Some of you may remember when I posted several months ago about my current PM practice changing their policy about breakthrough meds and providing misinformation.
I am now in a position where I can seek consultation with other pain doctors (I had to change my insurance to do this, but this is a very good thing, believe me).
Is it legal, as long as I do not accept prescriptions and fully inform the consulting doctor about my situation, to seek consultation elsewhere while still being treated by my current PMD?
I have such fear and guilt about doing this, but it must be done. I'm extremely nervous about getting in trouble or finding out that what I am enduring now with my current PM is the best I can get.
If I consult with other doctors and figure out that my current PM is the best I can do, is it legal for me to continue there (again, no accepting prescriptions from multiple doctors, etc.).
The situation is: I'm not actually leaving my current PM unless I find something better. I do not want to burn any bridges until I'm 100% clear on what's going to happen (go elsewhere or stay with current PM). I don't want to burn any bridges at all.
I know the rules of PM contracts (I used to have a job typing them up all day long) and I don't want it to seem like I'm doctor-shopping, but I can't stay where getting a tiny amount of breakthrough meds is harder than pulling teeth. I also can't stay where the PA keeps telling me, now twice and in front of my mom, that, "You are my only patient on pain medication."
It is time for a change. I just need to know the right way to do things. Thanks in advance for any advice you can give me.
Great! I would never accept scripts from more than one doctor at once. I'm having my wisdom teeth extracted soon, and I'm nervous about how post-extraction pain is to be managed. I'm going to call my current PM about it and get a straight answer from them.
I'm glad to hear that I don't have to terminate my contract before seeking consult elsewhere. I would only terminate my current contract if or when the consult goes well and I decide it's time to transfer care.
I don't think these contracts have any legal standing, do they? I was under the impression that it was just something drawn up by the pain clinic/pain doctor and it gives the doctor an excuse to get rid of the patient if he violates the "rules." I'm under the impression it is primarily done to protect the doctor or clinic so if a patient becomes addicted to something, she can't come back at them and sue.
I've only had one situation where there was a pain contract involved. The other PMs I've seen and been treated by, did not require one (did not have pain contracts)...nor did my spine surgeons....so I just assumed it was a choice some pain doctors were making.
Pain contracts are fairly standard practice. In fact, I'd be leery of a doctor who didn't use one. The contract doesn't just protect the doctor, it protects the patients by making the rules clear, keeping both the patient and doctor safe from entities such as the DEA, and ensuring that the clinic or practice can keep its doors open (not be shut down suddenly).
I've never not had one. Even my GP used one when she was giving me a meager amount of hydrocodone, but it was a controlled substance, so she had to.
I don't know for sure, but it may also depend on the state in which you live. I live in Tennessee, and it seems that there are pretty strict rules here for legitimate pain care. Doctors regularly use contracts, check pharmacy records (especially for Medicaid patients because Medicaid requires all doctors in this state who RX long-acting narcotics to check pharmacy records on a regular basis, not sure how often, though, and this is not something I was even aware was happening - the patient is not notified or required to take any action, it happens automatically), and use urine drug screening (I've never had a pill count...yet) to make sure everything is on the up-and-up.
I've always tried to be a model patient. I come to appointments with a pain journal and all of my meds. I have always brought back unused meds (bad reactions, didn't work, etc.) and scripts (from when insurance wouldn't pay for something). I have never "lost" meds, scripts, run out early, or asked for refills over the phone. I have never had a problem with a UA (they never mention it - I assume no news is good news and I know I don't do illegals or divert/misuse my meds).
Despite all this, the practice I'm in now is giving me garbage about the tiny amount of breakthrough medication they grudgingly give me. They misinformed me (saying the FDA was banning BT meds, and repeatedly mentioning Tylenol, which is nonsense because BT meds can be RXed without the Tylenol, but I can't exactly call them on this). I had to bring my mom in with me last time, and even then it was like pulling teeth. The PA is trying to convince me that I am the only patient on pain meds in their practice, and they're only working with me because, "You've always been such an excellent patient." Yeah? Then treat me that way. Give me the respect I've gone out of my way to give you.
