Pain Management Fellowships for CRNAs?

[Migrating]

I'm a curious student enquiring about specific fields and prospects. As such, I have done some research and came across the following: https://www.aana.com/ce-education/pain-management/advanced-pain-management-fellowship-program.

So... this is something I have never heard about; are there CRNAs that own pain management clinics and work in the same scope of practice as a pain management physician?

I am aware that pain management physician anesthesiologists also make considerably more than traditional physician anesthesiologists? Is the same true for these fellowship-trained CRNAs?

Thank you if anyone responds!

[Bluebolt]

I have met CRNAs who have done pain management training and do practice it independent of physician anesthesiologists. While this is possible it is an uphill battle and some states can make this type of practice very difficult for CRNAs. There are all kinds of legislative loopholes and old laws on the books that can be a barrier to practice for CRNAs.

They told me that most recently they had a legislative battle defending their scope of practice to treat acute pain but was told they aren't trained in CRNA school for chronic pain management. I've talked to some program directors who have stated they are implementing more of a focus on pain management and the pathophysiology and blocks required for that.

[subee, MSN, CRNA]

That was not true for my corporation. Pain docs made the same as the rest.

[wtbcrna, MSN, DNP, CRNA]

Generally, interventional pain pays significantly more than just doing regular anesthesia.

https://www.verywellhealth.com/average-anesthesiologist-salary-1735993

[Migrating]

On 2/26/2019 at 7:39 PM, Bluebolt said:

I have met CRNAs who have done pain management training and do practice it independent of physician anesthesiologists. While this is possible it is an uphill battle and some states can make this type of practice very difficult for CRNAs. There are all kinds of legislative loopholes and old laws on the books that can be a barrier to practice for CRNAs.

They told me that most recently they had a legislative battle defending their scope of practice to treat acute pain but was told they aren't trained in CRNA school for chronic pain management. I've talked to some program directors who have stated they are implementing more of a focus on pain management and the pathophysiology and blocks required for that.

Thanks for a lot of the insight. I ask these questions because I wish to do pain not necessarily for the money (please understand, this would technically be a year of "wasted" salary if I did decide to apply for a "fellowship" in pain) but because I have family in pain management itself, and I was always very interested in doing this. I would intend to provide care to underserved areas not open up "pill mills."

Do you have a website I can look into for the states that are more lenient to CRNAs practicing pain? Or could you list some if convenient to you? I can't seem to find useful information online about this.

[chiromed0]

Not a CRNA but I work in Interventional PM. I would agree with the others--CRNA's, while very capable, are probably doing some of the pain procedures b/c of a loophole that most state medical boards will constantly be looking to close. That being said it may be a losing battle. On the other hand, if it is just a matter of physician oversight/collaboration then working for a PM group I can see a CRNA that does procedures earning quite a bit more. Locally, I have heard of a PM physician having his NP's (don't know if it was CRNA or not) doing the procedures. I know of some "midlevels" doing procedures like facet blocks, etc. I do the office stuff, blocks, joint injections, TPI, etc., but the more invasive with fluoro/US are strictly physicians.

[murseman24, MSN, CRNA]

On 3/20/2019 at 1:21 PM, chiromed0 said:

Not a CRNA but I work in Interventional PM. I would agree with the others--CRNA's, while very capable, are probably doing some of the pain procedures b/c of a loophole that most state medical boards will constantly be looking to close. That being said it may be a losing battle. On the other hand, if it is just a matter of physician oversight/collaboration then working for a PM group I can see a CRNA that does procedures earning quite a bit more. Locally, I have heard of a PM physician having his NP's (don't know if it was CRNA or not) doing the procedures. I know of some "midlevels" doing procedures like facet blocks, etc. I do the office stuff, blocks, joint injections, TPI, etc., but the more invasive with fluoro/US are strictly physicians.

Some CRNAs do fluoro-guided invasive interventional pain management much like their physician counterparts. This is not the norm, and as is done with most autonomous, advanced provider roles, is found primarily in underserved areas where Ollies refuse to live.

[offlabel]

15 hours ago, murseman24 said:

..... and as is done with most autonomous, advanced provider roles, is found primarily in underserved areas where Ollies refuse to live.

Don't know if you're a student or not, but if you make these kind of statements outside the safety of a nursing forum, it'd be a good idea to know how to respond to someone when they call BS on it. Yours isn't the only credibility at stake.