Why? Well, b/c it seems like this comes up a lot. I know of patients with chronic back pain; and they are in fact afraid of narcotic relief, but then they refuse to listen to the PCPs or specialists. It's kind of frustrating, b/c some of these folks are like chronic victims, but regardless of what the experts recommend, they don't listen. One woman in particular is an IDDM with other complications, but she refuses to move. B/c she had radiation tx for breast cancer, when she gets an URI, it has, more than once moved into pneumonia and other complications. She just refuses to accept the complications/risks of immobility, yet nothing that any physician recommends "work," or "will work," according to her. So, we've been waiting for her to fall prey to complications of immobility, as she did before. She coded while they were performing a pericardial window--effusion that started with complications of an infection, mixed with the fact that radiation scarring is the gift that keeps on giving. She's just difficult. So on one hand, it's like PCPs have to deal with those seeking narcotics or the whole other gamut of folks that just won't listen to medical advice and get themselves into more trouble. It's kind of frustrating. At least with my pediatric clients, many of their parents are more likely to listen to medical advice. But these pts that come in for help but don't listen, well, it's frustrating.
Basically, though, I was wondering how often the average PCP has the "back pain" patients come in to be seen.
