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Identifying healthcare providers for a patient with chronic pain

Choosing a Health Care Provider

Numerous resources now exist that allow individuals to make an informed choice of who will provide their medical care. Unfortunately, the average health care consumer is unaware of where to find information about hospitals, medical providers, and insurance coverage. Imagine that you are assisting someone in your community (a real or fictitious person of your choice) in finding a medical provider. In your post, provide a brief description of this person and address the following questions:

What factors would you need to keep in mind while conducting this search?
How would you evaluate who the best medical provider for this person is?
Consider the type of care necessary, cost, the level and type of insurance coverage available, and any other related issues. What would make someone a good or bad medical provider for this person?
Review this week's reading "Your Guide to Choosing Quality Health Care," for ideas. Based on this information, conduct a search for medical providers in your area. What did your search reveal?

Solution Preview

Here's a description of a patient that I cared for in my practice. The patient is a fifty year old woman who has had persistent low back pain for twenty years following a motor vehicle accident. The accident occurred when she was stopped in a Volkswagon Hatchback to make a left turn. She was rear-ended by an eighteen wheeler going approximately 50 mph. When her vehicle stopped moving, she was still belted into the driver's seat which had been torn from its moorings and resided in the back seat. She had a shoulder dislocation requiring surgical repair, and new onset left-sided low back pain without any findings consistent with spine fracture, or disc protrusion. During the interval from her injury to first seeing her in the office, she had undergone numerous rounds of physical therapy, medication routines, and psychological counseling, but her pain persisted unabated. She is unemployed, insured through Medicaid, a smoker, weighs over three-hundred pounds (morbidly obese), takes antidepressant medication, and relates a history and review of systems consistent with a sedentary lifestyle. She has diagnosis of mechanical low back pain without any neurologic or radiologic findings. On examination she has very limited range of low back motion in all planes, diffuse tenderness over the left low back and flank region, no abnormalities on ...

Solution Summary

Identification of healthcare providers for individuals suffering chronic pain and associated life style issues, can be problematic. Usually a team must be established consisting of a coordinating provider, e.g., family practice, a specialist in chronic pain management, and the patient. Though using internet resources to narrow the provider choices, the best way to evaluate a caregiver is through personal interaction and neither participant should be unwilling to accept the possibility that a long term physician-patient relationship cannot be established. In such a situation the healthcare provider can be a very useful resource in suggesting other providers who may be a better fit for the patient.

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