Graduating fellows....any advantage of going into PP instead of hospital employee?

[RM38]

Almost nobody I know has signed yet. Overwhelmingly, the jobs I've come across have been:

1) Brand new(ish) offices in the middle of nowhere, where practices from more saturated areas are looking to capture a new piece of the market. The group will wine and dine you at the central location in a nice area, then tell you that you'll be commuting between three remote villages and working Saturdays.
2) Groups looking for a sucker to deal with meds/take the fall for the shady **** they're doing, with minimal to no procedures. Googling the practice owners returns "Felony" with surprising regularity (I wish I was joking).
3) PM&R based jobs looking for PM&R grads to do all the things PM&R grads went into pain to get away from in the first place.

This is why I always recommend spending the day at the clinic your are interviewing at. I have gone through the job search process twice now and dodged a couple of major issues. On interviews and on the job I have watched other doctors
1) Do epidural with their bare hands
2) Inject phenol on medial branch instead of actually doing RFA
3) Warn for 2nd positive cocaine and continue Oxy
4) Propofol for TPI (Last boss was doing this and wish I saw this happen on interview)
5) Mix particulate steroid in with contrast for TFESI and go WAY past 6
6) Saw 1 guy see 30 patients in a half day

There is a lot of craziness out there, especially in FL for various reasons. I have had several other Docs that I know back out of what seemed like a great offer after spending a day in clinic. Some people with the best personalities on interview are the worst to work with in real life. On another note I got my current job through a recruiter and I am almost 2 years into my second practice and I am very happy. Because of that I would not rule jobs that you find on those the sites out either.

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[chudat]

So now that pain is being flooded with EM applicants, future looking not too stellar

 

[Peterluger]

So now that pain is being flooded with EM applicants, future looking not too stellar

Well the question is, Do the emergency room people actually get hired by academic and/or reputable private pain groups?

 

[chudat]

Well the question is, Do the emergency room people actually get hired by academic and/or reputable private pain groups?

Why not? All supply and demand. If the demand is high, why would groups care as long as the applicant completed a fellowship.

 

[Ducttape]

Well the question is, Do the emergency room people actually get hired by academic and/or reputable private pain groups?

why not?

we have 2 people on this board itself who did or spent a lot of time doing ER medicine prior to doing pain.

I daresay their procedural quality is equal to that of PMR trained pain docs, almost up to par as anesthesia trained

 

[TeslaCoil]

why not?

we have 2 people on this board itself who did or spent a lot of time doing ER medicine prior to doing pain.

I daresay their procedural quality is equal to that of PMR trained pain docs, almost up to par as anesthesia trained

I would venture to say that Pain Medicine will always remain an anesthesiology dominated field. Program directors dont like hiring people outside of anesthesia/PMR because of the lack of prior experience in those fields. Not to mention that the board itself is ABA.

 

[chudat]

I would venture to say that Pain Medicine will always remain an anesthesiology dominated field. Program directors dont like hiring people outside of anesthesia/PMR because of the lack of prior experience in those fields. Not to mention that the board itself is ABA.

I think this is true but i am also anticipating an influx of nonanesthesia folks ie EM.

Hopefully the field wont be oversaturated any time soon.

 

[SommeRiver]

Procedural skills can be taught. I'd like to see some IM docs in the field.

 

[Bostonspine]

Why not? All supply and demand. If the demand is high, why would groups care as long as the applicant completed a fellowship.

I think ortho would hire them to do pain and walk in ortho clinic... they can do procedure and set fractures

 

[nvrsumr]

There are always going to be some barriers to being hired if you don't share the same primary speciality. Ie. Anesthesia pain group that does some part time gas at ASC with surgeons who refer to them. PMR spine group that wants a doc to also do EMGs.

 

[OneWord]

It’s because anesthesiology is full of weak people. That’s why Pain, which is a subspecialty of Anesthesiology, opened up to applicants from other specialties.

The best lack all conviction, while the worst
Are full of passionate intensity.

 

[willabeast]

I am retired now. In the past i did both PP and TPMG/Kaiser NCAL. Advantages of PP for me was mostly psychological, i felt as if i was more free. The reality may be that PP and Kaiser were equivalent in terms of freedom. The constraints in PP are less formal, but they exist, and in both situations there are consequences for not following the party line. In terms of money PP was more lucrative however that came along with more overhead expenses and as my goal was never to make as much money as i could i honestly cannot say which was better in the long run, it may be doctor or practice specific. One nice thing was that i practiced in TPMG/Kaiser in a fairly low cost of living area of California but was paid about the same as Kaiser docs living in the Bay area. Another nice aspect to my Kaiser practice was that i took no call at all for the last ten years of my practice. When i was in PP i was on call every other night and every other weekend. Probably does not apply to most people reading this, but that was my experience. BTW i love being retired. Feel sorry for everyone having to work but "For everything there is a season...".