“When a patient comes to us in pain, the expectation is that we’ll do surgery and immediately fix the problem,” said Ms. Cole. However, surgery is often not the best answer, and many patients at the Spine Center are referred to a pain management physician. The challenge, said Ms. Cole, is to both keep patients from feeling belittled by being sent to a pain management specialist and not a surgeon, and to manage their expectations of how effective pain management will be.
“Most of the time, 30 to 40 percent of the pain will be alleviated,” said Ms. Cole. It often takes hand-holding on the part of the pain management physician, she said, to keep the patient.
Like all ambulatory practices, centers offering pain management need to continually make sure their prices are both comparable or less than local hospitals and other facilities, especially for out-of-network patients, while being high enough to cover the costs of the procedures. However, Medicare data makes this determination easier than for surgical procedures. “Pain management is on the Medicare approved list. With something like spine surgery, it’s less easy to determine if we’re covering our costs but not overpricing, and if we’re competitive with the hospitals,” said Ms. Cole.
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