Sacroilitis
20 yo female just gave birth to first child and developed low back pain. MRI showed some L5/S1 disc space disease but to my surprise XR showed sacroilitis in the joint. Rhem panel negative. Has anyone seen this? I was planning on sending to rheum but the negative panel surprised me too. Normal BMI and no IVDU (Source: Student Doctor Network)
Source: Student Doctor Network - May 15, 2022 Category: Universities & Medical Training Authors: ED50 Tags: Pain Medicine Source Type: forums
Hospitals are losing tons of money: implication on hospital employees Physicians
I am seeing so many articles about this. They can’t just keeping going they way there are going right?
Thoughts?
Swing back to private practice groups?
Mass General Brigham posts $867M quarterly net loss
Despite seeing a slight increase in revenue, Boston-based Mass General Brigham ended the second quarter of fiscal year 2022 with both an operating loss and net loss, according to its financial report released May 13.
www.beckershospitalreview.com (Source: Student Doctor Network)
Source: Student Doctor Network - May 15, 2022 Category: Universities & Medical Training Authors: Jigsaw Tags: Pain Medicine Source Type: forums
2 good scribing opportunities
Hi all,
I'm looking for input on which job to take. I have 2 full-time job opportunities at specialty-type clinics, one at a spine surgery/neurology place, and one at a pain clinic.
Spine/neuro:
$19.50/hr, which is doable for me, with potential to go up after 90 days
I would work with a couple MDs and a DO all day every day, but only 2/5 days a week are in-person scribing (on the other days I have to go in to the office to then get on a computer and scribe remotely)...
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Source: Student Doctor Network - May 13, 2022 Category: Universities & Medical Training Authors: AMDG_nontrad Tags: Pre-Medical (MD) Source Type: forums
NYT: Common Pain Medications can Prolong Back Pain
Steroid, NSAID, and anti-regen KOL's are going to be pissed...
Common Medications Can Prolong Back Pain When Overused, Study Says
A clinical trial will be needed to verify the research, which offered a warning about taking steroids or nonprescription drugs for weeks on end.
www.nytimes.com
Common Medications Can Prolong Back Pain When Overused, Study Says
A clinical trial will be needed to verify the research, which offered a warning about taking steroids or nonprescription drugs ...
Source: Student Doctor Network - May 12, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Hospital looking to get 7.5-15% increase in payments
This is great. Increase in site of service fees of 7.5-15% if they get what they want guess where that cost will shift to? Doctors and patients is my guess.
Hospitals Look to Raise Treatment Costs as Nurses’ Salaries Increase — The Wall Street Journal
Health insurers and employers are pushing back against requests to increase hospital prices by as much as 15%
apple.news (Source: Student Doctor Network)
Source: Student Doctor Network - May 9, 2022 Category: Universities & Medical Training Authors: myrandom2003 Tags: Pain Medicine Source Type: forums
The Difference in Practice between ACGME Pain and Non-ACGME / NASS Spine Physicians, Post-Fellowship?
The intent of this question is not to debate which of the fellowship options, ACGME Pain Medicine or NASS / Non-ACGME Interventional Spine, is better. Rather, I am curious:
1. Is there a difference in practice between individuals who train at one vs. another?
2. For those who do Spine, are there hospital systems that require ABPM or ABIPP Pain Medicine board certifications vs. just PM&R board certification with having done the fellowship in order to perform axial procedures?
3. Can NASS /...
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Source: Student Doctor Network - May 3, 2022 Category: Universities & Medical Training Authors: JBM16BYU Tags: Pain Medicine Source Type: forums
SCS trial in patient with alcoholism
I have a patient who drinks daily. She wants a spinal cord stimulator to help with her post laminectomy pain syndrome.
I am hesitant as I am worried about possible bleeding issues with her alcohol use. Would you guys do the case? Would you get any labs prior to make sure she isn't at increased risk for bleeding? (Source: Student Doctor Network)
Source: Student Doctor Network - April 28, 2022 Category: Universities & Medical Training Authors: GottaHaveIt Tags: Pain Medicine Source Type: forums
TXA in patients with angina undergoing non-cardiac surgery... yay or nay?
Emergency lumbar decompression of hospital-avoidant octogenarian.
Previous strokes + MI documented in GP letter from 10years ago.
