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
molar pregnancy
Just curious, how urgently do you guys do these cases ? I'm trying to find some guidelines recommendations in relation to timing and urgency of procedure but not seeing much.
I started thinking about it because had gyn calling in middle of the night wanting to do D&A for molar pregnancy. bhcg~117k, otherwise vitals normal, labs normal, not bleeding, just have nausea and mild pain. is it really THAT urgent?
Anyone know of any guidelines for timing/urgency? (Source: Student Doctor Network)
Source: Student Doctor Network - November 11, 2023 Category: Universities & Medical Training Authors: anbuitachi Tags: Anesthesiology Source Type: forums
MME ?s
Greetings all, I have tried to research how MME are actually determined with little success. Does anybody have any good referance articles on how MME was orginally started/determined? Was talking to a colleague who mentioned it was intially started by giving patients differnt meds and asking feedback on how strong these meds were. Sounds pretty out there and I have never been able to find anything online/my ref books other then a bunch of articles on how to calculate MME. I am more...
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Source: Student Doctor Network - November 10, 2023 Category: Universities & Medical Training Authors: schmee90 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
Ease of MBB vs Epidurals
I’ve been out of training a few years.
I’ve seen a fair amount of patients who see other pain docs and receive multiple epidurals which unfortunately don’t provide relief.
The imaging shows a very minor disc bulge somewhere not concordant with clear radicular pain.
When I asked them about mbbs rfas the patients act surprised and have never heard about them.
Any thoughts why some pain people don’t do the mbbs/rfas? Are they technically more challenging to run parallel to the...
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Source: Student Doctor Network - November 9, 2023 Category: Universities & Medical Training Authors: CleanUp Tags: Pain Medicine Source Type: forums
SCS trial, splenectomy
78 yo M with FBSS and he's s/p splenectomy on acyclovir, fluconazol and PRN levofloxacin. He's got chronic leukopenia. Scheduled for trial next week and WBC 1.0 today. PLT normal.
What does everyone do in this situation? He's miserable.
Thinking move forward with the trial and be meticulous with sterile technique. Hibiclens BID x 3d prior. Keflex PO TID during the trial, which would be shortened to 3 days.
Reasonable? (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2023 Category: Universities & Medical Training Authors: MitchLevi Tags: Pain Medicine Source Type: forums
Doctors Employed by Hospitals Earn More than Independents...Implications for Pain?
"The reason that doctors employed by hospital systems can make more money than independent physicians is because employed doctors can have their income additionally #subsidized by the hospital #FacilityFees that they generate by ordering tests and performing procedures. The #StarkLaw was intended to prevent these hospital '#kickbacks' to doctors, but physician employment effectively circumvents this spirit of the Stark Law." (Source: Student Doctor Network)
Source: Student Doctor Network - November 6, 2023 Category: Universities & Medical Training Authors: drusso 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
SIJ Arthrodesis 27278 in Non-Facility Settings
"We proposed the RUC-recommended work RVU of 7.86 for CPT code 27278. We also proposed the RUC-recommended direct PE inputs without refinement."
Comment: Several commenters supported CMS’ proposed valuation of 7.86 work RVUs for CPT code 27278. They also supported CMS’ proposed RUC-recommended direct PE inputs for the non-facility site of service as they noted that current study data has sufficiently demonstrated safety and efficacy in the non-facility setting. However...
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Source: Student Doctor Network - November 5, 2023 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
G2211?
Anyone using/going to use this underwhelming but overly touted code to make another $16? (Source: Student Doctor Network)
Source: Student Doctor Network - November 5, 2023 Category: Universities & Medical Training Authors: GlowInTheDark Tags: Pain Medicine Source Type: forums
Furman SCS Technique
I was reading through the Furman chapter on SCS trials and found the described technique to be pretty intriguing. Essentially ipsilateral obliquing a touch and caudally tilting as much as possible so that you don't really have to guess where to start like you often do when going out of plane in AP. I have often found that the traditional starting point of 3 o'clock one and a half pedicle belows often isn't a flat enough angle, particularly on larger patients.
Does anyone do their trials...
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Source: Student Doctor Network - November 5, 2023 Category: Universities & Medical Training Authors: sdnuser001 Tags: Pain Medicine Source Type: forums
physician fee structure for meeting with lawyer
Just wondering what the going rates are for a physician to charge for meeting with a lawyer to discuss patient/client. Does it matter if the case is worker's compensation versus personal injury? Are the fees different for in-person versus over-the-phone? Any input on what is reasonable would be much appreciated. (Source: Student Doctor Network)
Source: Student Doctor Network - November 4, 2023 Category: Universities & Medical Training Authors: promethius Tags: Pain Medicine Source Type: forums
Part-time Tele work?
Hello,
I'm a current resident and will be applying for a pain fellowship. I want to practice neuro part time and was wondering how many shift requirements would be considered for a part time position? My ideally work week would be 4 days of pain a week and 1-2 tele neuro shifts (so maybe 6 shifts total?). Would tele companies let me work at this low number of shifts? What would compensation look like? Will it be $/hr or $/consult? How many hours (eg can I choose between 4 hour or 8)? Can I...
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Source: Student Doctor Network - November 4, 2023 Category: Universities & Medical Training Authors: Itsarainbow Tags: Neurology Source Type: forums
Clinic pt who wants coworker
Would you continue seeing a patient in clinic who requests your colleague in clinic do their procedures? It is frustrating to spend time with a patient, work them up for a procedure. Productivity based in PP and new attending. (Source: Student Doctor Network)
Source: Student Doctor Network - November 3, 2023 Category: Universities & Medical Training Authors: PMROralBoards Tags: Pain Medicine Source Type: forums
