What made Pain the right choice for you?

[TrailRun]

EM doc a year out of training considering applying to fellowship. Didn't have any exposure in residency. Not having success so far finding local docs to shadow, so was wondering what led you all to choose Pain? For me, the opportunity to relieve suffering in a tangible way, coupled with the lack of nights makes it appealing, but I'm sure I'm romanticizing it a bit. Have also considered Palliative but it seems there are opportunities within Pain to help those with cancer pain, etc. There's not a ton of 'day in the life of a pain doc' stuff out there on the web, youtube, etc. I know it will be quite difficult to match without any real experience but I guess it's true the vast majority of patients I see in the ER are there for pain in one form or another.

Thanks!

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[lobelsteve]

Before getting excited and romanced with pain, get some experience shadowing.
Post a zipcode and I'm sure someone here is or knows someone who would have you for a week.

 

[deleted875186]

EM doc a year out of training considering applying to fellowship. Didn't have any exposure in residency. Not having success so far finding local docs to shadow, so was wondering what led you all to choose Pain? For me, the opportunity to relieve suffering in a tangible way, coupled with the lack of nights makes it appealing, but I'm sure I'm romanticizing it a bit. Have also considered Palliative but it seems there are opportunities within Pain to help those with cancer pain, etc. There's not a ton of 'day in the life of a pain doc' stuff out there on the web, youtube, etc. I know it will be quite difficult to match without any real experience but I guess it's true the vast majority of patients I see in the ER are there for pain in one form or another.

Thanks!

Sounds like you need some real exposure, yojr post above could be about any generic specialty that doesn’t take call. My guess is you won’t be super satisfied if this is yojr only motivation.

 

[TrailRun]

Just outside of Boston. The academics I’ve contacted are busy with resident rotators, and haven’t heard back from the two private practice ones.

To dipriMAN’s point, I’d settle for moderately satisfied. Have realized the nights and stress of the ER are not sustainable for me, and weekends/holidays etc tough on family. Pain seems to solve those particular problems although I recognize it has its own challenges

 

[jsammi245]

Just outside of Boston. The academics I’ve contacted are busy with resident rotators, and haven’t heard back from the two private practice ones.

To dipriMAN’s point, I’d settle for moderately satisfied. Have realized the nights and stress of the ER are not sustainable for me, and weekends/holidays etc tough on family. Pain seems to solve those particular problems although I recognize it has its own challenges

While lack of call, holidays off and no nights are one of the perks of pain medicine I would not choose this specialty based on those reasons alone. I think one of the most important thing to ask yourself is if you can work with pain patients chronically. They can be difficult and unlike the ED you are following them chronically and you will be hearing from them if nothing you do is working. Opportunity to relieve suffering is a good reason but realize a subset of pain patients may not get better no matter how injections or medications you throw at them. These are the type of patients you may be following and can also be a source of burnout. I agree with the post above and try to get some shadowing experience in before you make the move. Best of luck!

 

[Ligament]

While lack of call, holidays off and no nights are one of the perks of pain medicine I would not choose this specialty based on those reasons alone. I think one of the most important thing to ask yourself is if you can work with pain patients chronically. They can be difficult and unlike the ED you are following them chronically and you will be hearing from them if nothing you do is working. Opportunity to relieve suffering is a good reason but realize a subset of pain patients may not get better no matter how injections or medications you throw at them. These are the type of patients you may be following and can also be a source of burnout. I agree with the post above and try to get some shadowing experience in before you make the move. Best of luck!

This is true, but remember you set the parameters of your own practice ultimately. For example, if you do not Rx chronic opioids for non malignant pain, you are going to have a very different population of patients which are less likely to burn you out. On the other hand, you will make less money. Of course, there are still patients that don't get better, but they are easier to walk with than if you are Rx'ing opioids for non malignant pain.

 

[epidural man]

EM doc a year out of training considering applying to fellowship. Didn't have any exposure in residency. Not having success so far finding local docs to shadow, so was wondering what led you all to choose Pain? For me, the opportunity to relieve suffering in a tangible way, coupled with the lack of nights makes it appealing, but I'm sure I'm romanticizing it a bit. Have also considered Palliative but it seems there are opportunities within Pain to help those with cancer pain, etc. There's not a ton of 'day in the life of a pain doc' stuff out there on the web, youtube, etc. I know it will be quite difficult to match without any real experience but I guess it's true the vast majority of patients I see in the ER are there for pain in one form or another.

Thanks!

Palliative care would be an excellent field also. People that do this work seem to love it.

I don't take care of much cancer these days, but in my fellowship, it was my favorite thing. We did a lot of interventional pain management and it was HUGELY beneficial for patients. It is rarely done however outside of academic centers (in my experience.)

 

[10KHertz]

Pain medicine = private practice = small businesses = autonomy = happiness…

 

[geauxg8rs]

Pain medicine = private practice = small businesses = autonomy = happiness…

Confirmed for me when I was a CA-3 “running the board” and private Ortho attendings would want emergency cases added in the middle of the night. I would tell him it would have to follow the bowel perf and finger(s) re attachment cases that were ongoing. He said he would just do them in two weeks when he was back from vacation. I saw how anesthesia was the hospital and surgeon b****.
That and hearing of long time (decades old) anesthesia groups getting let go so the hospital could save a few bucks.

Wanted to make my own way. Even if I make a little less than my gas colleagues, I am happy with my choice.

 

[Aldertonghen]

Palliative care would be an excellent field also. People that do this work seem to love it.

I don't take care of much cancer these days, but in my fellowship, it was my favorite thing. We did a lot of interventional pain management and it was HUGELY beneficial for patients. It is rarely done however outside of academic centers (in my experience.)

Could you tell us more about palliative care? Also, in the academia I have heard of palliative+ pain trained docs, how does that setup typically work?

 

[Baron Samedi]

In no specific order except for the first one:

100% elective treatments
Lifestyle
Personality fit
Entertaining patients
Procedures including OR stuff
Interpreting imaging studies
Getting to be the "expert" in something

 

[epidural man]

Could you tell us more about palliative care? Also, in the academia I have heard of palliative+ pain trained docs, how does that setup typically work?

Unfortunately I can’t. My experience is my two week rotation, and all the fellows that come back and tell me they loved the rotation - so my impression is that it is great. I liked my rotation a lot.