Methadone clinic & Pain clinic

[MGN]

Wondering what the renumeration is like for both niches?

[medisforme]

BC family med perspective, 

• most fam docs don't do private practice addictions work as there are just too many no shows and you have to put the word of mouth/advertising out there. You also have to content with overhead. Most work through local health authority, so you can bill sessional fees for no shows.  Working through health authority is a good gig as all your overhead/staff/etc... is paid for.  I do my own billing (takes about 15min/week) so i keep 100% of my billings.  You get paid $23/week per patient on methadone/suboxone/kadian.  Doesn't sound like much, but if you build up a large practice, and more importantly if you build up a stable patient base, you can make a lot of money.  Ie. stable patients you only need to see once every four weeks so essentially you are getting paid $92 for a 10min visit.  Billing might be different for psych/IM who have addictions fellowships.
• Pain clinic pays well if you are trained in different interventional procedures (mostly different types of injections) and likely depends on the province and what specialty you are talking about (you would have to look up the individual fee codes)  usually, this is PMR or anaesthesiology.  I have only seen FM docs do different types of trigger point injections (vs the variety of facet block, epidural, SI joint etc... you see at a typical pain clinic), which pay well from a BC Fam med perspective (which is actually quite pathetic to begin with), i think $76 per treatment.
• I have never seen methadone/opioid pain clinics, that would be an enormous headache and I suspect very unfulfilling.  Given the backlash and college guidelines around prescribing opioids for chronic non-cancer pain, you would also run the risk of getting audited.