Guiding Principles for the Pain Medicine Physician—In a Not So Ideal World

Abstract

The inspiration for this article is from a recent discussion with a surgical colleague who, when describing a treatment dilemma involving a mutual patient, prefaced his discussion with “In an ideal world …”. I have often thought of ideal world clinical conditions that would make my professional life less chaotic. Let's look at a few of these that are germane to practicing pain medicine physicians. In an ideal world : patients would be correctly diagnosed on the first evaluation; patients would be compliant with and favorably respond to prescribed therapies; there would be no need for follow-up visits as full recovery would follow initial treatment; we would be reimbursed for our services, promptly and at the requested charge; there would be no governmental or third-party oversight; addiction to prescribed analgesics would not exist; patients would always be truthful; and for good measure, professional liability and attorneys would not exist. I can always dream of …