Medicare advantage trap-
I wish more seniors were aware of this trap and that they can’t go back to regular Medicare.
Older Americans say they feel trapped in Medicare Advantage plans — NPR
As enrollment in Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.
apple.news (Source: Student Doctor Network)
Source: Student Doctor Network - January 7, 2024 Category: Universities & Medical Training Authors: bedrock Tags: Pain Medicine Source Type: forums
Pain- PM & R Office Build Out
I'm leasing some new office space and need advice on a build out. Office space is 1500 sq feet, landlord is doing a full buildout to my specs. How big of a room do you typically allocate to a flouroscopy suite (plan to do basic interventional spine procedures in the office). How big do you typically make your exam rooms? What are some features I should ask for in the build out. Planning for 3 exam rooms, 1 procedure suite for fluoroscopy, personal office, small work space for midlevel...
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Source: Student Doctor Network - January 4, 2024 Category: Universities & Medical Training Authors: PMR ’s chill Tags: Pain Medicine Source Type: forums
NANS Meet Up: January 18-21, 2024
2024 NANS Annual Meeting
Attend the premier meeting in neuromodulation, the 2024 NANS Annual Meeting, January 18-21, 2024 in Las Vegas.
www.neuromodulation.org
It's time to sharpen your pointy shoes and be prepared to be wowed. With more waveforms than a Casino buffet and battery lives that would make Elon Musk blush, this is the legit OG, SCS premier event and gathering of pain, neurosurgery, and spine royalty. Meet the new line-up of KOLs who will be available for pictures and schmoozing. Engage in stimulating, authentic, and thought-provoking di...
Source: Student Doctor Network - December 24, 2023 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Holiday drama
Patient with a disease state that warrants opioids under guidelines. Got to 120 MME and PCP asked my department to help out. We have a policy of helping PCP with unstable dose patients before handing patients back.
We transitioned them to a long acting agent and with PRNs. They originally didn’t like the plan, but then went through routine refills without any concerns.
They then called frantically requesting early refill before the holidays. When asked about overuse, they first said the...
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Source: Student Doctor Network - December 23, 2023 Category: Universities & Medical Training Authors: Czech777 Tags: Pain Medicine Source Type: forums
Dealing with insurance dictating procedures..
Hey everyone, I can’t be the only one dealing with facet treatment denials when the patients notes some leg pain. I literally had a denial where the patient had severe facet OA, mild foraminal stenosis and more back pain than leg pain with pos. Facet loading etc. The denial said “your imaging shows other causes” so now we have someone probably with no training in pain and probably not even a doctor dealing out denials based on imaging reports. This seems to be more and more common. Any...
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Source: Student Doctor Network - December 19, 2023 Category: Universities & Medical Training Authors: Laryngospasm Tags: Pain Medicine Source Type: forums
Treating back pain in the ER
Hey all,
ER doc starting a pain fellowship next year. Wondering if you have any tips/tricks or nuances I could start implementing in the ER, particularly with respect to low-risk back pain (strain, sciatica). Actually didn't see much in residency (since 10 hour waits were typical) but see a bunch now in the community. Assuming no red flag symptoms, the typical approach amongst my colleagues is NSAIDs, Lidoderm +/- Robaxin/Flexeril/Valium (rarely). X-ray if patient insists (recognizing...
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Source: Student Doctor Network - December 16, 2023 Category: Universities & Medical Training Authors: TrailRun Tags: Pain Medicine Source Type: forums
Will pain come back around?
Hi All,
Currently resident looking into pain and have been seeing a lot of posts about the current state of pain- slashed reimbursement, saturation in desirable cities, etc. I also have seen a lot about anesthesiologists flocking back to the OR give the insanity of their job prospects atm.
As many of these things work sort of sinusoidally, my question is- do we think pain will come back around?
Is there a future where older pain docs get fed up with slashed reimbursements and retire en...
