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Why Pain management Docotrs are a booming business

Laurie AnnLLaurie Ann Posts: 47
edited 06/11/2012 - 8:36 AM in Lower Back Pain
This past 3 weeks I have really learned why, especially my Pain management doctor has a booming business. I have had him for 2 years now, he takes his time with me in his office to answer all my questions, he looks for ways to help me manage the pain, and lastly he is a doctor who has no problem telling you when the surhgeons are passing the buck. The Orthapaedic Surgon at my last appointment said well I have fixed your bones, i cant do anything for you unless its bone related, have your Pain management doc refer you to a Neurologist! I left feeling so confused. I have no confidence in that Doctor anymore. When I told my pain doc what had been said he shook his head. I asked him what he thinking, he said this is why there is such a need for what I do, surgeons wont tell you when the back/neck surgery wasnt successful! I will remember this in the future and secure second opinions and manage my own health.
Always find a Doctor that will be un afraid to tell you the truth, even if it means outing another Doctor.


  • Some spinal surgeons are more willing than others to keep you on after a surgery. But if the surgery is completed and the patient does not require more surgery, they will refer him/her to pain management or another doctor, depending on the patient's needs. Some spine surgeons are more like "spine factories" while others operate their practice more like a "regular' doctor.

    After all, they are surgeons -- if the patient no longer requires surgery, they can't really justify keeping them on as patients. Perhaps it has to do with insurance...I don't really know. My surgeon doesn't function this way -- he orders any injections or nerve blocks that are done by the PM guy -- and he prescribes any drugs I need.

    What patients often do not agree upon with their surgeon is when their treatment is complete. Sometimes a patient has a surgical procedure that is medically successful, but the patient still has pain. The surgeon cannot really do anything further for the patient surgically, but the patient feels the surgeon has an obligation to make him/her pain better. Thus the patient feels the surgeon has not performed his job. Is that really the case? Is the surgeon "passing the buck?"
  • I dont know if they are passing the buck or not. When the surgery is done so are they but should it be that way or should they continue to help you try to figure out what is going on. My surgeon was done with me also told me to go to my pcp for meds wouldnt even give me a refill and yes i was angry with him because i had such a hard recovery. I dont think he wanted to admit that there was still a problem even though i couldnt stand for one minute without horrible pain. Im not saying all surgeons are this way some do enjoy dealing with their patients and others just do the job and thats it. Im very happy for the ones who have surgeons willing to continue their care I wish i would of had one like that. In the end my surgeon did his job-the surgery-so whether or not he should have continued my care would have been up to him.
  • Laurie,
    It is always difficult for the patient in what he feels in the middle of this disjointed approach to the same patient and it is no wonder that we are confused getting conflicting information for each side. Each is his own way is trying to do the best outcome for the patient.

    Most pain management elements are none invasive and the two approaches should work collectively, it is progressional and once all that the surgeon can do would the more beneficial aspects of PM is of optimum use.

    Managing pain is intended to contain the pains development over and above expected norms and keep the glass half full outlook more pervasive than not. Do we want the truth or someone to agree with our synopsis of what is going on, should that be the case ineffective and possibly detrimental procedures pressure others, that in differing circumstance may not be the best option for the patient.

    It is always hard to know what to do for the best and in general each provider is doing all that he can to ease our plight.

    Take care and good luck.

  • dilaurodilauro ConnecticutPosts: 9,832
    but in many situations with good doctors they are just doing what is best for the patient. If they feel that their speciality area can no longer provide relief for you then it is their job to refer you to someone else who may be able to help you. Our spines are a complicated piece of our bodies and thus need to be treated as such.

    I have had situations where one doctor (neurosurgeon) knew that he could no longer do more surgeries for me, so sent me on to a Pain doctor who worked me up for a number of ESI's and when that didnt work, he sent me to my current doctor, a Physiatrist. While I may not be pain free, this doctor has helped move along to the status I am in today, for which I am very grateful.

    Use this example. You have a computer problem, so you bring it in to Best Buy to have the look at it.
    They cant find anything wrong with it, but suggested that you see ABC Computer company. You see them and they find some additional problems but tell you to really correct the problem, you need to see PapaRon's Computer services. You bring it their and the problem is fixed. So, no one is passing the buck, they just realize their limitations.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I may not interpret your post correctly, thank you for my narcotic appetizer before dinner, but it sounds like your PM has his act together! Mine is the same way. My family doc obviously has overall care for me, but has deferred the PM side of things to a specific doctor she trusts (actually a physiatrist). He has been my best advocate (actually they both have) and I have built up a relationship with him over a 3 year period that if there is something, anything, that I don't like from another doctor I will ask him about it. I don't think I have ever walked out of his office without feeling better about things. He explains if I'm truly being blown off or what the other doctor's reasoning would be. He keeps me focused and truly lifts my spirits every time I see him. Without my PM and family doc I would be absolutely, completely lost. When I have hard days I can call his assistant and we discuss it on my next visit or he may ask me to come in.

    So after that whole little rant, I truly trust both of these doctors and value their opinion over anyone. They have proven over and over that they are truly looking out for my best interests. If I find other doctors that are "on the bus" I will keep them. The jury is still out, but I think this new neuro I've seen may be another to keep on my team. He is open to collaboration with my existing docs and that is so important to me.

    It is nearly infuriating going through the process of finding the right team, my frustration levels are high right now right along with my pain levels. But I can't give in.

    I hope you are able to find the right combination of doctors to give you some relief. God only knows it can take a while though!
    Spiney hugs >:D< >:D< >:D<
  • Over here in Wales, which is part of the UK, patients who have long-standing pain are so unpopular with all doctors that there was, until recently, nowhere for them to turn.

    One lady doctor took it upon herself to set up a clinic for them and several years later, not only is it flourishing, but she was knighted by the Queen. She is now 'Baroness XYZ, Professor of Palliative Care' and despite all her titles and accolades, you couldn't hope to meet a more pleasant, down-to-earth person.

    Palliative care aka pain management is a growing industry over here and one where someone like Baroness XYZ is welcomed by the medical profession. Once the surgeon has finished all the diagnostic and treatment phases deemed necessary, their duty of care is over and it is no longer within their mandate, nor is it feasible or at least financially viable for them to continue treating the patient.

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