Catastrophic Imaging Recall.

[101N]

CIR: "Yea, I had an MRI in 2010 and my last doc in California said he's surprised I'm walking! He thought I'd end up in a wheelchair by the time I'm 50. My spine is falling apart. I've got nine crushed discs, arthritis, and a broken vertebra!"

Me as the patient narrates this over my shoulder as I am showing them their new MRI: "Well, it' looks
age appropriate to me."

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[Promethean]

Makes you wonder whether the "doc" in Cali was a chiropractor fishing for business, or whether the patient figured that more dramatic story would score them better prescriptions?

 

[101N]

This is just their 'face saving' - although transparently inaccurate and exaggerated- why I need, disability, opioids, pity, more time off work, my wife to put my shoes on and do
the housework, etc, narrative.

 

[Promethean]

This is just their 'face saving' - although transparently inaccurate and exaggerated- why I need, disability, opioids, pity, more time off work, my wife to put my shoes on and do
the housework, etc, narrative.

Ah. It does sound like something my cousin's chiropractor has told her. I think that he knows that if he plays into her self-pity and general sense of entitlement and martyrdom, that she will keep coming to see him to hear how amazed he is that she continues to bear up under her immeasurable burdens. He doesn't give her opioids, but he did help her get disability, pity, and help from family to do any physical labor that she doesn't find enjoyable. Of course, she can suddenly walk and stretch fine when there is a craft show that needs to be shopped for hours.

She has said that she wants me to be her doc when I am an attending, but her tune would change pretty quickly when I prescribed diet, exercise, and physical and cognitive/behavioral therapy. Yeah, think I'm just going to dodge that on the grounds that it wouldn't be ethical for me to treat someone that I have a familial relationship with. Right?

 

[Aether2000]

many patients from one of the local pain doctors receive the same kind of interpretation of there MRI by the pain doctor in order to generate catastrophic findings so the patient will agree to injections. they actually dictate this nonsense into their notes that the patient has multiple disc herniation and has severely spondylitic dpine findings in what is actually a perfectly normal MRI.

 

[Ducttape]

Do not ever agree to take care of a family member or kin. Nothing good will come of it...

 

[PainDrain]

The worst seem to be spine surgeons in my area. I have had several patients told they need surgery ASAP or else they would be paralyzed.... I have reviewed pre and post op MRIs that show only mild disc bulges. Patients given the diagnosis of spinal stenosis with an MRI report where the radiologist says "no spinal stenosis". I can't fathom how this stuff continues.

 

[hyperalgesia]

Another win for press ganey.