Jobs, Chiropractors, and Hospice

[Anasazi23]

Hi folks,

I haven't posted in this specialty forum before, but I'm running out of options, and am looking for some perspective and advice.

Long story short, I took a job in south Florida, and we're having a heck of a time finding something decent for my wife, a recent "high tier" PM&R residency graduate.

I've been trying without success to help her find a position in the field, but are continually thwarted by a number of issues.

We've called every hospital in Miami, including the VA looking for a PM&R position. They state only that there are "hiring freezes" or that all their docs are on staff, and not salaried. She was interested in an inpatient staff position or house rehab attending, as the private practice scene in southern Florida is less than desirable. Namely, they're largely run by chiropractors who employ physiatrists, charge them significant overhead, and get you wrapped up in a shady "personal injury" situation that doesn't seem kosher.

I wound up taking a different job near West Palm Beach, and am finding the same obstacles here. The VA never has a physiatry position, and the local hospitals have only physiatrists with privilages. We don't have the cash as of yet to have her open a private office, and she wanted to get her feet wet with a hospitalist job in the interim.

There are interventional positions in orthopedic groups, but she's not fellowship trained. Other positions in this area are again dominated by chiropractors - something that makes us uncomfortable.

She is interested in palliative care, but also has no felloship in this either. Is it reasonable to apply for palliative care positions (of which there are a couple near here) as a general physiatrist, given that she has experience in pain management in cancer centers, etc?

We're incredibly frustrated with the job situation in this area, and are more dismayed that chiropractors seem to run the show in terms of office-based light pain and general rehab. Other centers in Broward County (Ft. Lauderdale area) are dominated by these so-called "Pain Clinics" which are a completely different story (they are legal loophole strip-mall offices that basically allow "patients" to dictate what medicines they are to be prescribed, providing they can produce an MRI or CT. It doesn't even have to be their own).

A quick search of the internet will reveal that there are more legit jobs in Florida, such as the VA, etc. However, these are not really options for us now since I've taken a good job in the area.

Are there ways we haven't exhausted to look for positions? We check all the locums sites, as well as the AAPMR site frequently, and have cold-called hospitals, all with no results. Also, what are you thoughts on the palliative positions?

Thanks for reading, and sorry for what is likely obvious frustration presented in the post. Any advice would be appreciated...

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[axm397]

are you just looking at the job postings on AAPM&R? Did u try the AAPM&R find a physiatrist function and look in your area for a list of physiatrists? You can then google them, find their practice, and cold call them.

The other option is to do disability evals. There are some companies that will pay you (rip you off) for diability evals - at least you don't have to do anything too shady and $ is $. Can also offer to do EMGs - NOT mobile EMG units or anything shady but can approach several orthopedic practices and see if their physiatrists even do EMGs. Can start out part time - negotiate a deal so if she buys her own EMG machine, she gets to keep the majority of the collections and not have to pay much overhead as doing EMGs don't require much staffing or space. nursing homes usually like having a rehab doc who can do consults - can she do that? go to geriatricians and see if they have any need - or approach medical directors of nursing homes and subacute rehabs.

Offering to work part time first may be an option so she can prove her worth.

 

[Anasazi23]

All great ideas - a couple of which we tossed around.

I'll discuss these with her over the weekend.

Thanks again - I'm sure something will work out soon. Minutes seem like hours when you're actively looking.

 

[topwise]

Is she at all interested in a fellowship? Might be a good way to get her feet wet and make connections in the area, and also have an income. If there's a VA in the area, sometimes they have fellowship positions that aren't advertised, but there's funding available and a position can be "created" for her.

 

[Anasazi23]

That's actually an idea we tossed around - but it seems as though there are really no fellowships in the West Palm area. If you say there may be an unadvertised position, that would be encouraging. I suppose we'll call the director of rehab there and see if there are any leads in that direction.

Any thoughts on the hospice / palliative care issue? Or, do you feel that those positions should be left solely to those fellowship trained in that sub-specialty?

 

[Test Pilot]

That's surprising. In Michigan, they're real hungry for PM&R graduates. A lot of the local groups are paying top dollar, especially for someone willing to do inpatient.

Some of these hip, lifestyle metros are grossly over saturated with physicians.