Mix of Pain and General Anesthesia Lifestyle?

[surfguy84]

I really enjoyed the OR but have no desire to be a surgeon. Anesthesia seemed like my kind of people and I really enjoyed the work. Only thing I think I'd miss are longer patient encounters (on occasion).

I've seen PMR docs doing pain, but never an anesthesiologist. Would it be reasonable for an anesthesia doc to have clinic time 1-2x/week then do general anesthesia the remainder of the week? Would you typically need to find two separate employers for this? Lastly, would a doctor be able to find this type of work in a desirable area (I'm from Socal and my wife and I want to return home either for or after residency)?

Thanks - appreciate your advice.

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[deleted162650]

PM @ssmallz

 

[Hoya11]

I really enjoyed the OR but have no desire to be a surgeon. Anesthesia seemed like my kind of people and I really enjoyed the work. Only thing I think I'd miss are longer patient encounters (on occasion).

I've seen PMR docs doing pain, but never an anesthesiologist. Would it be reasonable for an anesthesia doc to have clinic time 1-2x/week then do general anesthesia the remainder of the week? Would you typically need to find two separate employers for this? Lastly, would a doctor be able to find this type of work in a desirable area (I'm from Socal and my wife and I want to return home either for or after residency)?

Thanks - appreciate your advice.

Yes it is done. More often its just pain or just anesthesia. Academics is usually the place for the mix. So if you are looking for a big city, working at one of the university hospitals doing a mix would be a possible option.

 

[IlDestriero]

The couple of guys I know that do this mixed practice in a mixed group are always annoyed that they earn significantly more doing their procedure heavy pain days than OR days, but they only get ~10% more than the OR only guys and the rest of the profits are all split amongst the partners. One is still there another couldn’t stomach it any more and left to be 100% pain elsewhere.
Every group is different, distribution is different, payer mix is different, but it’s something to watch out for if you go that route.
In my peds anesthesia group it’s the opposite, and the rare procedure pain clinic guys are earning little in clinic and we are subsidizing them.


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Il Destriero

 

[ssmallz]

Mixing specialties is difficult. The problem is that pain and anesthesia are so fundamentally different and it becomes difficult to blend the practices. Anesthesia groups need people who can cover ORs and since the operating room schedule is often chaotic, it can be difficult to predict when coverage is needed. An anesthesia group will need you to be flexible with your hours and may not be able to guarantee specific days. Call responsibilities will also be difficult to split. Pain on the other hand is the opposite, in order to establish a good practice you need to have predictability in your schedule. Your office staff and patients need to know that you will be available at a specific time on a specific day so that they can schedule procedures and office visits. So...a situation where you practice 2 days/week anesthesia and 3 days/week pain would be impossible unless your pain group is part of the anesthesia group directly which leads to a whole host of problems as IlDestriero pointed out. The best you're realistically going to find is being able to do pain full time and picking up some locums work for anesthesia a few days a month

Based on your post though, I'm guessing you're a med student who is still deciding which specialty to choose so don't worry about your future job yet. Do anesthesia if you want to be in the OR, practice traditional anesthesia, and can deal with the nights and weekends or think this specialty genuinely interests you. If you're more a clinic guy, choose another specialty as there's no guarantee you will get into a pain fellowship with anesthesia and you can still do a pain fellowship from another specialty. If you complete a pain fellowship after doing an anesthesia residency, it will be very unlikely you'll want to practice both. Most guys choose one or the other because it suites them better and don't look back

 

[Aether2000]

Regardless of what the ABA would have you believe, they are completely different specialties requiring separate and largely non-overlapping skill sets and diagnostics. It is possible to do both (I have done half and half for the past 18 months), but it requires rigid scheduling without any open ended overlap. By this I mean, you cannot schedule doing anesthesia in the morning and pain in the afternoon since you have no control over the length of the surgical procedure that you are providing anesthesia for. It works better to have two separate employers or self employed status for pain.

 

[DrCommonSense]

I really enjoyed the OR but have no desire to be a surgeon. Anesthesia seemed like my kind of people and I really enjoyed the work. Only thing I think I'd miss are longer patient encounters (on occasion).

I've seen PMR docs doing pain, but never an anesthesiologist. Would it be reasonable for an anesthesia doc to have clinic time 1-2x/week then do general anesthesia the remainder of the week? Would you typically need to find two separate employers for this? Lastly, would a doctor be able to find this type of work in a desirable area (I'm from Socal and my wife and I want to return home either for or after residency)?

Thanks - appreciate your advice.

It can be done through hospital practices whereby you can cover call or some OR days.