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Source: Student Doctor Network - December 10, 2023 Category: Universities & Medical Training Authors: klumpke Tags: Pain Medicine Source Type: forums
Hey PMR folks- check the Pain Forum for some free CME
Opioid CME 4.5hrs for free (Lobel back at it Nov-Dec 2023)
Target Audience: Providers eligible to prescribe opioid analgesics & non-prescribers involved in the care of patients receiving opioid analgesic therapy, nonpharmacologic therapies, and non-opioid medication therapies for the management of pain; physicians, dentists and oral surgeons, residents...
forums.studentdoctor.net
Here is link, I will host it (means I don't get the CME). (Source: Student Doctor Network)
Source: Student Doctor Network - November 27, 2023 Category: Universities & Medical Training Authors: lobelsteve Tags: PM&R Source Type: forums
National Spine and Pain
Looked through the old posts at not much since 2021.
Talked to one of the docs in the group about a job opening with NS and P.
20-25 patients a day. Base 300 but you get that or 20% of gross collections, facility fees, pro fees, UDS and DME.
Does this make any sense? Anyone currently working with them? (Source: Student Doctor Network)
Source: Student Doctor Network - November 16, 2023 Category: Universities & Medical Training Authors: blockstar Tags: Pain Medicine Source Type: forums
Anesthesia vs. PM & R for pain management / spine
Hey guys! So I'm interested in pain management and was just wondering what the real differences of going into something like spine from PM&R or interventional pain from anesthesia was. I would ideally like to go into pain management through an anesthesia residency, but anesthesia seems to be getting more and more competitive, could you do something similar going through PM&R? I've also seen the compensation for pain management and anesthesia, and it seems much higher than PM&R but can't they...
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Source: Student Doctor Network - November 11, 2023 Category: Universities & Medical Training Authors: Spongeman7 Tags: Pain Medicine Source Type: forums
Opioid CME 4.5hrs for free (Lobel back at it Nov-Dec 2023)
Target Audience: Providers eligible to prescribe opioid analgesics & non-prescribers involved in the care of patients receiving opioid analgesic therapy, nonpharmacologic therapies, and non-opioid medication therapies for the management of pain; physicians, dentists and oral surgeons, residents and fellows, physician assistants, nurse practitioners, pharmacists, and registered nurses.
Summary: Assessment and treatment of pain remain challenging for healthcare providers and...
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Source: Student Doctor Network - November 9, 2023 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
The Rape of the Spine.
Nelson. RJ. The Spine Journal 11s. March 2015.
http://www.thespinejournalonline.com/issue/S1529-9430(15)X0002-7
Full text available to NASS members and organizations. I'm not allowed to reprint it here.
It is s spine surgeon telling how other surgeons are committing fraud. (Source: Student Doctor Network)
Source: Student Doctor Network - November 6, 2023 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
Spine MRI without/with contrast denials
I recently moved out East and have been ordering post-op spine MRIs without and with contrast (as I always have). I am getting pushback from insurance companies and radiologists about this - they want a plain MRI or a different Dx code. First of all, am I missing something regarding ordering post-op spine MRIs with contrast? I though we wanted to discern scar tissue from HNP. Did something change and I don't know about it? Secondly, if it is still recommended to order with contrast...
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Source: Student Doctor Network - October 19, 2023 Category: Universities & Medical Training Authors: knoxdoc Tags: Pain Medicine Source Type: forums
TFESI via AP approach?
I'm pain trained. I know there is supra and infraneural and the whole Kambin's triangle bit. I use oblique to get in.
However, I am wondering, why aren't TFESIs performed via the AP approach?
The spine guys do kyphos and Intracept in AP view.
Go down -> touch pedicle -> walk caudad a bit-> turn needle and go cephalad.
Obviously one shouldn't go lateral b/c there is no backstop. And one of course shouldn't go medial.
What am I missing? I'm just curious. (Source: Student Doctor Network)
Source: Student Doctor Network - October 17, 2023 Category: Universities & Medical Training Authors: CleanUp Tags: Pain Medicine Source Type: forums
