Transitioning back to OR anesthesia from pain...

[y2janitor]

Bringing this thread back....

I am leaving my current hospital-employed pain practice in the next few months (not all that bad, just not ideal location) and want to get into some locums anesthesia, but having a hard time getting credentialed because I've been out of fellowship 2 years. I'm board certified in both anesthesia and pain. Any advice ? Any good locums agencies that could be helpful? I know CompHealth requires having practiced GA within the past 2 years.

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[deleted171991]

Bringing this thread back....

I am leaving my current hospital-employed pain practice in the new few months (not all that bad, just not ideal location) and want to get into some locums anesthesia, but having a hard time getting credentialed because I've been out of fellowship 2 years. I'm board certified in both anesthesia and pain. Any advice ? Any good locums agencies that could be helpful? I know CompHealth requires having practiced GA within the past 2 years.

Why not look for a combined job? They will probably help you get back into GA if they really need a pain guy.

 

[AdmiralChz]

Why not look for a combined job? They will probably help you get back into GA if they really need a pain guy.

Agreed, I get so many e-mails a month from head hunters searching for combo jobs in pain and anesthesia. Which is weird because I'm so not interested in pain at all, and not doing a fellowship...

 

[y2janitor]

Why not look for a combined job? They will probably help you get back into GA if they really need a pain guy.

Not that easy to find , apparently.

 

[BCM]

Bringing this thread back....

I am leaving my current hospital-employed pain practice in the next few months (not all that bad, just not ideal location) and want to get into some locums anesthesia, but having a hard time getting credentialed because I've been out of fellowship 2 years. I'm board certified in both anesthesia and pain. Any advice ? Any good locums agencies that could be helpful? I know CompHealth requires having practiced GA within the past 2 years.

It is possible to get through the hospital credentialing process. You will likely need some cases observed. If you join a busy group, the observations can probably be done within a week. Good luck!


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[BlueMD49]

It is possible to get through the hospital credentialing process. You will likely need some cases observed. If you join a busy group, the observations can probably be done within a week. Good luck!


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I do 1 OR day a week, Acute and chronic pain. I also do Acute pain and approximately 10-15 bread and butter postop blocks when on service for a week.

Does anyone think I'll have problems with credentialing going back to 100% anesthsia for my next job?

Pain isn't as cool as I thought it would be as a CA2.

 

[BCM]

I do 1 OR day a week, Acute and chronic pain. I also do Acute pain and approximately 10-15 bread and butter postop blocks when on service for a week.

Does anyone think I'll have problems with credentialing going back to 100% anesthsia for my next job?

Pain isn't as cool as I thought it would be as a CA2.

If you are doing OR cases one day a week with the acute pain you shouldn't have a problem getting through credentialing. If you are low on numbers they could ask you to have a few observations with someone but it should be painless. Good luck!

By the way, I know the feeling.


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[Nivens]

Pain isn't as cool as I thought it would be as a CA2.

Mind expanding on this for a CA-2 headed towards pain?

 

[PainDrain]

Mind expanding on this for a CA-2 headed towards pain?

I will take a stab at it. Pain is a grind. Imagine 80-90% of your patients showing up asking for pain meds. They could careless that what they really need is to lose 50 lbs, stop smoking, stop using street drugs and to be gainfully employed. I wasn't always jaded but when you see an 80 year old grandmother giving her pills to her 20-something year old grandson to sell. Or the 75 year old on massive doses of oxycodone who has tested negative for his medication on three occasions since you inherited him from the local PCP who got shut down; another one selling their pills. I can't even count the number of times people tested positive for fentanyl because they were using heroin on the street. Pain from a procedure standpoint is great but a lot of insurance companies won't pay for what actually works, they love paying for cheap narcs though.

 

[Timeoutofmind]

I have posted elsewhere about my job. Its awesome. You can look up the post.

A lot of docs are all about the $$$$$$$$$$$$$ and are just basically foolish in many ways with the larger life decisions. And a lot of pain grads dont take into account what really makes for a long term gratifying, sustainable, and helpful to the community pain practice when they are getting all hyped up negotiating percentage of collections and ASC buy in agreements with their first partner/employer. The result is what you are reading in this thread over and over again.

A lot of bashing of pain in this thread. I am not going to bash Anes and good for u if you are happy where you are at Anes folks but I personally find pain orders of magnitude more enjoyable and stimulating. This Thurs and Fri I did a DRG stim and kypho. Awesome. Would waaaay rather be doing that stuff all day long vs sitting the stool or running around between rooms supervising, time flies in the OR for me.

And the office hours lifestyle and taking vaca whenever I want...epic

Peace

 

[epidural man]

One of the pain doctors in my area lost his DEA license and now does injections only. He's already at retirement age so he seems to be happy with his 1 day/week practice. I actually think that he was not intentionally breaking the rules but was careless regarding documentation.

The DEA recently revoked the DEA license of an IM doctor who was prescribing opioids also. His former patients have been scrambling to find new pain doctors, but from what I've seen of their records, this doctor was dirty.

Right before I moved to this area, the former president of the county medical society was sent to prison for crimes related to opioids, along with a pharmacist co-conspirator.

So the DEA is definitely watching things. But with the right documentation, it is possible to get away with a lot of questionable things regarding opioids, and there is a wide grey area between prescribing opioids to a dying cancer patient and prescribing opioids to a known drug dealer.

So here is my thought..

If i did private practice pain, I wouldn't get a DEA license...really no need (unless I saw cancer pain).

Perfect excuse to not give out opioids.....

 

[PainDrain]

I have posted elsewhere about my job. Its awesome. You can look up the post.

A lot of docs are all about the $$$$$$$$$$$$$ and are just basically foolish in many ways with the larger life decisions. And a lot of pain grads dont take into account what really makes for a long term gratifying, sustainable, and helpful to the community pain practice when they are getting all hyped up negotiating percentage of collections and ASC buy in agreements with their first partner/employer. The result is what you are reading in this thread over and over again.

Not entirely true. I knew full well what I was getting into; what I failed to realize is the level of drug use/abuse in my region. Not that I was naive but the scope never occurred to me until I was already traveling down this road. You can do pain one of three ways: no narcs and procedures only, full narcs and procedures and lastly a mix of both. If you have a "no narcs" solo practice then you really need to have a massive referral base and put your name out there. It doesn't matter if you are solo or hospital employed you will be inundated with patients who don't want procedures and you still have to make a living. If you go "full narcs and procedures" then you are the problem. Justify it however you want but if the majority of your patients are on MEQs >90 and you are taking anything that walks through the door then you are a scumbag. You are really not helping these people. Lastly if you are truly doing pain with a small amount of prescribing combined with procedures, PT, psych, etc then you are probably making a decent living and helping some folks.

Ps. When I was looking for jobs I was contacted by a local hospital looking for a doc. Met with CEO and several others in management and they were very interested until I described how I would only make medication recommendations and would not prescribe narcotics (with exception of cancer pain). I never got a response after that. They were merely looking for someone to handle the problems their other staff created. No thanks.