PM&R career change questions

[jeahfoo1]

Hey everyone. I've been practicing for about 4 years now. I did a non-ACGME pain fellowship and started working with an ortho group as the interventional spine guy in the group. I find that overhead is getting higher and higher and reimbursements are going down (what's new, right?). I'm also considered about long term fluoroscopy exposure. What do you think is the long term outlook on interventional pain and interventional procedures in general? Would it be worth looking into inpatient rehab jobs?

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[flapjack3d]

Hey everyone. I've been practicing for about 4 years now. I did a non-ACGME pain fellowship and started working with an ortho group as the interventional spine guy in the group. I find that overhead is getting higher and higher and reimbursements are going down (what's new, right?). I'm also considered about long term fluoroscopy exposure. What do you think is the long term outlook on interventional pain and interventional procedures in general? Would it be worth looking into inpatient rehab jobs?

I dont have an answer to your question, but you should change your profile picture for anonymity.

 

[lobelsteve]

I dont have an answer to your question, but you should change your profile picture for anonymity.

Yup, dont want anyone to figure you out.

1. Outpt pain is typically 2-4x pay of inpatient. No weekends or call.
2. Do you track your radiation exposure? This must be done.
3. Overhead and reimbursement are your groups problem, not yours. Unless you are a partner. You should get mgma data ans then talk to your group.

 

[pmrmd]

I don't understand why you would go from a position of actively helping people to becoming a figurehead to sign for facility payment. Invest in an US machine if you are worried about fluoro time.


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[AndyDufrane]

I did the same thing as the OP, did an nonacgme spine fellowship, did it for 1.5 years, got sick of it and started as an independent contractor inpatient medical director gig, it was good for awhile financially, but if you don't like doing inpatient, which I never did, it does begin to wear on you, you have to like what you are doing on a daily basis, the chill schedule and good money don't make up for the fact that you are not doing what you like, I would suggest looking for another gig, I was also working part time once in a sport med ortho practice as a spine guy, the overhead was high, so I decided not to go full time and parted ways, I think its tough being a pmr in an ortho group as you really can't keep up with the overhead of an ortho practice, better to try a multispeciality group

 

[Dr. Ice]

To work for a medium sized ortho practice is to live in constant fear of consolidation or in the corporate world "M&A." The issue of overhead pervades orthopedics unlike any other speciality. The constant battle of fighting overhead while trying to run an efficient practice will always be a point of contention amongst the group. A large corporate entity with university or large hospital affiliation will always be knocking on the door looking to acquire offering the promiseland of unbeatable insurance rates and unlimited ancillary support. Residence is futile and consolidation is inevitable. As a non surgical doc in this type of setting, the constant fear of being axed looms as the empire will choose whether or not you are deemed worthy of acquisition as well as you will remain an employee under their model and any sort of equity you may have been offered will no longer be offered to you. Multisleciallty practice, small lean 2-4 person practice or hospital employment are really the only viable future options in my view...

 

[jeahfoo1]

I did the same thing as the OP, did an nonacgme spine fellowship, did it for 1.5 years, got sick of it and started as an independent contractor inpatient medical director gig, it was good for awhile financially, but if you don't like doing inpatient, which I never did, it does begin to wear on you, you have to like what you are doing on a daily basis, the chill schedule and good money don't make up for the fact that you are not doing what you like, I would suggest looking for another gig, I was also working part time once in a sport med ortho practice as a spine guy, the overhead was high, so I decided not to go full time and parted ways, I think its tough being a pmr in an ortho group as you really can't keep up with the overhead of an ortho practice, better to try a multispeciality group

What are you doing nowadays?

 

[AndyDufrane]

What are you doing nowadays?

so I sent you message , check your inbox