This is what’s being called a “successful” pain clinic

“We can accommodate up to 40 patients a day,” said James Choo, MD, the center’s director. The surgery center offers a “fast track” program that provides procedures quickly for selected patients who may need lumbar/cervical/thoracic epidural steroid injections, lumbar or cervical medial branch injections, sacroiliac injections, selective nerve root injections, stellate ganglion injections, lumbar sympathetic injections, and trigger point injections in the knee, shoulder or hip…

Currently, the surgery center performs more than 4,000 minimally invasive procedures annually. Minimally invasive procedures can run the gamut from lumbar sympathetic and stellate ganglion blocks to caudal epidural steroid and facet joint injections, medial branch blocks, spinal cord stimulator trials and more…

The clinic provides behavioral medicine services through a unique collaboration with the Behavioral Medicine Institute, a private practice group of psychologists and licensed clinical social workers who specialize in helping chronic pain patients, also in Knoxville…

A key function of PCET’s psychologists is to provide narcotic pain medication risk assessments on all patients who come to the clinic…

Drs. Browder, Choo and Jones have appeared before the state legislature and the Tennessee Medical Association on recently passed legislation that regulates how narcotic medications can be prescribed and establishes a controlled-substance monitoring database. Drs. Choo and Jones were also part of the governor’s task force that developed new guidelines for writing prescriptions for controlled substances.

“The guidelines essentially establish a definition of who a specialist in pain medicine is, and only those specialists can write higher doses on narcotic medications,” Dr. Browder said…

“You just can’t give services away,” Dr. Browder said. “You have to make sure they are appropriate and reimbursable, that you watch over the business side of things and keep expenses down.” …

Except the definition of “successful” has to do with running a profitable business, not helping pain patients.  I wonder if this group keeps track of how many patients are harmed by all these injections?  Or when a pain patient gets worse, do they just abandon them?

4 thoughts on “This is what’s being called a “successful” pain clinic

  1. i do know that there is a surprisingly (to me) large amount of people who get no effect from the treatments for pain that are currently offered (steroid, epidural, facet, etc.)..I had severe back pain for 5 ys and moderate for 7 yrs and am happy to say only have small flareups for the last 5.

    after 5 years of excruciating pain, often times unable to bear weight, to turn over, to walk, i was finally referred to a pain center at a local hospital. They gave me my first epidural treatment, no result. they had warned me of that, but reassured me that generally by the 3 shot it would help most people. 6 mos later, i returned and had another epidural, which also was ineffective. about a month later, i had my 3rd shot (at this time they were only allowed to do 3 shots in a patient per year). i wasn’t very confident this one would be any different than the other two, but 3 days afterward, i was able to walk (carefully) and to function again more normally. This is the shot that helped me.

    then my back pain finally eased off enough that as long as i was relatively gentle, i could function perfectly normally. i then had a series of facet injections, and since then i have not needed more than a vicodin every once in awhile for many years.

    i would not be able to walk if i had not had these epidurals and facet injections. i don’t believe that cause any harm at all to anyone. the worst that could happen is it doesn’t work. and no, pain clinics or docs or group practices do not just ditch you if the treatment doesn’t work. they try other things, combos, things that are alternate methods, etc. my pain clinic told me to call any time if i needed to be seen again.

    and of course, owning any business is always about the money. that is the measure of success. but that doesn’t mean there aren’t good people doing their job, or that the docs don’t care, or that they are sloppy. it means they see a lot of ppl who are in pain and they must have a good rep because they get a lot of new patients every each month. So, in order to make their money and be successful, they must actually be successful at what they do, or ppl would stop coming.

    Liked by 1 person

    • I also had three sets of injections, none of which made a difference. I was lucky as my doctor at the time was honest with me and told me there was nothing else he could do. The reason there was a limit on the amount of steroid injections one person can have is because of the long-term damage these drugs can do to your bones, and other very negative side effects.

      But I’m not sure you can say what, exactly, made your pain better. Was it the combination of shots, the medication you were taking, or just time itself? When I was in gymnastics, I had a pinched nerve that took six months to heal. It was the amount of time that I stopped doing gymnastics and allowed it to rest that made it better, as I didn’t have any injections at that time.

      The worst that can happen is that it doesn’t work? No, I’m sorry, that’s just not true. Unfortunately, many pain patients have been harmed by injections, many by sloppy injections. If you check out the stories under my category “Voices of Pain Patients,” you can read about some of them. And thousands were harmed, some of them dying, by compounding pharmacies making infected steroids.

      You can also read about patients who have been abandoned by their doctors. Just because it didn’t happen to you doesn’t mean it doesn’t happen at all. Many patients refuse further injections and that’s when many doctors abandon them, mostly because they have nothing else to treat them with EXCEPT for injections.

      Of course there’s a long line of patients waiting to see these pain specialists, because what is the alternative? Acupuncture and massage? There’s also a long line for surgeons, too. It’s called desperation, not success.

      Liked by 1 person

  2. Chronic pain patients are a heterogenous population that require a multitude of treatment options to care for them. We take an evidence based approach to treating our patients. Not every patient will respond to any one single type of care whether the treatments are psychological, rehabilitative, medical, or interventional. We individualize our care, tailoring out treatment modalities to each person and taking in consideration the validated science to help our individual patients. Minimally invasive procedures are helpful and science continually proves their efficacy for many chronic pain conditions. They are not without risks and the risks, benefits, and alternatives are explained to patients each and every time prior to the initiation of a procedure and with the consent of our patients. All modalities including medicine, psychological treatments, and rehabilitative services also have their risks. By having a multitude of choices, we hope to minimize harm and maximize positive patient outcomes and functionality.

    Of course any medical practice is a successful business. The quality of our care is evidenced by the Centers of Excellence award, presented by the American Pain Society in 2014. Statewide, our dedication to best medical practices is shown by two of our providers being named to the Tennessee Governor’s Task Force to develop the recent guidelines for pain management. The article that is selectively quoted also shows that our practice is a model deserving national attention.


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