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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by gatorhead
I shed some light on this in one of my other posts and I believe it to be true. I have no data to back it up but I can add 2+2 and as my son says it equals 5! The recent pill mill laws were a growing trend, hyped by an "epidemic". Treating physicians can no longer prescribe their known patients with narcotic pain medicines. Instead they have to seek out "PAIN Clinic's" some of which are pill mills, pay the cash get what you want, go to the next one. The one's that nee it cannot get it. The ones who want it get more than they need.
It never was about patient safety. In Florida at least our Governor opposed the pill mill law and was lobbied by those who operate them. Its big bucks. The DEA stepped in and questioned every single doctor about their prescriptions and why they prescribe this to said patient and then ask why that is a better alternative than say, yoga. Finally as of July 1 , 2012 you have to have a certification as a pain doctor to prescribe. You can see where this is a pain in the royal butt for doctors.
The answer to the problem started becoming popular about 8 years ago. Sure they gave them long before that but the epidural/nerve root blocks started becoming the norm and is the ONLY solution at many of the "legit" Pain clinics left here in Florida. Problem is they are cutting corners buying the cheapest drug from where ever they can. There are many cases where a dirty needle was stuck back into the vial to obtain more medicine!Just as there were always injections, there were always complications.
The injection trend is here to stay! There is far more money to be made with it than there ever was writing a script. Most places charge on average between $1500-$1800 per injection and do it up to 3 times in 6 months. They charge for office visits on top of that and have you come in for follow ups inbetween. They could only charge for the office visit prior to these and the whatever kickback they received from the pharmaceutical companies. In addition to this they are not bothered at all by the DEA! So for them it is a free for all, win situation no matter how you look at it.
Injections anyone?
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While I feel sad that all of this has led to such an awful outcome, one should not throw the baby out with the bath water!
In over 20 years of clinical practice, I oversaw and sent out numerous patients when indicated for various types of spinal ESI's. They were always done by very reputable PM docs in the area. There were and are a few unscrupulous ones who most referers were aware of, so we just stayed away from them.
In my experience, those whom I sent to one of the "good guys," at best were helped tremendously and at at worst, had no relief. A couple here and there (rare) had temporary complications of an "epidural headache" but they were carefully followed up and resolved within a week or two. On the other hand, the "bad boys" were known for various serious failures and complications. One of the worst ones was a patient who had too many discograms, one of which was septic and because it was work comp, went undiagnosed for 6 months. Not pretty.
So I guess my thought is that one should exhaust all conservative efforts to address their spinal pain issues before progressing to ESI or surgery with the understanding that if you go the latter two routes, you have made a thoughtful and educated decision so that if something goes wrong, while that would not be okay, at least you weighed the risks! ESI's DO help an awful lot of people....unfortunately some will get hurt in the process!
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