questions about pain management/anesthesia

[cloudyroom]

1) typical lifestyle (hours, income, etc)

2) procedures that a pm doc does? is the trend going towards pm docs doing more minimally invasive surgical procedures?

3) are the slashes in insurance reimbursements going to affect pm docs/anesthesiologists more than other docs (ortho surgeons, etc).. i realize that doctors salaries are being cut across the board.

I'm debating between surgery and anesthesia. i've got good board scores, published papers, presented @ national/international meetings, tons of extracirriculars... really i'm looking @ anesthesia @ UMiami, UCSD, UTSW, Columbia/Cornell, Harvard, UCLA, USC, Mayo Jacksonville... Pretty much the tropical vibe + NYC.

any info on these programs for anesthesia would be great as well

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[The_Sensei]

Do your own research, chump.

 

[Noyac]

Do your own research, chump.

That's one way to welcome new members. Not my style but then again I am not an ..........!

 

[The_Sensei]

That's one way to welcome new members. Not my style but then again I am not an ..........!

Me neither; but this topic has been beaten to death. A simple search will reveal any answers to this individuals questions. Not trying to be a hard-on; just tired of people posting the same questions ad infinatum without first doing some research of their own.

 

[canavarim]

take it easy boss
simply u don't have to answer or even read everything here ..
we r here to help eachother ...

 

[miamidc]

Anesthesia resident at UM. Fugging lovin it bro.

 

[cloudyroom]

believe me i've read all of the previous posts but i was looking for some more up to date information. insurance reimbursements are constantly changing and i was curious about the specific hits pm docs are taking.

 

[me454555]

The answer is really very simple but your not gonna wanna hear it. For the thousand and first time, the answer is ............ WE DON'T KNOW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Anyone who wants to tell you one thing or another about salary reimbursments in the future is speculating which means they can be right and can be wrong. There is no way to tell what reimbursmants will be.

That being said, please don't go into anesthesia. You don't really sound like your very much interested in the specialty, just simply the dollars.

procedures that a pm doc does? is the trend going towards pm docs doing more minimally invasive surgical procedures?

You should really know what procedures a doc does before even considering it as a specialty. Why would you pick this a specialty w/out knowing the procedures? Oh yeah, $$$$$$. Will the trend of pm docs doing minimally invasive procedure continue? If you knew a little more about what procedures they did, you might be able to figure this one out on your own.

typical lifestyle (hours, income, etc)

Yet another question you could probably have answered on your own by simply talking to a pain doc. While they won't tell you their income, I'm sure they will be more than happy to tell you about their day to day lives.

are the slashes in insurance reimbursements going to affect pm docs/anesthesiologists more than other docs (ortho surgeons, etc).. i realize that doctors salaries are being cut across the board.

I think I've already covered this one

Surgery, especially ortho, and anesthesia are night and day. If you like ortho you will be bored as hell in anesthesia. If you like anesthesia you will be miserable in ortho. If you wanna do anesthesia just for pain, its not worth it, just go into ortho b/c they will always make more $$.

 

[cfdavid]

Me neither; but this topic has been beaten to death. A simple search will reveal any answers to this individuals questions. Not trying to be a hard-on; just tired of people posting the same questions ad infinatum without first doing some research of their own.

Did you ever consider that new members with experience in this matter might want to contribute to the OP's question? I didn't know that anything ever said in the past was the word of God.......

Also, in the time it took you to type your dicky response, you could have moved on to several other more "acceptable" posts.

