When should I consider making a referral to the Pain Clinic?
Primary care practitioners see the vast majority of pain complaints and manage them quite well. Occasionally, a pain condition presents itself that is perplexing, multifaceted or resistant to standard treatments. We make our services available for this subset of pain conditions. Neuropathic pain (including RSD), residual cancer pain, pelvic pain, refractory pain of long duration with high levels of disability and pain behaviors in developmentally disabled children are conditions that would warrant a referral.
How can I provide the best pain care to my patients?
As consultants, we recognize and respect the therapeutic bond between primary practitioners and their patients. We strive to forge an alliance with the practitioner to provide the smoothest, most coordinated care for our shared patients.
Communication is of the utmost importance. Therefore, you will receive a letter detailing our comprehensive evaluation after the first visit, as well as brief notes after follow-up visits. We will try to coordinate the initiation of new medications or therapies if there is any risk of interference with an existing plan of treatment.
We ask only that you do not start or stop pain-related medication without contacting us, as several medications have either drug-drug interactions or withdrawal symptoms. We have a physician on-call at all times to respond to emergency needs that arise.
Finally, we spend a fair amount of time and effort “de-medicalizing” pain. We try to reduce the emphasis on tests and procedures, once life-threatening entities have been ruled out. We ask for your cooperation in not ordering more tests, X-rays or other such things, even at the risk of irritating the patient or parents. Often, the more unnecessary tests are done, the slower the progress is.
How can I ensure a smooth referral process for my patients?
As a consulting service, we must receive a physician consultation request to receive reimbursement from most insurance companies. We request that pre-certification numbers for “pain physician, ” “physical therapist” and “psychologist” be sent along with the physician consult. Sending these pre-certification numbers will avoid delays in scheduling appointments.
Any relevant records, tests and radiological studies should accompany the initial letter. Certainly, sending copies along with the patient is helpful. We often receive a consult request that reads, in total: “evaluate and treat chronic (insert body part) pain,” which minimally serves the patient. The more relevant information we have at the time of evaluation, the better we can help the patient and primary physician alike.