Health Careers in Pain Management

Learn about Physician Careers in Pain Management

Doctor treating a female patient.
A patient describes her symptoms to the doctor. Getty Images

Pain management is a medical sub-specialty associated with anesthesiology. Many pain management physicians are often trained as anesthesiologists. As such, they may choose to practice in an outpatient clinic, instead of practicing in a surgical setting. Other pain management physicians may have a background in other specialties such as primary care. Due to the demand for pain treatment, there are not enough pain management doctors to treat all pain patients and therefore, primary care physicians are often left responsible for managing pain in their patients, too.

The field of pain management is often a debated topic in the media and among politicians and pundits due to a reported increase in the rate of death caused by addition to or overdose of prescription painkillers. Many experts feel that more research needs to be done on the causes of chronic pain, rather than the treatment via painkillers.

That being said, the field of pain management is growing and evolving, and pain management physicians offer relief to many patients who are incapacitated with chronic pain. Below is an overview of careers for physicians who specialize in outpatient pain management.

Typical Work Week

Pain management physicians (anesthesiologists) work out of an office typically, where they see about 22-27 patients per day on average. They may work as private practitioners in business for themselves, or they may be employed by a hospital or medical system. Pain management specialists help patients to manage chronic, debilitating pain that may be caused by a variety of conditions, diseases, or injuries.

The pain management physician or a member of the staff will interview the patient about his or her pain and may perform some simple tests such checking for range of motion and overall mobility. Also, there may be some other diagnostic tests performed.

After diagnosing and assessing the pain, a pain management physician may treat the pain in a variety of ways including:

  • Physical therapy
  • Oral medication
  • Trigger point injections
  • Epidurals
  • Chiropractic treatment
  • Massage therapy
  • Acupuncture

Not all of the therapies are necessarily provided onsite. The physician may refer the patient elsewhere for some of the services, or to someone else within the practice if therapists are on staff. If the patient's case is too complex, or if it's caused by something better treated by another specialist, the pain management physician may refer the patient out to a different physician.

In addition to physicians, other medical professionals may help treat pain patients such as nurse practitioners, physician assistants, or other nurses and medical assistants.

Why Practice Pain Management?

Pain management can be a very rewarding specialty because of how greatly you can improve patients' lives. Also, anesthesiologists who prefer to work in an office setting may enjoy pain management because of the office environment as opposed to providing anesthesia services in an operating room of a hospital or surgery center. The hours for pain management are more stable and predictable since the doctor does not have to be available or on call for emergency surgeries.

Challenges

One of the greatest challenges for pain management physicians and their staff is dealing with addicts and drug seekers and preventing them from getting drugs that are not needed for medical purposes.

In fact, if pain management physicians do not screen their patients properly and train their staff to recognize drug seeking behaviors, the clinic and the physician could be liable for drug charges. Additionally, some patients, if addicted, become belligerent or even violent when they are denied pain medications. Therefore, it's paramount that all staff document patients thoroughly and check for any behaviors or signs that the patient could be merely seeking drugs to feed an addiction (or to sell to other addicts) rather than to treat pain.

In addition to thorough patient screening, (including drug screens), documentation, and diagnosis, pain management practitioners also conduct spot checks of patients, including random "pill counts" where patients are selected at unannounced times to present their prescription to the physician for confirmation.

The physician or staff can then verify that the patient has the appropriate amount of pills on hand, based on the original prescription, and is not selling them or exceeding the recommended dosage.

Training

Most pain management physicians are trained as anesthesiologists. They may do a fellowship or additional training specializing in pain management, but the additional training is not required in order to practice pain management. Physicians in specialties other than anesthesiology, such as internal medicine, may practice pain management with additional training such as a fellowship or CAQ in pain management.

Compensation

The average annual income for an anesthesiologist who practices pain management is approximately $502,000. For pain management physicians who are not anesthesiologists, the average annual income is lower. The difference in income may stem from the fact that anesthesiologists are qualified to do more procedures, such as epidurals, than non-anesthesia pain management physicians.

Related Careers

If you are interested in treating patients for chronic pain, you may also be interested in these other non-physician careers:

Additionally, you may be interested in other physician specialties such as Physical Medicine and Rehabilitation (PM&R), or palliative care, both of which include some pain management as part of their work.

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