As a chronic pain patient I first want to thank you for your service and dedication. I know in these times, prescribing for chronic pain is stressful and frightening. I know that reimbursement rates from Medicare and Medicaid are substandard, enough so, that you sometimes think what are the benefits in treating chronic pain. I know like most doctors you’re just trying to make a living, pay your mortgage, put your kids through college and save for retirement. You never expected to be in a situation where law enforcement was looking over your shoulder, you would spend half your time documenting why you do what you do, or explaining the same to insurance companies, so you can treat a patient. In my book, you are in so many ways, my hero for doing so, because you make it possible for me to have some semblance of a life.
I understand that sometime you get afraid for yourself and your family and with some patients whose pain is difficult to manage, or for those who are weary, frustrated and angry; you’re tempted to tell them what they want to hear or maybe even lie to them to make your day a little easier.
As difficult as it may be to tell the truth, that is what we want more than anything else. You see, we get lied to constantly; we have to contend with a government, media and individuals, some of who are family, who tells us we’re not really having that much pain, we are in fact, just drug seekers. That gets reinforced when we turn on the TV, radio, pick up a magazine or get on the internet. So we feel mind fucked which makes us even angrier. Some of us have given up and I’m sad to say, taken our lives. For those all hope was lost, what was irrational became rational, an answer to a problem we could no longer get any help for.
So please forgive me when I’m short with you, it’s not you, it the rest of the world I’m angry with. But whatever happens, please understand that when I come to your office it’s the respect, dignity, compassion and honesty you show that keeps me coming back, not just the medication you prescribe. It’s what gives me hope and courage to hang on a little bit longer. And no matter how difficult a situation may seem, please remember I want to give back these same things. Even if your reason for doing something is personal rather than professional, the one thing I need above all else is an honest answer. As a doctor I’m looking for someone who’s rational, objective, compassionate and honest. As your patient I will commit to giving back the same thing so your job is a little easier.
And if for some reason you should decide to give up treating chronic pain, don’t wait to the last minute to warn me, give me enough time to find another doctor, then we can go our separate ways remembering the respect we showed for each other.