Last presented to hospital with hypertensive crisis and active NSTEMI 3 years back; self-DC from ED with no follow-up once pain settled with GTN infusion.
Baseline exercise tolerance: Walking to bathroom = SOB and chest pain. Cannot lie flat due to paroxysmal nocturnal dyspnea.
No allergies/reg meds.
BP 200/100. ECG = q-waves, TWI and RBBB - no baseline ECG to...
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Source: Student Doctor Network - April 25, 2022 Category: Universities & Medical Training Authors: woopedazz Tags: Anesthesiology Source Type: forums
$4M PayDay for Spine Surgeon Whistleblower
It's like a feeding frenzy in the HOPD for employed spine surgeons...
"Waldref’s office said Yam will receive $4.1 million from the settlement. As well, Medicare, Medicaid and other affected federal insurance programs will receive $10 million. The remainder will be returned to the federal Treasury, Waldref said."...
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Source: Student Doctor Network - April 21, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
MRI in the ER
So what exactly is the real reason ER docs don’t order MRIs of the spine if someone comes in with clear symptoms suggestive of an acute radiculopathy?
I’ve never been able to give patients a good answer.
Ducttape? Or anyone else who might have insight? (Source: Student Doctor Network)
Source: Student Doctor Network - April 21, 2022 Category: Universities & Medical Training Authors: Dr. Ice Tags: Pain Medicine Source Type: forums
Labs prior to spinal injections?
Does anyone order labs routinely prior to injections? Had a patient (works as RN) tell me she was surprised that I did not check platelets prior to her CESI. I don't routinely order them but if I did it would probably not be so much for MBBs but more for interlaminar CESI/LESI. Thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - April 20, 2022 Category: Universities & Medical Training Authors: oneforfighting Tags: Pain Medicine Source Type: forums
RFA of the Superior Cluneal Nerve--Hope for Hordes of New Afflicted
#Gamechanger
Pain Ther.
2022 Apr 17. doi: 10.1007/s40122-022-00385-x. Online ahead of print.
Radiofrequency Ablation of the Superior Cluneal Nerve: A Novel Minimally Invasive Approach Adopting Recent Anatomic and Neurosurgical Data
O Visnjevac 1 2 3, M Pastrak 4, F Ma 2, T Visnjevac 2, A Abd-Elsayed 5
Affiliations expand
PMID: 35430676 DOI: 10.1007/s40122-022-00385-x
Abstract
Objectives/introduction: Superior cluneal neuralgia (SCN) is a distinct cause of lower back and/or...
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Source: Student Doctor Network - April 20, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
c-arm size
Anyone have experience with a modified c-arm (somewhere between mini- and standard)?
My partner and I (both hospital-employed) are looking to offer more joint procedures (IA shoulder, hip, and genicular blocks) in the office setting and I would prefer fluoro over US. This would open up more time spine and complex procedures for the hospital ASC. I was looking into something that may accommodate these procedures, but without the radiation and overhead (and without the bells and whistles...
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Source: Student Doctor Network - April 9, 2022 Category: Universities & Medical Training Authors: NHDO Tags: Pain Medicine Source Type: forums
Negotiating with an academic pain group- all advice welcome!
I always wanted to go back to my home residency program to join the pain group.With recent departures in their pain group and two new neurosurgery spine attendings, I know they are quite interested in recruiting me and I feel certain that I can generate the department a lot of money.
However, the contract offer was very underwhelming with regard to base salary (10%ile in my area), productivity bonus (they placed a ceiling on how much I can earn- a low ceiling), an expectation to work 5 days...
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Source: Student Doctor Network - April 2, 2022 Category: Universities & Medical Training Authors: cameroncarter Tags: Pain Medicine Source Type: forums
Intradiscal PRP
anyone? I’ll call out @drusso as he is our resident regen expert but hope this can lead to some open discussions!
Effectiveness of intradiscal platelet rich plasma for discogenic low back pain without Modic changes: A randomized controlled trial
To determine if autologous platelet-rich plasma (PRP) injection into a degenerative intervertebral disc, without Modic changes on magnetic resonance i…
www.sciencedirect.com (Source: Student Doctor Network)
Source: Student Doctor Network - March 27, 2022 Category: Universities & Medical Training Authors: Tboned Tags: Pain Medicine Source Type: forums
