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With pain fellowship starting soon....feeling FOMO seeing my non fellowship colleagues going into PP

gassedout2015

Full Member
Feb 9, 2016
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Title says it all. Feeling FOMO seeing my friends making 400-500k with no fellowship...and doing pain may actually be a pay-cut. Any words of encouragement from potential pain fellows or pain attendings would be greatly appreciated.
 
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ethilo

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Jul 2, 2012
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In the OR straight into PP is drastically different than a pain practice will be. You're probably closer to the practice of a minimally invasive spine surgeon than an anesthesiologist with pain. So if you want to do anesthesia then wahoo, but if you want to do pain then you'll do pain. Dunno too many 50/50 pain/OR practitioners, it's just not sustainable.
 

Nivens

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Dec 5, 2012
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Whats ur second fellowship?

If you say you did pain and now you doing cardiac, I might need an intervention right now.

Nothing that exciting/original. I’m CT/ICU. Don’t take me too seriously- I’m just bellyaching. Watching my cofellows launch their lives has me a bit jelly.
 
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Nivens

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FWIW, my cardiac year was incredible- the best year of my professional life, covid aside. I struggled between pain and cardiac for a long time, and ultimately chose the thing I enjoyed doing the most, rather than the thing I thought had the “most upside/most secure future”. Seems to have been the right choice for me.
 
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Timeoutofmind

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It can be great (I say that to encourage you), or can be crap (just being realistic lol)

Pain is create your own destiny, not gonna be handed to you. Totally different than OR anes.

For many people they never figure it out, and end up in discouraging situations in pain

I make a bunch of money
Work total of 40 hrs a week all paperwork included, never chart at home
No call or nights/holidays/weekends
4 days a week pain, one day a week anes (7-3)
Take off whenever I feel like, about 10 weeks a year, dont coordinate with anyone else
Minimal narcs
No disability or med-mal, or PI work
I dont supervise any midlevels
Its much more intellectually stimulating. Or at least a different type of stimulation, than OR work

Make a big difference in people's lives (diagnosed two hip fractures in the same day in the office last week!)

Read my other posts on it to get an idea of where I am coming from
 
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GandalfTheWhite

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Aug 8, 2011
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It can be great (I say that to encourage you), or can be crap (just being realistic lol)

Pain is create your own destiny, not gonna be handed to you. Totally different than OR anes.

For many people they never figure it out, and end up in discouraging situations in pain

I make a bunch of money
Work total of 40 hrs a week all paperwork included, never chart at home
No call or nights/holidays/weekends
4 days a week pain, one day a week anes (7-3)
Take off whenever I feel like, about 10 weeks a year, dont coordinate with anyone else
Minimal narcs
No disability or med-mal, or PI work
I dont supervise any midlevels
Its much more intellectually stimulating. Or at least a different type of stimulation, than OR work

Make a big difference in people's lives (diagnosed two hip fractures in the same day in the office last week!)

Read my other posts on it to get an idea of where I am coming from

whats the salary, malpractice, and dealing with insurance for reimbursement situation like?
 

Timeoutofmind

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whats the salary, malpractice, and dealing with insurance for reimbursement situation like?

Im employed

Salary is just eat what you kill (they did guarantee me a base for the first two years though). I made around 500K last year with the 10 weeks vaca

Malpractice is provided by my employer. I live in a very physician friendly state though so not a major worry.

I dont deal with insurance, they have a prior-auth and a billing dept etc

Anyway, not trying to be a commercial for pain fellowship, just giving you a different perspective

In fact, I dont want to say much more than I have. I think it just feeds people going into pain for the wrong reasons. I think unless you are thoughtful and actually care about pain patients and go into it for the right reasons as an actual doctor who wants to really treat and diagnose pain comprehensively you will struggle. There are a number of SDN posters that went to big name fellowships and joined aggressive PP groups and ended up bailing on pain. Its inevitable when people get involved in high volume injection mills with all NPs doing everything except the shots, etc to make the big bucks. Inherently, that model is just predatory and volatile. Hard to sustain for the long term for many different reasons.

Peace
 
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Hoya11

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Sep 4, 2004
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Im employed

Salary is just eat what you kill (they did guarantee me a base for the first two years though). I made around 500K last year with the 10 weeks vaca

Malpractice is provided by my employer. I live in a very physician friendly state though so not a major worry.

I dont deal with insurance, they have a prior-auth and a billing dept etc

Anyway, not trying to be a commercial for pain fellowship, just giving you a different perspective

In fact, I dont want to say much more than I have. I think it just feeds people going into pain for the wrong reasons. I think unless you are thoughtful and actually care about pain patients and go into it for the right reasons as an actual doctor who wants to really treat and diagnose pain comprehensively you will struggle. There are a number of SDN posters that went to big name fellowships and joined aggressive PP groups and ended up bailing on pain. Its inevitable when people get involved in high volume injection mills with all NPs doing everything except the shots, etc to make the big bucks. Inherently, that model is just predatory and volatile. Hard to sustain for the long term for many different reasons.

Peace

Agree with above.

In the right situation, pain can be great.

As with anesthesia, that right situation is easier to find in less saturated areas.

Having a pain fellowship opens the door to a bunch of different job opportunities - forever.

If you do anesthesia and something happens, you always have pain to fall back on.

I had a great year doing the fellowship and have never regretted it - even though I had a bad experience in a bad group like you described..

If you do not do the fellowship you will always wonder what if..

But just to argue the anesthesia side for a moment:

The action/thrill of anesthesia is unmatched.

Last night I emergently intubated a young guy who had vomitted while admitted to the medical floor and was coding.. he came back after being intubated, having CPR, and suctioning his ETT.. he is still alive in the ICU now.. this happens like every shift for most anesthesiologists covering a hospital of decent size..

Yes diagnosing hip fractures/injecting grandma is cool too, i guess, but .. different..
 
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dchz

Avoiding the Dunning-Kruger
7+ Year Member
Sep 25, 2012
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Covid. I didn’t have a chair when the music stopped, but that’s the short version of a very long and complicated story.

You mean you didn't have a chair in the big cities in the NE where you want to live :p. I can probably find a CT job for you today if you gave me your CV.

this happens like every shift for most anesthesiologists covering a hospital of decent size..

If you're having aspirations every shift someone in your hospital is doing something wrong....
 
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