So I believe it's time for a change. I'm not afraid of legal trouble, I just wanted to know what the right way to do things was, and I'm also curious to hear from others who have transitioned their pain care from one place to another (especially where it worked out well). I am not new to PM, but I am young and want to make absolutely sure I do not make a mistake that could have easily been avoided if I had asked for advice and direction.
hi oddyssey. just to be darn certain about any potential ramifications, make certain to fully and completely read any and all info pertaining to your contract BEFORE you do this. you just want to make 'certain' that you will not have any problems in doing this since in all likleyhood, the way things just ARE connected esp with insurance, the 'old' pm will most likely find out some way, somehow. there probably WILL be a request made from any NEW PMs you may consult with for your 'old' records FROM your current pm TO the new one? thats just kind of a standard practice, ya know what i mean? and there just ARE many other ways too that if you just do NOT want your current PM to actually know, they can. you just NEED to be very certain you want to risk this BEFORE you go in.
a better idea may be to actually call any other PMs that you were planning on seeing and simply ask what you 'should do' in the situation you are in? telling them you truely feel like you are not getting 'appropriate' pain care treatment and you are considering a needed change, but are afraid if you do try and make an appt for 'only' a consult with their PM doc, you could lose the ability to get ANY good pain care at all if this is not 'good' with your current PM? just trying to look at all possibles here.
while i would 'think' it would be okay and totally within your rights to check out other docs, it ALLLL depends upon how you current PM would react here and any actual rules they have as standard protocals as to whether or not you just could lose them. just KNOW for CERTAIN before, K? if push comes to shove here and you DO now have options, you may have to cut ties with your current place to even find out just how your pain would be treated by another. most PMs, i wouldn't think anyways, would be really as forthcoming with esp any realistic expectations with narcotics at 'only' a consult, as opposed to you going there for an actual 'new patient consult/treatment' type of situation? it could actually give the impression OF doc shopping to "some" even small degree to that particular PM. appearances ARE everything with PM and i am only thinking it could be taken that way by a new PM in seeing someone who IS already under care at another PM going for a 'consult' with another, even if you do NOT accept or ask for narcotics? that would be what i would worry about here too if ties are not actually just cut and you take that leap of faith with a 'new' PM all together since it really does sound like the place you are at now really even 'understands' HOW to treat pain realistically? just my thoughts on your situation here odd.
i really would think long and hard about this before you go ahead with it, and for many different reasons too. like i said, ya have to really look at how this "could" simply 'appear' to the new PM with just a 'consult"(would you ask him, how differently would you treat my condition? if so, that could be potentailly construed as finding out if they believe in BT meds or "inquireing' about what possible narcotics they 'may' even use on you too, and THAT would or could be seen as something different). vs if you just were a brand new patient looking for much better care than you are getting would be(but AS an actual patient vs 'consulting with) and if your current PM should find out too? it all kind of depends upon what risks you are willing to take in both sides i mentioned above and if you even 'could' go back to that PM after 'consulting" and what 'they' may think too kinda thing? its just not like seeing a surgeon for a second opinion type thing? it could send the wrong signals to alot more than you may think odd.
most people just do not 'consult' with PMs, ya know what i mean? since it can appear or be merely assumed that a person IS looking for a doc that uses narcotics. its just a whole different world than consulting with another specialist for that second opinion would be. i DO really think here odd, that if you really do feel that whatever your pain needs just ARE and what documentation of the pain generators you have, looking at those two things and how you have been treated, you just may have to cut ties and start up with another PM to really honestly find out what types of treatments they offer to you per your actual pain needs. its just taking that leap of faith with another. and that of course depends upon how much you are actually suffering at the hands of a potentially clueless PM and things going wither way with another. if things do not work well with a new one, you can try a different one if that is an option.
just exactly what are your sources or source of pain and what are you currently taking? that would help to know. i know my PM will ONLY allow two BT meds per day no matter what(when i started there i had been on low dose OC with four oxycodones per day). but that was kind of a good bad thing that did force me much sooner than i probably would have to have to find many other ways to try and manage my pain without using any narcotics. there are good therepies and topicals that in alot of cases work better than my narcotics do for what my many different types of pain areas.
just for your own sake here odd, make certain of what your real absolute needs are before you chose to do anything. i just have a feeling here that if you 'consult' it could come back to bite you in a few different possible ways, along with those 'appearances of'. PM IS just a very very unique type of 'specialty' with ALOT more restrictions and regulations too. i do hope you can get your real needs met here odd. trying some phone calls 'may' be better than going there in person. unless as i said, you ARE a brand new patient? thats just a whole very different type of situation than what a 'consult' would be. they may even HAVE to make you a new patient to even GET an actual consult with PM involved too? ya just don't really know yet. good luck, marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
The other situation here is: the PM I'm currently seeing is eventually going to be phasing out the PM part of their practice. They are a neurosurgery office with one PM doctor, and that PM doctor isn't going to be treating anymore.
