Pain Management Community

you are absolutely right i have a specialist for my pain but for a family doctor the only one who could not say no was the clinic for the indigent and migrant workers i have health insurance but no one else will take me.

totally lost what it s your asking or saying? yes primary care phy. do not feel comftable writing pain meds much these days with there licence to worry about pl selling their meds abusing their meds ect. so once they realize wow you have true pain issues you would benifiet from a ain clinic" so u have 2 dr.'s pl as they grow older i for one have a primary pain specurinary,gastroatolagent osteopedic, dermatolagist plastic surgeon for all my skin cancer i oh yea and a optamolagist, and a gynacolagist and im 52 plus i have breast exams cololoscomys it never endsand im 52 so u go with the flow b grateful there is someone out there willing to write pain meds because they r few and far between!

we are happy with our Pain doctors,the point is that once you get a Pain Specialist your family doctor drops you and when you go to get another one they ask if you are a pain patient and after that they do not take you as a patient. Like i said i have to despite having great insurance go to a clinic for indigent and Migrant workers because all the other Family Doctors the "audition" goes well until they ask do you take Opiate's "yes i do" do you have a Pain Specialist "yes i do" well i will not be able to be your family Doctor but thank you for coming. and out you go, and it goes like that Doctor after Doctor until all thats left is the clinic for the indigent and they can't turn anyone away.

That is terrible.

I have not experienced this since my pcp also takes care of my pain med RXs. I have seen a pain management specialist a couple of time to see if he had anything new to suggest. He did not.

I believe that the fewer doctors one sees the fewer mistakes might happen. I do believe in specialists when one really needs them. My husband got his pain meds from his pcp also, no problem.

That is just horrible. Perhaps it is geographic at this point??? We live in Oregon.

Take care, Annette

she has tried 4 family doctors they basically ask 1st insurance name and age and brief what your needing and who was your past doctor or health she has told them that she doesnt need a pain doctor she already has one she needs the care that the pain doctor wont do but soon as they hear pain management even though they say they are taking new patients they tell her they will need to talk to the doctor each time they call back and say sorry but they arent taking new patients now or they are to busy its like she has the plague or something I mean they havent even taken time to look at her records. THIS IS NUTS.

A family doctor is NOT an expert in pain management. The poor physician might have had a course in pain management in medical school or as part of a rotation in anesthesiology while in a residency program — or maybe not. It might have been addressed at a medical convention - or not. Internists are not pain management (PM) physicians. PM doctors are typically anesthesiologists or neurologists who have completed a residency or a fellowship in PM. They are far more experienced, talented and skilled in treating various forms of chronic pain.

Think about this for a moment. Someone presenting in the office with spine-related chronic pain could use any or all of the following PM treatments: a corset, brace, TENS, traction, acupuncture, biofeedback, physical therapy, kinesiotherapy, injection of steroids and anesthetics, non-steroidal anti-inflammatories, cortisone, rhyzotomy (radio frequency denervation), spinal cord stimulator, intrathecal infusion pump, off-label medications (anti-depressants, anti-convulsants), combination of long-acting pain medication with breakthrough meds, counseling, hypnosis and meditation. Your typical internist or family practitioner is not trained, equipped or skilled in these PM techniques. In fact, most such patients also require a psychological intervention. The average family doctor is not capable of delivering this kind of treatment. This is why you are referred to a comprehensive PM program.

If you have tried all of the above treatments and they have all failed, then you can go back to your internist and ask him or her to manage long and short-acting opioids, off-label drugs and anti-depressants. But you must be certain that you have tried and failed with all of those PM options before going back to the referring family doctor.

I hope this makes sense to you. Good luck!

Charles you are missing the point we are saying ONCE WE HAVE PAIN MANAGEMENT WE LOSE OUR INTERNIST AND NO OTHER ONES WANT US AS PATIENTS BECAUSE WE SEE PAIN MANAGEMENT.IT BECOMES REVERSE DISCRIMINATION OF THE PATIENT. WE DONT NEED THEM FOR ANYTHING TO DO WITH PAIN BUT THEY WILL NOT TOUCH US WITH A TEN FOOT POLL. I have grade a insurance and pain Management Doctor with spotless record but can not get a "real" internist as a family physician.

