My Pain Doctor Abandoned Me, But I'm Not Going Away Quietly

By CindyLee Calaluca, Guest Columnist

Recently I was terminated by my pain management physician without notice and with no plan for continued care. Why? I complained to the physician that I did not appreciate getting no call back when I repeatedly contacted his practice — over an 8-day period — to report that my chronic pain now had a severe acute component to it.

The acute problem is caused by a severe deep vein thrombosis, extending from the groin to the toes in my left leg – the result of a surgical wound from a toe amputation tearing open from severe swelling. Additionally, an old pressure ulcer had abscessed. The acute pain I am experiencing is because of an overlap with my poorly controlled chronic pain, thanks to the CDC guideline for prescribing opioid medication.

All I can do now, because of the pain, is lay in bed and force myself to sleep to cope with the pain. I am totally incapacitated and unable to do daily activities independently. I am 70 years old, a widow, and my only living relative is a 69-year-old brother who lives 2,000 miles from me.

The physician responded to me inappropriately. He told me he gets 3,000 phone calls a day and saw no reason to respond me, because there was nothing he was going to do about my pain. Furthermore, he had an arrogant demeanor and feels he isn't required to call me. I get an appointment once a month with him and that's where his responsibility for my care ends, he said.

Naturally, that opened the door wide open to abandonment and neglect of a patient. His practice has no after-hour or weekend coverage beyond an answering service.

Before he walked out on me, he insulted my career experience, called me uneducated, and said I didn't know what I was talking about regarding health care or laws.

It is a shame that in his superiority complex, he forgot, if he ever knew, my career or educational background. You see, I am an adult and geriatric nurse practitioner who holds a doctorate in nursing practice with 55 years of clinical experience, along with 20 years of simultaneous healthcare administration. That physician is about to find out how "uneducated, stupid and wrong" I actually am.

That's the story behind my being abandoned and put in my place for complaining. I tried to be nice and have an adult conversation with this man. What a shame his child showed up!

I completely understand the problems created when patients arbitrarily lose their providers without adequate and proper notice. I live in a community of less than 500 people. The nearest pain management practice that uses oral medication is 45 miles away. The next one is two and a half hours away. Then there's University of Alabama Medical Center, which is six hours away. Right, I'll just pop into the pain center tomorrow. Like that's happening.

I have had it with all the buck passing by politicians, law enforcement agents, and the CDC making doctors too afraid to practice pain management correctly. Putting a sign in the lobby stating that under no circumstance does the practice treat pain is not correct medical intervention. In fact, since pain is a symptom of illness and that the body is imperiled, it is turning a blind eye to abandonment.

I am no longer going to be a good patient and not respect myself. I refuse to play the game anymore. Since I am dying, I am not going quietly into the night. I am going to advocate and do so loudly, visibly and boldly. I will advocate for patients one last time.

CindyLee Calaluca lives in Alabama. Pain News Network invites other readers to share their stories with us. Send them to editor@painnewsnetwork.org.

Why Choosing a Doctor Is Like a Job Interview

By Pat Akerberg, Columnist

There’s an online answer for just about everything.  If you use a search engine, you are soon inundated with links, marketing products and services to match your needs.  There are even dating services that connect you with possible romantic partners.

Choosing the right doctor isn’t quite as simple as shopping for a new pair of shoes or making a love connection. Shoes that don’t fit can be returned. First dates that don’t work out can be cut short.  But our medical needs carry significant costs, benefits and risks. The right -- or wrong -- doctor can be life changing.

Like any important decision, it’s best to begin with an approach in mind. Doctors carefully scrutinize us as would-be patients.  Isn’t it in our best interest to make the same effort? 

After all, we both have important needs to fill.  So what if we approach our decision just like a job interview, with us doing the hiring?

When I worked in business, the three key points of a solid job interview were focused on:

1. Does the person have the competence to be effective in this role?

2. Are they a “good fit” for the job requirements?

3. Does the person pose any risks or concerns?

If any of those questions turned up a negative answer, that candidate was eliminated. We can borrow from this formula as we search for the kind of doctor that we need.

Competence

This includes expertise, years of experience, a solid track record, and the transparency to share it.  Without transparency, there’s very little objective information available, like a surgeon’s complication rates, for instance.  

There are some ways to get a feel for this prior to your appointment.  The internet can be helpful with this part of your research.  You can conduct a search for support groups for your particular chronic pain condition. (Example: “support groups for trigeminal neuralgia”).

In my case, I rely upon one that I consider to be my most valuable resource for facial pain – it’s the TNA Facial Pain Association.  Once I joined, through discussion groups I could get candid feedback from other members about their experiences with different doctors or treatments -- and learn who the leading experts are in the field. Support and friendship with people who truly understand what you’re going through are extra benefits

An informative website from the Agency for Health Care Resources and Quality can also help with several quality of care topics, including pertinent questions to ask your doctor.

The leading experts may not be in your geographic area.  Will you allow that to keep you from consulting with them?  Some doctors offer Skype consultations if you ask.  Local may not always equal the best chances for success.

A Good Fit

From a doctor’s perspective, a good fit requires you to share factual information about yourself so that they can effectively treat you. 

A good fit from a patient’s perspective begins with a list of the traits and characteristics that meet your unique needs.  These are your “must have’s.”  Here are a few of mine for doctors:

• Listens and makes eye contact with me
• Seeks to understand, invites my input
• Seems engaged and interested in addressing my situation
• Takes time to explain things to me
• Comfortable with questions (isn’t defensive or dismissive)
• Flexible, operates well in a partnership
• Transparent about treatment outcomes
• Offers a clear plan

There is no substitute for the experience gained from tuning up your radar and conducting your own interview.  It can be helpful to have a spouse or family member accompany you to appointments to compare notes. 

You may want to make a “nice to have” list too. People in pain often want some empathy from healthcare providers, yet may not always get it.  Is empathy a “nice to have” or “must have” for you? 

Risks and Concerns

Caution is also a part of doing your due diligence to find the best possible doctor.

Unless there’s an extreme need for aggressive treatment, a good rule of thumb to minimize risk is to start with the least invasive, lowest risk treatments. These are often done by practitioners who offer complementary, alternative approaches (acupuncture, physical therapy, chiropractic, homeopathic, etc.)

There is no substitute for doing your homework and becoming knowledgeable about several important things:

• The costs involved for services and treatments, and how they relate to your insurance coverage and out of pocket expenses. Healthcare Bluebook uses a nationwide database to estimate a “fair price” for everything from drugs to surgery to x-rays.
• Patient reviews and experiences with a physician.  There are a number of websites where you can read what people are saying about a particular doctor, including RateMDs, Vitals and Healthgrades.
• Red flags like sanctions, malpractice claims, or medical board actions against a physician can usually be found through your state medical board or licensing agency.  
• The latest research studies related to your condition.  It will serve you well to be aware of the most effective treatments, the odds for success and potential risks. You can see published research studies at PubMed and the National Institutes of Health.

In terms of knowing the risks upfront about treatments, later is too late if the unthinkable should happen.  You don’t want to be left on your own to scramble for help. 

In the end, it never hurts to have more than one choice available or more than one opinion before you decide. 

Becoming informed will empower you to be your own best advocate when entrusting your medical care to someone. Just like any good hiring decision, choosing the best doctor can prove to be an investment well worth your active involvement.

Pat Akerberg suffers from trigeminal neuralgia. Pat is a member of the TNA Facial Pain Association and serves as a moderator for their online support forum. She is also a supporter of the Trigeminal Neuralgia Research Foundation.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.