Youtube:Private Pain Practice Response to COVID-19 w. Dr. Timothy Deer

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Dr. Deer is basically leaving it up to pts to decide what is "elective", other than his exclusions of SCS, pumps, etc.

I don't necessarily think he and many others have bad intentions. So much of your approach depends on your personal assessment of COVID in your area.

I guess, like many other issues, it's really about a person's intentions and motivations.
 
That makes sense. Who knows better than a patient how bad their pain really is? That’s why I always ask them how much oxycodone they want and what strength it should be. It’s essential to take this pain seriously!
 
Agast said:
That makes sense. Who knows better than a patient how bad their pain really is? That’s why I always ask them how much oxycodone they want and what strength it should be. It’s essential to take this pain seriously!
Click to expand...
I have to believe the guidance/orders left this wiggle room on purpose. Governors could have said all medical is cancelled except "threat to loss of life or limb". They did not. They used the term "elective", which has one meaning for physicians and a totally different meaning for everyone else.

I'm doing 100% telehealth because I truly fear the letting this thing into my clinic. How can we say something is "urgent" and not be available on weekends? But time will tell. If there's an outbreak at a clinic/office, it will be an ugly exposure.
 
I think the purpose of the wiggle room is to acknowledge that the state doesn’t know what every single surgery is for and so hopes the doctors will use their best judgement. Sort of like hoping people will sit their asses at home and not throw backyard BBQs.

A reasonable question to ask yourself would be, if your patient died 11 days later from coronavirus and people started looking into what you did, would you still be firmly convinced that your procedure was truly urgent and could not have waited? A beloved patient of mine had cardiac clearance to hold his plavix and he really, really wanted the epidural. 3 days later he died in his sleep and forever I will wonder what part I played in it. I’d rather have him back than the $150 that’s for sure. It’s too easy to be cavalier because what we do is so quick with almost immediate pay off. I hate not working and I hate not making money, but not causing harm is priceless.
 
Jigsaw said:
The term "elective" includes medical procedures that are not immediately medically necessary to preserve the patient's life or long-term health, except that procedures that cannot be postponed without compromising the patient's long- term health, procedures that cannot be performed consistent with other law at a later date, or procedures that are religiously mandated shall not be considered "elective" under this Order.

Click to expand...
My interpretation from this is that ALL pain procedures are deemed "elective" by the state of WV. It's a stretch to say you are compromising a patient's "long-term health" by postponing a pain procedure. So Dr. Deer is on thin ice here imo.
 
Agast said:
I think the purpose of the wiggle room is to acknowledge that the state doesn’t know what every single surgery is for and so hopes the doctors will use their best judgement. Sort of like hoping people will sit their asses at home and not throw backyard BBQs.

A reasonable question to ask yourself would be, if your patient died 11 days later from coronavirus and people started looking into what you did, would you still be firmly convinced that your procedure was truly urgent and could not have waited? A beloved patient of mine had cardiac clearance to hold his plavix and he really, really wanted the epidural. 3 days later he died in his sleep and forever I will wonder what part I played in it. I’d rather have him back than the $150 that’s for sure. It’s too easy to be cavalier because what we do is so quick with almost immediate pay off. I hate not working and I hate not making money, but not causing harm is priceless.
Click to expand...
Thats why we are moving away from holding antiplatelet and anticoagulant therapy for epidurals.
 
SSdoc33 said:
That is not the conclusion you should have drawn from her post. Well stated, agast....
Click to expand...

I’m pretty sure it’s possible to conclude an infinite number of things from any presentation of ideas, none of which is invalid in any sense but an arbitrary one.
 
ateria radicularis magna said:
projects.propublica.org

Dollars for Docs

ProPublica has compiled the disclosed payments from pharma companies to doctors and other health care providers. Search for your doctor in our interactive database.
projects.propublica.org
Click to expand...

projects.propublica.org

Dollars for Docs

ProPublica has compiled the disclosed payments from pharma companies to doctors and other health care providers. Search for your doctor in our interactive database.
projects.propublica.org

The highest earning on the website. I knew I recognized the name. This was the PD for Dr Death. Go figure
 
Ducttape said:
Anyone who cleared, in a single year, $881,000 from device reps may be a little biased...
Click to expand...

Maybe he's just more evolved.

1586113598270.png
 
bedrock said:
Deer is definitely not the guy I look toward for ethical guidance in any part of pain medicine, before COVID, during, or after COVID.
Click to expand...
I agree- his name should never appear in a discussion of ethics.
 
paindoc007 said:
why all the hate
Click to expand...

I contrast Deer with Ken Follett. Follett (now retired) was one of the kindest, most ethical neurosurgeons in the field of neuromodulation and was not purchased by the equipment companies (God knows they tried). You could trust what he said, as it was not influenced by money. I can't say the same about MANY of the speakers who appear at the neuromodulation meetings.

Everybody likes money; however, there are some things that are not worth the money.
 
hawkeye2009 said:
I contrast Deer with Ken Follett. Follett (now retired) was one of the kindest, most ethical neurosurgeons in the field of neuromodulation and was not purchased by the equipment companies (God knows they tried). You could trust what he said, as it was not influenced by money. I can't say the same about MANY of the speakers who appear at the neuromodulation meetings.

Everybody likes money; however, there are some things that are not worth the money.
Click to expand...
He timed that impeccably. Now to find competent DBS performing physician between Denver and Chicago...
 
You must log in or register to reply here.

Similar threads

drusso
Pain is most common Long COVID symptom...
Replies
4
Views
702
kstarm
K
S
Chronic pain practice without advanced procedures
Replies
20
Views
3K
BobBarker
BobBarker
drusso
Dr. Oz to lead Centers for Medicare and Medicaid: Implications for Pain?
2
Replies
55
Views
4K
powermd
powermd
bk03
Neurology to Pain Medicine
Replies
25
Views
2K
bk03
bk03
drusso
  • Poll Poll
Is it time to DOGE pain?
Replies
12
Views
1K
DrSpine
D
Top