The shortness of this article should not belie its seriousness. This discusses one of the most frequent comments in the surveys.
This article is a composite of some of the complaints we have received. Nearly fifty percent report problems in relating to their doctor. Some remearks pertain to an HMO, although in fairness, certain HMO’s are among the best regarded by their patients, if you cn find the right HMO. University Medical Center Pain clinics are rated the highest, but most of those who complete surveys are cared for outside any University Medical system.
I know my doctor is angry because of the way he treats me.
Why my doctor hates me:
1) My central pain is very, very complicated and takes a lot of his time, so I get him in trouble with the HMO who employs him, who limits his time per patient and even submits him to a computer profile comparing HIS patient time with that of other doctors in the company.
2) I am in pain. I need pian medications. He has to listen to me beg for a prescription for a controlled substance. He is afraid if he has many more like me, the regulators will target him as an overprescriber and even take his license away. He has a family to feed and worries between following his Hippocratic oath and paying his mortgage.
3) In addition to controlled substances, I have side effects from the “standard” anticonvulsant his HMO gets most cheaply, so he has to prescribe something more expensive, about which he is questioned and about which he questions me.
4) The HMO does not pay him to fill out forms for disability or to testify if Worker’s Comp challenges my injury. He would have to fill out disability forms on his own time and there are many of them. I go to someone else for form completion, who works at a University, which is in competition with the HMO. It gets awkward. Fortunately, the University Professor knows a lot about Central Pain, and respects its severity. He has had several patients take their lives over it, so I don’t have to explain that I am really in pain.
5. My pain is too high for a spinal cord stimulator to reach it up in the nose, mouth, and sinuses, so the surgeons do not agree with him that I would benefit from a spinal stimulator. They don’t believe in brain stimulators, and so they embarassed my doctor, who had read about one. I might try a pump, but the surgeons don’t think it will reach my face either. He had to refer me out to these specialists, so that goes against his “profile” at the HMO, which didn’t have any pain neurosurgeons.
6. It is hard for him to tell when the pain is from nerve injury or if there is something else he has to worry about.
7. This is really the biggest problem of all, and the one that affects me the most. My doctor can’t make me better and this drives him crazy. I absolutely do not feed his ego, and this gets tangled up with respect. Fortunately, he is able to help my muscle pain so I can thank him for that. This is the only way we still have a professional relationship. I think the way he gets treated by his boss, which he never wanted in the first place, means he needs ME to give him his self respect and self esteem. I have not learned how to do that.
I am the one with pain, but he is the one with anger. Just for the record, where am I supposed to get my self esteem? I can hardly do anything. My doctor is like my friends. If I tell someone I am having a really bad day, they have to take it on faith, because nothing looks different in me that they can see. It is like they have to belong to the Church of Me, and believe in me or else they will just think my talk of pain is moral weakness or something. I have tried an endless list of medications, and in the end, nothing stops my burning. The sedatives help me with the extreme suffering, so I use them. I can get help from the muscle pain meds he prescribes, but it is really the fact I have quit moving that allows me to get around the muscle pains.
The only way I figure my doctor will begin to like me is for our nation to begin respecting doctors again. Then he won’t be relying on me to justify his years of hard work in medical school. In the meantime, I will just have to do the best I can and hope something good will come out for CP and he can give it to me. Then, I think he will like me a lot, because I will be more grateful than any patient he has ever had.