Friday, August 26, 2011

Five Ways That Comprehensive Pain Management Centers Differ from Pill Mills

By David Greene, MD, CEO


1. Board Certified or Fellowship Trained Doctors

2. Other treatments than writing prescriptions

3. Patients make an appointment

4. Predominantly Insured Patients

5. Use of Pain Management Narcotic Agreements and other Surveillance Methods

Comprehensive pain management practices are very different from typical "pill mills". Unfortunately, the two get lumped together in public perception. Pill mills are pain offices that are basically in the business of handing our narcotic prescriptions. With the country in the midst of an epidemic problem with narcotics, pill mills are receiving a bad reputation, and deservedly so. Legitimate pain centers have unfortunately been lumped into that public perception too.

Pain management clinics most often have fellowship trained and/or board certified doctors who have received substantial training in both interventional procedures along with medication management for pain. This is very different from pill mills, who often use doctors who do not have specific pain training.

Pill mills typically just dole out prescriptions. Pain management centers are different in that they typically provide additional therapies such as physical therapy, chiropractic, and interventional procedures.

At a "run of the mill" pill mill, people are usally able to simply walk in rather than making an appointment. At more legitimate pain management centers, however, individuals need to call and make appointments. Usually if it is a new appointment with a referral from a doctor's office, medical records need to be received from the referring office. This will take more time than what a walk in appointment allows.

At comprehensive pain management centers, individuals have insurance and use it for their treatment. Pill mills typically work outside the traditional insurance payer system. This means either having individuals without insurance self pay, or having people who have insurance just not use it and pay cash.

Comprehensive pain centers typically use pain agreements, known as "pain contracts". These contracts help make sure patients comply with agreed upon protocols such as pharmacy board prescription monitoring, drug testing, and pill counts.

This protocol trio is an effective combination that assists in preventing diversion. It has been documented that over 20% of individuals will divert their pain prescriptions, and that diversion spans all ethnic and socieconomic groups. Pill mills may not utilize these surveillance tactics, which help deter the rising narcotic abuse epidemic in America.

These factors together differentiate pill mills from comprehensive pain management centers. By combining all of these services and qualities, the more modern pain centers can actually help patients cut down their amount of narcotics being taken. This may stem the tide of narcotic abuse, and also help transfer some of the medications being written to those of the non-narcotic variety.




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