Dr. James Murphy has organized a truly exhaustive list of documentation you can prepare in advance for an appointment with a pain specialist.
This is a summary of how chronic pain patients can effectively prepare for a productive and meaningful visit with their Kentucky physician to address pain care options –especially when care involves the use or potential use of controlled substances. The goal is that patients and physicians will work together to maximize the therapeutic benefits and minimize the inherent risks to patients, physicians, and society.
The patient-physician relationship must be a true partnership based on respect, trust, honesty, and clear communication. The following is a summary of what patients can do to help their physician partners.
This is an excellent idea for many reasons (not only for Kentucky patients), and I can vouch for its effectiveness.
- It saves vast amount of valuable face to face time.
- You can avoid having to fill out the endless forms while hunched uncomfortably with a clipboard in a waiting room.
- You can spend enough time on the documents to be as thorough as possible – even if it takes you weeks of a few hours here and there (this is how I did it for my SSDI application).
- Your own words go into your medical record, not only transcriptions of what the doctor scribbles in his notes (or types on her computer). You have the opportunity to make an organized and logical case supporting your own point of view.
- You won’t have to worry about forgetting to mention any troubling symptoms during the appointment, even if they seem insignificant or unrelated, so your doctor gets a complete view of your situation.
Treating chronic pain can be straightforward when the primary focus is providing relief. But inescapable concerns about potential drug abuse and regulatory scrutiny [DEA takes away license] can make treating chronic pain very complex and stressful for patients and physicians.
The Chronic Pain Patient’s Guide to Kentucky’s Regulations
Prepare answers to some basic medical history questions.
Obtain copies of pertinent documents and medical records.
Make a list of your healthcare providers along with their contact information.
You may wish to store the data on a flash drive, CD/DVD or upload to a secure website for retrieval by your physician. Be advised, until you give these documents to your physician you are responsible for keeping them private.
Bring a friend or family member with you for support, assistance with questions, and to help verify information.
This last point can be critical. When you are alone with the doctor during those precious few minutes allocated, either of you could forget (or deny?) what was said.
Most patients feel vulnerable (low status) to their doctors (high status), and are afraid to question them or express contrary opinions. It’s better to use the “buddy system” and bring along a witness who who’ll stick up for you if things get too emotional.
For the initial visit prepare the following:
- Medical history
- Medical records
- Substance use
- Social and family history
- Other medical issues
- Education and consent
- Ability to function
See http://jamespmurphymd.com/2015/02/13/pathway-to-partnership/ for detailed lists in each category. Dr. Murphy has gathered and organized all paperwork and documentation you might need for a pain appointment.
You may go to the Kentucky Board of Medical Licensure website, download these self-report questionnaires, fill them out, and bring them to your office visit.
- Opioid Risk Tool
- Patient Health Questionnaire (PHQ-9)
You may also go to the website for ICSI (Institute for Clinical Systems Improvement) and download and complete these two forms:
Appendix A (Brief Pain Inventory); and
Appendix B (Patient Health Questionnaire PHQ-9)
If this all seems a bit overwhelming, you can begin to simplify matters by visiting the Murphy Pain Center website and downloading the “New Patient Package.” In it you will find policies, consent forms, agreements, educational materials, and a “New Patient Evaluation” form. These are the kinds of materials you will likely be filling out at your physican’s office visit. Having this information on hand can make your visit more productive.
In conclusion: Due to growing concerns about drug abuse, coupled with layer upon layer of regulations, physicians are becoming increasingly anxious about prescribing controlled substances for patients suffering in chronic pain
I greatly appreciate the great effort (and, no doubt, great frustration) Dr. Murphy devoted to this endeavor.