Sports and IPR
Started by klumpke
From physiatrists I have met who do both sports and general PM&R, typically it is more outpatient practice thrown in, like spasticity management, EMG, prosthetics/orthotics, interventional spine procedures, stroke/TBI/SCI outpatient management, etc. There are probably some PM&R physicians out there that do inpatient mix, I wouldn't doubt it, but I think the typical is throwing in more of the other outpatient PM&R practice items.
I have a mix of sports, spine, general rehab and subacute. But it is really hard to keep the skills up to par if you have a very mixed practice. I just know my limitations and send out referrals. I stopped doing epidurals 5-6 years ago but I have local Physiatrist who love the referrals.
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I'm ACGME sports trained: Started 70/20/10 sports/spine/EMG. Now 70/20/10 spine/EMG/sports.
I enjoy spine as much as I do sports pathology and with spine feel like I have things to offer since I do ESIs, RF, MILD, etc.. Don't love EMGs but they are fairly easy and have easy internal referrals from a hand surgeon. I would jettison EMG in a heart beat if I could, but it pays decent and there is a need in my area.
IMO it is very hard to do only PM&R sports unless embedded in a big/busy ortho practice. Need at least one other skill - spine or EMG makes the most sense given pathology. Like PMR2008 mentioned you definitely lose skills - I have a handful of CVA and SCI spasticity patients that I manage but try to stay away from it at this point.
I enjoy spine as much as I do sports pathology and with spine feel like I have things to offer since I do ESIs, RF, MILD, etc.. Don't love EMGs but they are fairly easy and have easy internal referrals from a hand surgeon. I would jettison EMG in a heart beat if I could, but it pays decent and there is a need in my area.
IMO it is very hard to do only PM&R sports unless embedded in a big/busy ortho practice. Need at least one other skill - spine or EMG makes the most sense given pathology. Like PMR2008 mentioned you definitely lose skills - I have a handful of CVA and SCI spasticity patients that I manage but try to stay away from it at this point.
Just depends what the competition for sports is where you want to work. Likely be an employed or academic position. A lot of people do more than just inpatient (such as outpatient, SNF or other IRF). A lot of sports markets can be saturated so may take a while to get started or have to accept non-ideal patients.
Yeah definitely depends on where you are geographically, practice set up that you are in, and skill set. Academics is not uncommon for sports medicine fellowship trained physiatrists and would likely allow you the opportunity to do only sports/MSK. I'd imagine pay probably sucks though and would have to be ok with teaching in some capacity. If you can work for an ortho group you could probably get by without doing spine related procedures, but would likely need to do EMGs or find a way to build up an ultrasound practice (injections, diagnostic, etc.), possibly incorporating regenerative medicine to some degree. Otherwise you could certainly do half sports and then half inpatient (consults vs primary vs combo of the two) or SNF consults. Having a small inpatient census can be very easy to manage and would/could afford time to have a robust outpatient practice incorporating sports along with other general rehab related stuff. Would need to feel out the need and market in the area you would practice and figure out your call situation if you were to do other stuff. I would imagine it would be tough to do sporting event coverage if you are also expected to cover call on weekends. That sounds like a lot of free time that you'd have to give up. Also not sure you would need a sports fellowship for a lot of what you would see. Honestly if you get good MSK training in residency you don't really need a sports fellowship unless you are dead set on event coverage, academics, or are able to secure a sports fellowship that incorporates spine procedures. From what I gather from the sports forum it seems as though sports jobs are somewhat hard to come by unless you are willing to do a split....outside of academics.