 

[hoboken]

I

 

[gogiants]

I'm in the middle of a pain management rotation right now and really loving it. This field encompasses the fun procedures of anesthesia but you get to be the boss (i.e. no surgeon to deal with) plus the hours are great plus the pay is great plus it is only going to be more in demand in the future (those babyboomers want to stay active forever). In terms of procedures you get to do a lot of different stuff but the bread and butter is epidural steroid injections in the lumbar region mostly. takes about 15 minutes and you could make your whole practice just doing that. pain patients can be difficult to tolerate so you have to decide if you are up for that, but honestly i've found that most are pretty decent people (the chronic pain patients/fibromyalgia tend to be the most difficult) and most love you for what you do which is really make a huge difference in their life. you are NOT just a drug pusher contrary to what those outside the field think. you are going to have to prescribe opiates but the major part of the practice is definately the procedures. in fact at my clinic we are consultation only which means we do the procedures and make drug recs but don't actually write any prescriptions, just refer back to primary docs. its a great way to go.

what draws me most into it is the procedures, and the lifestyle (when i have kids i would really like to work part time at least for a while and this is very possible). the money ain't bad either (especially if you are smart enough to get out of california)...you can make in the millions if you really wanted to work hard, or live in alaska. right now anesthesiologists are the only ones who can get board certified in this (we have an IR attending who is trying to challenge that now though by doing the fellowship) and i really don't think you have to worry that much about others overtaking the field, at least in the next 10-15 years.

oh yeah, and as for anesthesia programs I am a UCSD med student and can vouch for the fact that it is a phenomenal program with great people and the hours are great too (like 60 hrs/wk on avg). definately strongly consider it. good luck.

 

[Laryngospasm]

I'm in the middle of a pain management rotation right now and really loving it. This field encompasses the fun procedures of anesthesia but you get to be the boss (i.e. no surgeon to deal with) plus the hours are great plus the pay is great plus it is only going to be more in demand in the future (those babyboomers want to stay active forever). In terms of procedures you get to do a lot of different stuff but the bread and butter is epidural steroid injections in the lumbar region mostly. takes about 15 minutes and you could make your whole practice just doing that. pain patients can be difficult to tolerate so you have to decide if you are up for that, but honestly i've found that most are pretty decent people (the chronic pain patients/fibromyalgia tend to be the most difficult) and most love you for what you do which is really make a huge difference in their life. you are NOT just a drug pusher contrary to what those outside the field think. you are going to have to prescribe opiates but the major part of the practice is definately the procedures. in fact at my clinic we are consultation only which means we do the procedures and make drug recs but don't actually write any prescriptions, just refer back to primary docs. its a great way to go.

what draws me most into it is the procedures, and the lifestyle (when i have kids i would really like to work part time at least for a while and this is very possible). the money ain't bad either (especially if you are smart enough to get out of california)...you can make in the millions if you really wanted to work hard, or live in alaska. right now anesthesiologists are the only ones who can get board certified in this (we have an IR attending who is trying to challenge that now though by doing the fellowship) and i really don't think you have to worry that much about others overtaking the field, at least in the next 10-15 years.

oh yeah, and as for anesthesia programs I am a UCSD med student and can vouch for the fact that it is a phenomenal program with great people and the hours are great too (like 60 hrs/wk on avg). definately strongly consider it. good luck.

No offense, but you appear to have a very superficial knowlege of this field. PM&R, neursurg, and others are already encroaching on the field. Neurosurg would be more than happy to take the high paying, simple, and easy procedures to supplement their increasingly poor patient population and reimbursement structure. PM&R is readily accepted to many fellowships and jobs following fellowship training without too much discrimination.
What the future may hold also includes a separate pain residency, which really would be superior, lets face it, you need more than a year of specific training in PM fellowship, you would be better off with a four year residency focused on it. Lets not get into the patient population, the most difficult out there, and the effect that takes over the years on attendings. Not to mention the needle jockeys who use up the patients LESIs etc, only to "refer" them to you for medical management when they can not "treat" them anymore..i.e. the money has run dry.

 

[Cyndee MSN NP]

Lets not get into the patient population, the most difficult out there, and the effect that takes over the years on attendings.

I know a PM doctor who rarely sees patients unless they are lying face down. He has 2 NP's and they do all the "scut" work. Anywhere from 60-80%of those patients have a psych diagnosis, and I'm not talking about depression. Also, remember there are a lot of patients who rely on their meds to pay their rent. You will get a lot of undesirables and they can become dangerous.