I really do not see what I have to lose. The other place I'm looking at claims to be "integrative pain management." They are a true PM practice with multiple doctors and a pain psychologist.
I've been thinking about calling or e-mailing their office manager and asking about it. I have a very rare genetic condition that not many docs have heard of, so I'd at least want to know if any of their docs have heard of it or are willing to learn. The doc I'm going to now has done nothing spectacular that another doc couldn't do. I haven't even seen him in a year (I see the PA every time now, and she's so judgmental - she just doesn't get it).
The only thing it says in my contract is not to get controlled substances from other doctors. It says nothing about not seeing other doctors. I have every right to "shop" for a doctor just like anyone else would for any other specialty. As long as I do not accept prescriptions from another doctor, I don't see the problem here.
Believe me, I have gone over every situation, possible situation, appearance, etc. in my head for months. I'm a chronic worrier, so it's not like I haven't thought about this.
I know you're just being honest and thinking along the same lines I have been for the past 4 months. I cannot be the first patient in history to switch from one PM to another. It would be really, really nice to hear some positive success story right about now.
I know myself and many other PM patients have done "consults" with other PM doctors. I did, saw three other PM doctors for "consults" and both the office staff making the appointment and the doctors that I saw all were told why I was there . I didn't hide it because I had nothing to hide. I explained why I was considering changing, what treatments/medications had been tried, did in fact, ask what treatments or therapies he might consider, brought the studies done, reports and films with me so that he could see them while I was there and despite them telling me that there weren't any other options as far as injections /PT, etc went, they said that about all they could offer was medication management and would do it if I decided to change doctors.
The PM doctors are well aware that some PM doctors don't handle medications , only are interventionalists or "shot jockeys", and are more than willing to consult with a new patient.
just wondering backh, if when you had your consults, if you were already under the care of an actual PM or if you were like going FROM like your primary or surgeon(just someone "other" than an actual PM facility)? that would make a difference in how this could be construed more than if you were already being treated by an actual PM practice kind of situation? what WAS the actual reason you felt a need for the change that you explained to them? did you feel you were simply not being treated adequately for YOUR actual needs? just wondering. its just different "types' of real circumstances are what would more or less kind of make things potentially 'appear' in certain ways to any PM facility you were actively being treated at by both by the one you ARE seeing and the 'consulting' new doc, vs having no actual real PM to oversee your pain care AT the time of your consults, ya know what i mean? but also being a 'new patient' as you mentioned above, vs already under someones PM care too really does change things as well. and boy do i know about the huge differences in how certain alleged 'pain care' docs can be as far as what they will and will not simply even 'do' for a patient that is merely the actual 'appropriate' therepies(not just injecting and sending on their way?) and also any types of meds/narcotics if they are needed too. its kinda sick in how some facilitys just 'are'.
it's just in any PM situation when looking for a treating doc, it IS a very different situation than say getting a second opinion from a surgeon about surgery would be, ya know? its just that potential narcotics may be involved longterm, so there ARE those 'appearances" to have to add to the equation, always. even that very importanly remembered 'first impression' with the PM(what you say, do, and even body languege)can matter in how they simply 'see you' and your overall pain needs. but good documentation of diagnoses really does help alot there too. since you simply cannot see or feel another persons actual pain.
