Skip Intro said:
I did a pain rotation and except for the money I can't, for the life of me, understand why anyone would want to go into this field. No offense to anyone who's chosen it, but the patient population you've got to deal with (the endless turnstile of little old ladies with bad backs and drug seekers) is just depressing. Not to mention the fact that your lifetime exposure to ambient x-radiation, even with protection, is staggering. I'd like to see a longitutidinal study of pain management specialists and cancer rates, especially the particular nasty hematopoeitic cancers like leukemia.
If you want to do pain management so you can afford that third house and/or the Lambourghini, more power to you. Thank heavens there are people like you who want to expose yourself to an annoying, frustration patient population with a substantial increase in occupational hazards for a few extra bucks.
-Skip
As a primary care doc I can tell you I sent all of my drug seekers to pain docs. A lot of anxiety is treated with percoct out there.Pain specialist can usually weed out the drug seekers. I think that a pain practice can be rewarding. I derived a great deal of satisfaction from easing the suffering of
patients dying from cancer. That said, I would not specialize in pain management. The one time that I felt concerned for my safety in my office involved an ex-con with chronic back and knee pain. The guy would walk in the office with no appointment and demand refills. I had to "ease out," of the doctor patient relationship with him. patients have claimed that their meds were stolen. I learned that oxycontin can be injected, smoked and sorted. I stopped prescribing that medication. It is amazing to me that an fp would open a pain clinic. Most that practice probably consist of writing scripts for pain meds. A lot of docs do not realize the seriousness of writng for pain medications. You are held responsible if the patient harms themselves with the medication that you prescribed. Doctors have even been charged with negligent homicide. Periodic tox screens must be perperformed to insure that the med is not being diverted.
An fp pain clinic would consist of a bunch of narcs being supplied by a doc.
I am not against the use of pain meds for patients with an identifiable cause for their pain. The drug seekers have made it difficult to treat even legitimate pain. Virginia prosecutes docs that they feel has been negligent in prescribing pain meds.
I use to share office space with an anesthesia guy who specialized in pain. He grew to dislike some of the patients and would drop them for whinning too much for early refills.
I have never had a patient loose their bp medication, well okay once. I cannot tell you how many times pain meds have been lost and fallen into the toilet or been stolen.
I enjoyed treating "real pain." Medicine is all about easing suffering.
A doc who opens a pain clinic and is not trained can be accused of practicing outside of the scope of his training.Pain control is more than just pushing pills it involves psychologists,PT,neuro,ortho and surgery. From time to time the initial problem that caused the pain visit must be revisited to see if the problem has resolved.
A patient can die during surgery. Chemo can take you out. The only doc that I read of being criminally charged was a pain doc who "lost" a patient.
CambieMD
