PMR and Interventional procedures

[igotmyswag]

HI there. I am just entering my 4th year of medical school and i am considering PMR for 2009. I am currently trying to fin d out a little more about the specialty. What interventional procedures are performed by physiatrist? Also, i have an interest in cardiac/stroke rehab, and possibly pain management. Are the former as lucrative as the latter? Thanks in advance for your responses?

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[PMR 4 MSK]

HI there. I am just entering my 4th year of medical school and i am considering PMR for 2009. I am currently trying to fin d out a little more about the specialty. What interventional procedures are performed by physiatrist? Also, i have an interest in cardiac/stroke rehab, and possibly pain management. Are the former as lucrative as the latter? Thanks in advance for your responses?

interventional procedures - highly dependent on the program but in general, coming out of basic residency - trigger points, basic joints, nerve blocks, (hopefully) Botox, ligaments and tendons. Some programs do basic spine work such as LESI, facet joints and SI joints. A few get even more advanced. Do a fellowship and you can put a needle just about anywhere you and the patient want to...

Cardiac rehab not often run by PM&R, IME. Stroke rehab = Medicare inpt = reimbursement sucks, getting worse. Lucrative is relative. Right now, using sharp objects pays more than using your hands, eyes, and especially, ears. 5 years from now, who knows?

 

[Gauss]

While not considered an intervention, EMG/NCS is a procedure that PM&R is reimbursed well for.
Intrathecal baclofen trials and pump management are becoming more common in residency. Pump insertion would pay well but usually gets punted to neurosurgery due to comorbities/risk/OR time/etc.

 

[lobelsteve]

HI there. I am just entering my 4th year of medical school and i am considering PMR for 2009. I am currently trying to fin d out a little more about the specialty. What interventional procedures are performed by physiatrist? Also, i have an interest in cardiac/stroke rehab, and possibly pain management. Are the former as lucrative as the latter? Thanks in advance for your responses?

Depends on training.

Some should not touch the needle.
Others put wires in the spine and a battery in the butt.
SOme put cement in the vertebrae.
Some take goo out of disks.
Some put wires in the face, scalp, etc.
Some put needles in the cheek and get them behind the eyeballs. (Gasserian)

Depends on training, patient need, comfort levels, etc.
In PMR residency I learned not to let my attensinds do more than trigger points. In fellowship I learned you can do anything.