odd, if this is the type of practice you say it is, i would simply go to ANY actual 'pain clinic' setting facility well BEFORE the other place phases out. the facility you mentioned really at least "sounds' like a more 'normal' pain care facility. from what you described about where you are currently at, this really doesn't sound like a really great type of place in the first place to get the best possible types of pain care modalities offered anyway(as opposed to a total pain clinic facility would be). and who in the heck wants to be judged and made to feel guilty becasue they have pain requiring the use of some type of narcotic. this IS a totally different "type' of situation(than i assumed from your original post) where you are going to HAVE TO need a new PM as opposed to simply 'consulting" while being treated at an actual real PM facility that is NOT going to eventually close down your pain care. and that is what i would simply TELL any new facilitys you want to check out when you call for any consult. this IS a 'replacing" your PM because they are going to be closing down their PM part of the practice, so it DOES put this whole situation in a much different light. and it should not matter to your current one either since THEY know they are going to be phasing out and any patient still going to be needing continuing care in place "before" that occurs as well.
if i may ask, what is your rare genetic condition? just wondering since i too have a couple of 'born with' genetic crappy conditions too that are generating pain. then 'aquired' ones from spinal cord damage 'syndromes" from hell that also need specific types of care that stemmed from my 'genetic condition". and also have found it very difficult to get anyone in the PM world and flippin neurosurgeons even to understand initially in most cases. and was also given, by three different NSs, totally opposing info ON it. it does suck when YOU actually know more about your specific conditions than the treating doc does. i would simply ask any PM facility that you call, or try and see if they have an actual website like mine i know does, and see/ask what they DO treat. or if they HAVE any docs that do actually know how to treat your specific condition. it may save you some time and hassle. just a thought odd.
since you are eventually going to be losing your PM and needing a new one IS a totally different story vs going from PM to PM just to see what they will offer you would be when you simply DO already have a PM actively treating. the post i made to you above was just strictly the 'risk side' of how things merely CAN be seen by certain PMs and what yours will probably find out about that if you did NOT want them to, that could have been a problem for you. but since they WILL be phasing out your current PM, this IS an absolute need to have to replace. i was just trying to let you know what 'could' happen in just weighing pros and cons in how i saw this based upon your origninal post made me think of, thats all.
i would make certain tho to do what backhurtz did tho and have any and all of your medical records with you and ALL testing/scans you have had done too with you at the consult. and another thing that i would do here too as soon as possible(like now) is obtain ALL of your ongoing medical records FROM your current PM who is treating you so YOU will actually KNOW what has been written about you and your ongoing treatment with this stupid PA who has been seeing you. this way you will be prepared for any possible issues that may pop up when any new facility gets your old PM records transferred over to any new one. considering just how she has treated you overall here and how judgemental she has been, you do NEED to read thru your own records, trust me. it is the best possible way to simply be prepared going into another PM. this also allows anyone who obtains any records from any treating doc or surgeon the ability to really 'see' just how that particular doc/PA/NP actually views you and their overall impressions of you, your conditons and your ongoing care too(i do this at least once a year with ALL my treating docs and primary too). and with THIS particular PA, i would think,esp with the BT med issues, she 'may' have stated things in a more 'judgemental way sending certain 'implications out in the clinic notes? you also need to check for ANY possible real mistakes that i have always found in at least some of my "documentation" as well. it just can and does happen much more than you would think. you just need to cover all bases before seeing someone new and cutting ties with this current facility before you MAKE that 'move permanently.
but i most certainly would odd, call your current PM facility today and ask for the medical records dept so you can get that needed release of information sheet simply sent, signed and send it back to get the records you DO need to see. all i do is check the box that states i need these for MY own personal medical records i DO keep on myself at home. i DO soo hope that you can find another soo much better manager of your paincare odd. sorry i did not have the whole picture when i responded above. i really was only trying to think of what 'could' potentially occur for YOU. unfortuently with PM itself, it IS a totally different world than in any other type of medical setting that i have ever been to in my life. the fact we even have to sign a contract and even be on narcotics at all FROM this facility MAKES this a different world alone ya know? please do keep us posted on your hopefully short search here odd. marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
Yes, I was under the care of the PM doctor for two years at that point, along with my surgeon from my first surgery. The reason behind my decision to consult with other PM's was two fold, I wasn't particularly happy with the treatment- not so much the management of the pain, but the lack of figuring out what was causing the decline that I was experiencing after my first surgery, so I consulted with the other doctors, and told them why I was there. They were PM/physiatrists as well, so they managed pain meds, therapies and treatments, but also were capable of figuring out what was causing the worsening of the problems that I had.
