Our specialty

[RUOkie]

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For those of you who are intereseted in why some of the older physicians on this board complain about our specialty, look at the email I got today from the listserve of the Pain council.

"My patient received one Botox A treatment for headaches (100U) with good results.

I repeated in 3 months, however patient reported suboptimal results.

It's too soon to repeat.

Please advise. Thanks"


I guess we are supposed to give this doc a cookbook to follow. No PE, no other history! Just-"What should I do if my injection didn't work?"

OK-Rant over.

 

[Ludicolo]

"My patient received one Botox A treatment for headaches (100U) with good results.

I repeated in 3 months, however patient reported suboptimal results.

It's too soon to repeat.

Please advise. Thanks"

My advice is to stop performing Botox injections or treating headaches if you don't know what you're doing.

A little context: per their professional website, this inquiring physician had held the following "key" positions (I removed the identifying information, but these were at some fairly renowned institutions):

Chief, Adult Brain Injury Service
Chief, Spinal Cord Injury Outpatient Clinic
Medical Director, ___ Children's Center
Director EMG Laboratory
Co-director, ____ Residency Program

 

[RUOkie]

I guess that is why it pissed me off so much. So what if she was a SCI / TBI doc? She obviously felt that "pain management" was easier than what she was doing previously and just set up shop. Those of us who treat headaches and other chronic pain conditions know differently. She makes herself out to be a fool. I am very hard on myself, and turn away patients that are out of my normal scope of practice. Otherwise I will be a mediocre physician (which has always been my biggest fear).

 

[RUOkie]

And then today, get a great reply from the one and only David Simons! (I met him about 15 yrs ago, and assumed he was retiring soon--I guess I was wrong!😀)

 

[PMR 4 MSK]

Yeah, at first my computer marked it as "possible spam." I thought initially it was. Then I realized it wasn't much better than spam.

Not sure what she was fishing for.

 

[axm397]

some of those qualifications are apparently false

 

[Ludicolo]

some of those qualifications are apparently false

Gee, ya think?

 

[axm397]

I alerted the appropriate people at the appropriate institution(s) so hopefully something can be done about the claims on the website.

 

[RUOkie]

well done!

 

[SSdoc33]

I alerted the appropriate people at the appropriate institution(s) so hopefully something can be done about the claims on the website.

so, let me get this straight: a colleague was asking for help on treating a patient, and what she gets in return is someone secretly questioning her qualifications and huge headache. nice. im sure this will definitely increase her desire for further education and improved patient care. im not saying she's guilt-free, but do you really think that was the best way to handle it? you sound like little a tattle-tale here. i assume you didnt email the original sender and say who you were and what you were doing.

look, the nature of our field does lend itself to some, shall we say, less than exemplary practice of medicine. part of that is the fact that the field is some broad, and it is difficult to know everything about every situation. part of it is lack of uniform stardards in training. part of that is that there are a lot of bad docs in the field -- no doubt about it.

 

[axm397]

the people who I discussed this with were already familiar with the post (others have also told them) and they are very familiar with the physician. I don't know the whole story and I don't care to know the whole story. I have a personal interest in not having the institution involved get a bad reputation (since I did some of my training there) so I didn't see it as tattling.

False advertising on a website has some legal ramifications so this goes beyond just poor taste in posting or plain stupidity. The institution has had other less than stellar physicians use its name in advertising so I thought they deserved to be alerted.

I am all for educating colleagues and having nice clinical discussions and learning opportunities -that is what forums like this is all about. And if there was nothing inappropriate about the website, I would not have done anything about it.

 

[RUOkie]

so, let me get this straight: a colleague was asking for help on treating a patient, and what she gets in return is someone secretly questioning her qualifications and huge headache. nice. im sure this will definitely increase her desire for further education and improved patient care. im not saying she's guilt-free, but do you really think that was the best way to handle it? you sound like little a tattle-tale here. i assume you didnt email the original sender and say who you were and what you were doing.

look, the nature of our field does lend itself to some, shall we say, less than exemplary practice of medicine. part of that is the fact that the field is some broad, and it is difficult to know everything about every situation. part of it is lack of uniform stardards in training. part of that is that there are a lot of bad docs in the field -- no doubt about it.

I will say that my original post/rant was to point out what you mentioned above. We NEED to police ourselves. Just like reasonable spine surgeons need to police theirselves by identifying the people who do L1-S1 fusions for DDD and back pain! Our specialty has such an inferiority complex that we are reluctant to identify poor physicians. Unfortunately there are a lot of them! I personally have no problem with axm397 pointing out fraud!

In addition, the doc we are discussing put him/herself out on display, by screaming his/her ignorance. He/She could have asked for help in a more private setting if the person was concerned about anonymity. In my first few years out of training, I called other physiatrists every week (either faculty from my training program, or senior members of my group) for help. I still ask for help all the time.

 

[SSdoc33]

I will say that my original post/rant was to point out what you mentioned above. We NEED to police ourselves. Just like reasonable spine surgeons need to police theirselves by identifying the people who do L1-S1 fusions for DDD and back pain! Our specialty has such an inferiority complex that we are reluctant to identify poor physicians. Unfortunately there are a lot of them! I personally have no problem with axm397 pointing out fraud!

In addition, the doc we are discussing put him/herself out on display, by screaming his/her ignorance. He/She could have asked for help in a more private setting if the person was concerned about anonymity. In my first few years out of training, I called other physiatrists every week (either faculty from my training program, or senior members of my group) for help. I still ask for help all the time.

Ruokie, i hear you, and understand.

Axm, thats busch league. you have nothing to do with this situation, dont insert yourself where you dont belong. if you feel the need to do something about it, get in contact with the emailer directly, and educate her about why she is being inappropriate, and the best resources for her. what you have done is a punitive action, rather than a rehabilitative action.

 

[axm397]

Axm, thats busch league. you have nothing to do with this situation, dont insert yourself where you dont belong. if you feel the need to do something about it, get in contact with the emailer directly, and educate her about why she is being inappropriate, and the best resources for her. what you have done is a punitive action, rather than a rehabilitative action.

I have to respectfully disagree on this issue. I have my own personal reasons for getting involved and I don't feel that I did anything wrong and I also don't feel like I "inserted myself where I don't belong" because I know the institution, I know the people, and like I said, I have reasons for not wanting the institution to get a bad reputation. If anything, I just should not have shared the info on this board but I can't undo that.

I have nothing to educate her about - I don't care about what she posted - I only care about how she is advertising herself on the website. Sure her post is what prompted me to find her website, but if a patient or a friend had asked me about her, I would have done the same. Nothing excuses her from posting misleading info about her "positions" and affiliations on her public website.

 

[rehab_sports_dr]

I agree with those in favor of policing ourselves

AXM did not go to the medical board- she addressed a false advertising issue with the institution whose reputation was at stake- that seems appropriate to me

 

[lobelsteve]

Axm did the right thing. We need more self policing, not passive aggressive mumblings. We need an end to series of 3, blind procedures, and untrained, undertrained proceduralists. My day job is stabbing people in the back.