Hospital asking me to sign an amendment based on 2022 CMS physician fee schedule...help?
I need your collective wisdom about how to respond to my HOPD employer decreasing wRVU based on the proposed 2022 CMS physician fee schedule which was announced back in July.
In short, midwest, HOPD of a large system, wRVU at 25 percentile with target wRVU of 8000 before generating bonus. Not perfect but I am the only FT pain guy at this HOPD, am my own "boss" with a comfortable 3-year guaranteed base salary, my wife liked the town, and it is my first job out of fellowship.
Although I just...
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Source: Student Doctor Network - September 14, 2021 Category: Universities & Medical Training Authors: dillonkor Tags: Pain Medicine Source Type: forums
Biden and Dem ’s Put Kibosh on MD FIRE
Say bye-bye to Back Door Roth’s and alternative IRA investment strategies. And remember, “Elections have consequences.”
D’s have never been on the look out for physicians interests and their actions speak louder than words.
House Democrats propose new retirement plan rules for the rich, including contribution limits and a repeal of Roth conversions
A proposal from House Dems would repeal Roth conversions in individual retirement accounts and 401(k)-type plans for those making more than $400,000 a year.
...
Source: Student Doctor Network - September 14, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
RT before or after vertebral augmentation?
Dear colleagues,
What is the best practice concerning pathological painful compression vertebral fracture (at the level of T9 for ex.)?
MRI shows minimal retropulsion without significant compromise of the spinal canal.
Does the sequencing of VA and RT affect the speed of pain relief? (Source: Student Doctor Network)
Source: Student Doctor Network - September 14, 2021 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums
Arthrodesis of the Spine by the Non-Spine Surgeon
AANS/CNS Position Statement on Arthrodesis of the Spine 8.21.21
Patient safety and optimal outcomes are maximized by team-based treatment of patients with either trauma or degenerative diseases of the spine involving a collaborative relationship between neurosurge
www.cns.org
It was only a matter of time until the spine surgeon spoke out against what is happening in our pain management world right now with the spinal simplicity and other "fusion devices." (Source: Student Doctor Network)
Source: Student Doctor Network - September 12, 2021 Category: Universities & Medical Training Authors: buddababa Tags: Pain Medicine Source Type: forums
UCI/PSPS Webinar: SIJ Fusion-Is it Spine Surgery or Pain Procedure?
All SDN KOL's encouraged to join in for this stimulating, thought-provoking discussion on an important and nuanced topic... (Source: Student Doctor Network)
Source: Student Doctor Network - September 10, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Maybe there ’s a job, come shadow.
Fellow in the job hunt. Mainly targeting private practices in small/medium sized cities near mountains with a huge range of places to end up.
Not much listed online in these locations, so cold calling some reasonable looking places. At three to four practices I’ve gotten this response
“We might be hiring. You can always come out and shadow for a day though.”
I appreciate the offer to shadow, but always assumed that would happen it but later after we’d gone back and forth a bit and agreed...
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Source: Student Doctor Network - September 7, 2021 Category: Universities & Medical Training Authors: agolden1 Tags: Pain Medicine Source Type: forums
Pregnant patient
Have a pregnant patient on the schedule tomorrow for back pain. Curious to here what people would be comfortable doing in terms of procedures or medications for these patients? (Source: Student Doctor Network)
Source: Student Doctor Network - August 5, 2021 Category: Universities & Medical Training Authors: dipriMAN Tags: Pain Medicine Source Type: forums
Perc MBB-PNS Before or After Conventional vs Pulsed RFA??
Prospective, Multicenter Study of Percutaneous Medial Branch PNS for the Treatment of Chronic Axial Low Back Pain – SPR Therapeutics
One of the most prevalent and challenging musculoskeletal conditions, chronic low back pain (LBP), is a leading cause of disability in adults.[1] The SPRINT PNS System offers a motor-sparing 60-day …
www.sprtherapeutics.com (Source: Student Doctor Network)
Source: Student Doctor Network - July 26, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Chloraprep vs betadine
I work in a hospital outpt setting and have been using chloraprep for all of our procedures both epidural and non spine. Numerous studies have shown its superiority over betadine.
The issue comes in with the package insert stating it is not for use where you might come into contact with meninges.
The real issue comes from hospital paper pushers stating they want to do away with chloraprep and just use betadine. I am more concerned with increased infection risk with betadine over...
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Source: Student Doctor Network - July 23, 2021 Category: Universities & Medical Training Authors: geauxg8rs Tags: Pain Medicine Source Type: forums
Differences between Pain Societies?
Hi everyone! As a resident interested in pursuing a pain medicine fellowship, I’ve noticed that there are many many pain / spine societies (AAPM, NANS, ASIPP, SIS, NASS, ASPN, PSPS, etc). How do you decide, as a pain physician, which of these you pay dues to and try to get involved in? (Source: Student Doctor Network)
Source: Student Doctor Network - July 19, 2021 Category: Universities & Medical Training Authors: JBM16BYU Tags: Pain Medicine Source Type: forums
Fluoro Procedures Resource
Hi all,
Just started pain fellowship on 7/1. I've been using the Furman Atlas of Image Guided Spinal Procedures and it's great but was wondering if there are any good websites, apps, or videos you guys recommend in addition to the Atlas.
Is there anything like NYSORA or BlockJocks for chronic pain procedures, especially fluoro guided procedures?
Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - July 15, 2021 Category: Universities & Medical Training Authors: gaspasser786 Tags: Pain Medicine Source Type: forums
Tizanadine vs. Clonidine, Guanfacine
I'm a psychiatry resident with many patients who have many psychiatric and non-psychiatric symptoms which would benefit from treatment with an alpha-2 agonist. For example, TBI from MVA, so has issues with impulsivity, anger/aggression, anxiety, and PTSD but also chronic pain, especially back pain. In an effort to reduce polypharmacy and increase efficacy I am considering starting/changing-to alpha-2 agonists
I am discussing with my psychiatry supervisors, but I hoped for some insight/wisdom...
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Source: Student Doctor Network - July 13, 2021 Category: Universities & Medical Training Authors: aim-agm Tags: Pain Medicine Source Type: forums
referral for pre-procedure medications only
Hey just wanted to see what the general consensus is. We had a patient who called who wanted to be seen, as primary care physician wanted the patient to go to pain management for just pre-procedure pain medication and anxiolytic. Sounds like the patient only wants 1-2 tablets of each. Assuming you have room on your schedule, would you see this patient knowing that is all the patient wants and that the patient will not be following back up with you? (Source: Student Doctor Network)
Source: Student Doctor Network - July 10, 2021 Category: Universities & Medical Training Authors: promethius Tags: Pain Medicine Source Type: forums
Re: Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis
(Source: BMJ Comments)
Source: BMJ Comments - July 9, 2021 Category: General Medicine Source Type: forums
