Quote:
Originally Posted by pain_doctor
The issues here are beyond belief. MOST folks don't have any problems, but unfortunately certain personalities are attracted to high-tech and invasive procedures because of what might be called "psych issues". These folks, e.g. hypochondriacs, narcissistic persons etc., may not be recognized easily without a formal evaluation. Invariably, they do well on a trial, but will go bad after less than 4 months, and demand some sort of satisfaction, often getting the device removed or wanting immense amounts of medications and weekly visits in clinic. For all concerned, it is best not to court fire by missing this.
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Welcome pain_doctor
SO! You're a pain doctor. It's nice to see an actual physician take the time to get on a forum such as this. I (think) this indicates that you care enough about your pts to see what feedback is coming from SCS recipients.
I find your post rather interesting....and a bit difficult to comprehend what it is that you are trying to get across.
It appears to me that you are catagorizing 'These Folk' e.g. hypochondriacs, narcissistic, etc to be the ones who
'Invariably' present with 'problems' and demand some sort of satisfaction.....and wanting immense amounts of meds and weekly visits in clinic.
I think we should rewind a bit here and go back to the initial visits during the 'sales pitch' of these devices. It is repeatedly stressed to the patients that we should NOT expect to get more than 50% pain relief.
THIS ISSUE seems to somehow go by the wayside after the doctor receives his VERY LARGE financial kickback. It is at THIS point (perhaps the 4 months you speak of)"that something may go wrong and they demand some sort of satisfaction.....and wanting immense amounts of meds and weekly visits in clinic" - your words quoted....
Shouldn't it go unspoken that a PAIN PATIENT will be receiving BT meds for the 50% of pain relief that the SCS might not cover?
And WEEKLY visits seem a bit far-fetched......perhaps MONTHLY.
I'm sensing a bit of resentment coming from you, a PAIN doctor. I would think it would be understood from DAY ONE that a PAIN doctor will be prescribing PAIN meds to a PAIN patient.
Are you very familiar with RSD? Neuropathy? I'm thinking yes because a diagnosis must accompany the paperwork in doing the SCS procedure and most patients have conditions such as these. Are you aWARE of what it is like for a patient to have these conditions?
When you signed up to be a PAIN doc, did you not take into account that patients with these horrible chronic conditions WILL be needing 'chronic care' from you?
......hypothetical questions here. You aren't on a witness stand.
Some of what you say sort of reminds me of MY pain doc. He takes at least 6 vacations a year. He really doesn't seem to give a HOOT about the ongoing care to the patients he sees for intense chronic pain. He only seems interested in doing the HIGH COST procedures with his BIG needle. And oh yes how he LOVES to do the SCS implants. But guess what? He won't even consider doing pain pumps. Guess why? Because "Then I'd have to 'marry' those patients" (his exact words).
Anyway, it'd be GREAT if you stick around. I'd love to try to understand you further.
Rae