If you approach the consults with honesty, it doesn't really matter if you are only consulting, in fact, I found that the doctors appreciated the fact that I wasn't coming looking for pain medications because I had already left the other doctor, but was looking to see if they would be a good fit for me, or if I would be a good fit for them. It really did make it so much more pleasant because neither of us had preconcieved expectations of the other, and there was no "time" crunch that happens alot when a new patient shows up having already been on meds, expecting that the new doctor will write for them right away.
I didn't bash my then current doctor, just told the new ones that I was happy with how things were being managed as far as the increased pain and disability, and wanted to see if /how they would treat me/it and if they had any other ideas aside from what had already been done and what they believed the problem might be.
It is far better to go for a consult now, before someone is in need of new prescriptions, it gives you a chance to meet the office staff, the doctor, get some ideas and then find out if you think that he/she is someone that you feel comfortable with. If not, then you move onto the next consult. If you don't find someone that you are comfortable with, then you can keep consulting with another doctor until you do.
Thank you SO much. Your situation is exactly like mine. I have absolutely NOTHING to hide, and I just would love to see if there is another doctor or pain management practice that would be a better fit for me, especially since the one I am using now doesn't feel like a good fit anymore. I do not want to scramble to do consults if/when my current PM decides to stop RXing meds altogether. I want to get a feel for another doctor and see what they would do while I have no time crunch.
I understand the rules of my contract and would never jeopardize my care by accepting prescriptions from another doctor before ending my contract with the current doctor. I have no intention of bad-mouthing my current doctor. I have been happy overall with my pain care with him; however, it no longer feels like a good fit and I am feeling some pressure and initiative to look elsewhere.
I have every intention of being up-front and honest with everyone involved. They can see all of my records from whomever they wish. I just believe that I have a right to find a doctor who may be a better fit for me.
Thank you so much for your reply. I will definitely let you all know how things go.
odd, honestly, i DO feel you are doing the best possible thing considering everything that i now know is going on and will be going on soon at your PM. what I responded to was what you asked in that very last paragraph in your inital post which stated: "i want to make absolutely sure i do not make a mistake that could have easily been avoided if i had only asked for advice and direction". so playing devils advocate there, that is what i gave you hon, thats it. the "possibles" in just how some PMs can construe consults only, and not simply going there AS a new patient instead and see how things simply 'go' with THAT particular PM?. it DOES take some time to even build up that very very needed level of real trust between the PM and the patient too,which can even change the overall treatment you HAD been getting to even more over that time. but what i posted are just some things that have to be considered in ANY consult situation with any PM, under specific types of circumstances. you know as well as i do that not all PM patients are simply even 'there' for the right or even legal reasons that just are unfortuently for all involved also a part of THAT lil world, ya know?
it really comes down to more of what that individuals actual realistic 'needs' are that would dictate, as in BHs situation(needing someone who could treat pain but also help with diagnosing too, that alot of PMs just do not actually even do except injection types of rule out Dxing,which not all patients can even use or need depending), what YOUR real issues are and the 'whys' in the need for consulting with various PMs to make 'certain' that you DO get a good PM that will help with whatever you need from your own new PM in the long run. if they do not actually even know about YOUR particular condition, what help can they really be to you? so you too just do need to know what anyone actually even treats/knows about as far as your real medical condition along with your absolute need to actually find a good PM NOW vs waiting til they phase out your ability to even get the needed meds to just give what is basic continuity of care here as well.
but at the same time, every PM also has to really be watchful and careful of every patient overall but esp that is not sent/referred to be the 'new patient' status, but only a 'consult' too, ya know what i mean? while we DO deserve and have the right to look for that perfect fit with ANY doc/specialist we see. everything can change for any PM when they end up taking on a patient who actually turns out to be what just IS in every single PM practice out there by simply looking at the overall odds and insane addiction rates, the "doc shopper". who ONLY wants to know if that PM uses narcotics so they can either keep their own addiction going, or keep up diverting their meds for cash. its just, unfortuently for us as well, a big part of THAT particular type of practice that every PM simply dreads like all get out. mostly becasue their can be ramifications for not just that PM who wrote that Rx for the person who got 'caught, but it also impacts every single other patient there too if that PM should get shut down by the overall governing body of the DEA for whatever reason they decide to use. so THAT really was the bigger 'why' in what i stated odd and nothing to do with you personally or anyone else simply trying to find the best fit for their needs. appearances unfortuently DO matter here for the potential PM, but also does include that more case by case basis of 'how' anyones real pain generators need to be treated, and the real needs OF the actual patient as a whole too. i was simply trying to make you more aware of possible mistakes and what other things could be merely construed by certain PMs in this type of world that PM simply is and consists of in its daily ongoing practice too. but both you and BH also had/have very real and specific reasons for what consulting just IS needed for.
