5 Tips to Enhance Pain Specialist Communication With Primary Care Physicians

Written by Heather Linder | October 18, 2012 | Print  |
Communication break downs between primary care physicians and consulting pain management physicians can lead to inadequate and potentially hazardous patient care.Dr. Yousuf Sayeed of the Spine Center of DuPage Medical GroupYousuf Sayeed, MD, of the Spine Center at DuPage Medical Group in Naperville, Ill., takes several steps with his patients to ensure open channels of communication with referring physicians.

Communication is important for all specialties, he says, but pain specialists often have patients with unique needs requiring extra care. For example, often pain patients require powerful medications and many have underlying physical problems, such as disc pathology or surgical diseases.

"A unique set of individuals may require higher levels of communication," he says. "Most primary care physicians don't witness these types of issues on a daily basis. With a pain management patient, heightened communication between pain management and primary care physicians alike can lead to much better collaborative care."

The biggest challenge physicians face with pain patients is making sure the appropriate treatments are administered to bring the patient relief. If a pain physician's assessment doesn't reach the primary care physician, a follow-up could be missed or an acute treatment plan may not be properly executed, Dr. Sayeed says. Communication is vital for properly caring for patients.

Patients with acute pain are often easier for primary care physicians and pain specialists to treat than patients with chronic pain syndromes, Dr. Sayeed says. Many primary care physicians may hesitate to write prescriptions for opioid narcotics because of potential side effects and look to pain specialists for both their experience and advice. It's best when both physicians are open as to the end goal of the patient because any existing concerns or muddled communication can cause further delay in care.

"When managing opioids, there is a huge advantage to communicating," he says. "If communication is not [properly] utilized, it can lead to over or under utilization."

Dr. Sayeed weighs in on five challenges and solutions to keeping lines of communication open between pain management and primary care physicians.

1. Increase visibility. Working with primary care physicians begins with establishing a positive working relationship. Many times the two types of physicians won't naturally come in contact with one another frequently.

Try increasing your visibility at the hospital or practice, Dr. Sayeed says. "Visibility communicates that your services are available," he says. Increasing visibility can even be simple steps, such as eating lunch at the hospital once a week or volunteering for a committee. It also increases face recognition and develops communication channels which did not exist prior.

"It may not be direct communicating," he says, "but it promotes communication and builds trust."

2. Talk on the phone. The "gold standard" for communication is physicians calling one another, Dr. Sayeed says. It's the optimal way to keep both parties informed, but it is often overlooked because phone calls can be time consuming.  

Direct communication can also be a form of positive marketing. "When a physician takes time to call the primary care physician, that primary care doctor will remember it," he says. "This helps build a practice. You will be known as a caring and communicative physician."

3. Use written requests. Another way for pain management physicians to keep in touch with the primary care physician is by sending written requests. Letters have been used for many years and are reliable and good for documenting the communication.

However many times primary care physicians are too busy to read all of their letters. Requests can slip through the cracks or be left unattended for a period of time.

4. Send records electronically. Electronic communication, such as email, is becoming more HIPAA compliant and is the fastest means of reaching out to another physician.

However, patient security still remains a large deterrent from communicating electronically, Dr. Sayeed says. Many electronic processes are not yet approved for medical use. "We have to be very careful with instant messaging, email and these types of e-media unless it's through a secure portal," he says.

5. Work toward a common goal. Pain and primary care physicians should establish a "team plan" and work together to reach a common goal of patient treatment, Dr. Sayeed says. A common goal lets the patient know there is no discrepancy of care and nothing will slip through the cracks.

"Having a common care plan can be reassuring to a patient," he says. "The majority are very appreciative to have doctors communicating with each other."

Developing a team plan entails brainstorming with the primary care physician and exchanging ideas and advice. "Primary care doctors tend to have a longstanding relationship with patients," Dr. Sayeed says. "They can provide information not easily gleaned from a record or chart."

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