How to evaluate your Pain Management Specialist: 

Dr Richard NadjarianIn my last post, I wrote about factors that patients might want to consider when choosing a pain management specialist, including specialty training, board certification and fellowship subspecialty training. At this point, you have done your research and have chosen a specialist. How do you now know if you have made the right choice? How do you properly evaluate a pain management specialist?

This question can be particularly difficult for patients. A physician who looks good on paper may be less than stellar in practice and vise versa. In general, there are a few factors I would recommend considering when evaluating a pain management specialist.

How thorough was your initial evaluation?

A thorough history and physical examination should be performed by the pain management specialist, followed by a discussion of possible diagnoses and appropriate treatment options. The discussion of treatment options should include the risks and benefits of each option. If a diagnosis cannot be determined at the initial visit, a plan designed to arrive at a diagnosis should be discussed and implemented. Your physician should take the time to walk you through these steps.

Was a diagnosis established?

I cannot stress the importance of a specialist taking the time and effort to make the correct diagnosis. This usually results from performing a thorough history and physical examination. A pain management specialist may be technically excellent when it comes to performing procedures, but if he or she has made the wrong diagnosis the patient is unlikely to improve. A correct diagnosis coupled with a correctly performed procedure has the best chance of a good outcome.

Was a well thought out treatment plan thoroughly explained?

A specialist knows why he or she recommends particular treatment options for a particular diagnosis. However, this information is not always clearly conveyed to the patient. A pain management specialist should take the time and effort to clearly explain the treatment options being offered and why, including answering any questions the patient may have. Uncertainty breeds anxiety. An informed patient better understands what to expect and is therefore more at ease.

What is the goal of treatment?

Not all pain related problems respond to treatment and even fewer have “cures”. However, similar to other medical problems such as diabetes and high blood pressure, most pain related problems can be managed quite successfully. Having said this, it is a pain management specialist’s responsibility to be upfront and honest about patients’ problems and convey realistic expectations for treatment. Goals for treatment vary among diagnoses. However, as a general rule, the goal of treatment is to achieve at least 50% reduction in pain with functional improvement. Realistic treatment expectations should be part of any comprehensive treatment plan.

These basic guidelines should allow you to better evaluate a pain management specialist. In the end, success varies from patient to patient but is most often marked by decreased pain, improved function and no complications.

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