute phase. Pain practices capture more of the chronic stuff where there's a higher likelihood of opioid management.


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[Disciple]

Thank you for all the response. In response to drpainfree, I guess I should have clarified whether a PM&R pain medicine doctor could work in a hybrid practice setting of (sports med+pain)where they evaluate knees,shoulder, foot,etc with ultrasound injection, reduce fractures dislocations, as well as doing spine injections/spine procedures. Thanks

PMR training used to be available that would prepare you for exactly this (minus fracture reduction/management). It still is, maybe, to a lesser degree.
Was done away with for political reasons.

 

[lonelobo]

I finished my PMR training in 2004, and at that time we had 6 Months of multispeciality clinics with Ortho, 3 Mo with Neurosurgery, 3 Mo in multidiscplinary pain clinic.
So I think depending on your program , you can get excellent base of training for the above scenario