I have never experienced any of this either. In my state family doctors can no longer prescribe narcotics for longer than 6 months without having a special license. So they send you to Pain Management. Not what I would call a clinic but doctors that are experts in treating pain using all kinds of methods. But they don't stop treating you for other things. My family doctor knows I see a PM doctor. He doesn't necessarily like the idea of people taking narcotics for long periods but he still treats me like any other patient. Otherwise, why do you even need to tell another doctor? I have never ever been asked by any doctor, specialist or other, if I'm seeing a pain management doctor. Certainly never when I made an appointment. As far as I'm concerned, if a doctor doesn't need to know then he won't know. That goes for every single person in your life. Need to know only.

Thank you you hit it right on the nose finding a pm doctor isnt the problem its finding a family doctor pain doctors dont want to be bothered with issues such as filling out paperwork for longterm disability they dont want to see you for the flu etc.
so they will tell you that you need a family md Good luck on that 1st you need to get thru the door and just mention that you are a on pm and see how far you get so I guess this leads to having to go to the ER each time isnt that what they are trying to stop
lets face it any changes in are care system will 1st need to be imposed on the doctors that no longer care.

I don't really get this at all. I have changed pcps a number of times while on opiates due to moving mostly. I do not recommend telling the person setting up your appt. any more than you need to, but I believe you need to be totally honest with the doctor at your first appt. I have been, and have not had a problem. I still suspect this is a geographical thing, where do you all live?

I live in Oregon and have always lived on the West Coast or in Nevada.

Take care, Annette

Maybe I'm one of the lucky ones but I have pleasant experiences with my PCP. When I first visited her she asked about my chronic pain history and who my PM was-a doc notorious for under medicating his patients & pushing procedures. My PCP actually referred me to a PM who would better manage my chronic pain (w/out over-medicating me) as she was concerned about my overall health due to poor pain control--stress, depression and high BP.

I was so fortunate to find her for these reasons; but recently she did say that she was waiting for the PM to send patients back to her. I know they studied together, and maybe they were scratching each other's back, I don't know. I was just confused when she said she was waiting on him to "send her patients back".

I have had good experiences with my pcps also.

Maybe your pcp lost patients entirely to the PM doc, because they were basically healthy to start out with. The only reason I even see my doctor is for pain management and PAP tests once every 3-5 years. Without the pain management, I would probably go to a local Planned Parenthood type clinic for my PAP tests and never see my pcp at all. I am not saying this is a good thing, just one explanation that came to mind.

Take care, Annette

I can't say that I see this happening at all.

As mentioned, a Pain Mgmt. Dr. is a specialist, just like many ohter type of Drs. and just because I am seeing them, I go to my Primary Dr. when needed or any other type of Dr. if needed and have never been turned away or made to feel different just because I have chronic pain.

There is not just one Dr. out there that is meant to handle every single health issue that may come up.

I have other friends I know that are also in Pain Mgmt. and don't have any issues seeing their Primary or other Drs.

So I don't think this is some widespread issue and hope you can find a good Dr. for your wife. Doesn't she have a caring Oncologist that is helping her with her pain? I can't imagine a Primary Dr. turning her down for treatment of the flu or other type of regular issues that may come up.

As mentioned, laws are such that you can't get narcotics from more than one Dr. but that shouldn't be an issue for people.

So I guess I'm just not seeing the issue here?

Well pesky you have more than one patient in more than one region of the country who has this issue going on, and you could vome here and visit with me and go to every practice accepting new patients and watch as we get turned away day after day ,Doctor after Doctor all because we see Pain Management Doctors. and some people have said don't tell them you see one, well last time i checked thats called lying and the doctor will not know all the Med's you take and will not be able to take the med's your pain Doctor prescribe's into account when they write a script,and what happens if they want to write for a pain med for something you dint want to violate your contract??