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regional vs pain
- Thread starter MS4SoonToBeMD
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I had the same question before I started anesthesia. They seemed more or less the same to me. I was wrong. Regional is like any other general anesthesiologist. The usually get the ortho rooms and do blocks instead of GA.
Pain is a whole different thing. Need a lot of patience for it. They have a clinic, prescribe a lot of drugs, and do some needle injections/burning.... They typically don't spend much time in the OR. Think of it like internal medicine with procedures once or twice a week.
Pain is a whole different thing. Need a lot of patience for it. They have a clinic, prescribe a lot of drugs, and do some needle injections/burning.... They typically don't spend much time in the OR. Think of it like internal medicine with procedures once or twice a week.
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Regional is an up-and-coming area of OR anesthesia. If you play your cards right though, you'll likely be able to get adequate training in residency especially if you're a few years away from entering. It is not an ACGME accredited fellowship, however. No separate boards like critical care and pain. In short, anyone can do regional. The people who are fellowed may be more likely to do things like continuous catheters, advanced blocks like lumbar plexus, etc. I got adequate block experience in residency. Not stellar, but OK. In my job now I get to do a fair amount of regional, but it's still the basics. Interscalene for shoulders, supraclavicular for everything else in the arm (I've pretty much ditched the axillary block now), femoral for total knees and ACL's. I'm teaching others in the group ultrasound guided popliteal blocks as well. These are all very basic techniques that any decent residency program will make you proficient at by your CA2 year. Some places are better than others, Virginia Mason and Dartmouth come to mind.
Pain doctors can have a varied practice. Some do 100% pain which is a mix of new patient evaluations, continuing medical management, and office based procedures. Surgical procedures like implanted spinal cord stimulators and intrathecal pumps are within their domain as well. Office based procedures mainly consist of things like epidural steroid injections at all levels of the spine, diagnostic nerve blocks, radiofrequency ablations, and neurolytic blocks. The only way to do pain is with a fellowship these days. Around here, many private pain docs are part of anesthesia groups meaning that they share in the regular OR duties at least for overnight call, and sometimes doing regular cases during the day. One advantage of pain may be that you can go solo, open up your own office and do your own thing. You'll never be able to do that as a general anesthesiologist and this appeals to some people.
Pain doctors can have a varied practice. Some do 100% pain which is a mix of new patient evaluations, continuing medical management, and office based procedures. Surgical procedures like implanted spinal cord stimulators and intrathecal pumps are within their domain as well. Office based procedures mainly consist of things like epidural steroid injections at all levels of the spine, diagnostic nerve blocks, radiofrequency ablations, and neurolytic blocks. The only way to do pain is with a fellowship these days. Around here, many private pain docs are part of anesthesia groups meaning that they share in the regular OR duties at least for overnight call, and sometimes doing regular cases during the day. One advantage of pain may be that you can go solo, open up your own office and do your own thing. You'll never be able to do that as a general anesthesiologist and this appeals to some people.
