• Rene Przkora, Ajay Antony, Andrew McNeil, Gary J Brenner, James Mesrobian, Richard Rosenquist, and Amr E Abouleish.
• Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL.
• Pain Physician. 2018 Jan 1; 21 (1): E43-E48.

BackgroundWe hypothesized that there is a gap between expectations and actual training in practice management for pain medicine fellows. Our impression is that many fellowships rely on residency training to provide exposure to business education. Unfortunately, pain management and anesthesiology business education are very different, as the practice settings are largely office- versus hospital-based, respectively.ObjectiveBecause it is unclear whether pain management fellowships are providing practice management education and, if they do, whether the topics covered match the expectations of their fellows, we surveyed pain medicine program directors and fellows regarding their expectations and training in business management.Study DesignA survey.SettingAcademic pain medicine fellowship programs.MethodsAfter an exemption was obtained from the University of Texas Medical Branch Institutional Review Board (#13-030), an email survey was sent to members of the Association of Pain Program Directors to be forwarded to their fellows. Directors were contacted 3 times to maximize the response rate. The anonymous survey for fellows contained 21 questions (questions are shown in the results).ResultsFifty-nine of 84 program directors responded and forwarded the survey to their fellows. Sixty fellows responded, with 56 answering the survey questions.LimitationsThe responder rate is a limitation, although similar rates have been reported in similar studies.ConclusionsThe majority of pain medicine fellows receive some practice management training, mainly on billing documentation and preauthorization processes, while most do not receive business education (e.g., human resources, contracts, accounting/financial reports). More than 70% of fellows reported that they receive more business education from industry than from their fellowships, a result that may raise concerns about the independence of our future physicians from the industry. Our findings support the need for enhanced and structured business education during pain fellowship.Key WordsBusiness education, practice management, fellowship training, curriculum development, knowledge gaps, private practice.

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