but like i said, it IS pretty much a case by case basis as to how any PM will 'veiw' any given patients needs as far as what IS absolutley a need as part of their own ongoing paincare. i myself was simply referred to the ame pain clinic that i had gone to years before for TP injections(i REALLY had just loved that PM who did my injections too). and it was a good fit for me. they immediately, that same day i was seen for my eval/consult with the actual pain doc himself, started titrating up on what had been then Rxed by my neurosurgeon as a very low dose of OC(the crazy NS also wanted to actually implant a dang cord stimulator less than four months post op? and before even trying ANY real other types of modalities even despite telling me it would take at 'least' one year for my cord to fully heal. but overall 'most' NSs do NOT like to have to rx narcotics long term either). but they also took away all my then four BT meds per day too. not happy at all til we 'discussed' how my pain simply 'presented(very out of the blue and sudden 'hits' from flares)" and i HAD TO at least have 'some' back. so they did give me what their actual BT med limit just is for every single patient at my clinic no matter what your true needs are, two per day. but they still were titrating me up which was a godsend, and continued this from feb when i started til april when i really felt at least a good "dent" in at least the treatable with narcotics pain anyways. i know i DID feel very lucky to have found a good PM that i already had at least "some' history with, and i am still there. while i do not always like or agree with some of 'their' policys, i still follow them, and they have seriously helped me and really tried to keep my overall pain down too. that i know/feel.
i just DO hope odd that you will get moving sooner vs later and not wait anymore to try and find that much better fit. as both of you stated, crunch time is NOT when you want to be scrambling around trying to do this for yourself. hopefully this other facility WILL be what will meet your own needs in all the best ways. just also still DO, honest to god, try and obtain ALLL records FROM the current PM as soon as possible too just so YOU are totally aware of what is or is not even IN your overall clinic notes and esp that VERY needed documentation of pain generators, meds you have tried and esp doseages too and everything else you know you have going on as well, simply documented.
i found out the hard way when i went to apply for SSD just how insanely wrong the info actually was with some of my records. of course, ONLY after i had been turned down by SSD and actually obtained everything SSD had used to 'determine" their decision. which honestly was just crazy considering i could NOT stand becasue of RSD in my R knee down thru my entire foot, and my L hand was useless and also actually clawing too, and 'they felt' i was totally capable of going back to my old job again, WTH? when esp, all of this crap was VERY well documented by mostly the physiatrist who was also my rehab doc in the post op acute rehab facility as well, down to all the nerve losses showing up IN my dang EMG/NCV.
i had totally missing real diagnosises that were told to me in clinic by my NS but NOT ever documented in the dang clinic notes, and in other cases was given dxes that i never had been given. everyones medical records ALWAYS will contain at least some levels of real errors. some are very minimal and some pretty darn impactful. but by getting the PMs records now odd, seriously just gives YOU more control/overall knowledge here and if anything is wrong in them, the time to get it fixed, or in some cases depending upon the mistake, getting it totally removed from your very critical records before any new consults are done(or at least the actual records are asked for). honest to god, i simply 'assumed' like most of the population, that everything needed or told to me AS real dxes were simply well stated in my medical files from many different specialists and my primary. but no one truely even knows just what is or is not actually even in them til you obtain them and simply read thru them to make certain everything that you have been 'told' by any given doc IS indeed in them. it would take about a week and a half to obtain your PM notes odd if you just called on tuesday and asked for the medical records dept so they would send you out that needed release of info form for you to just fill out and send back to them? in about a week or so, they just show up in your mailbox.
since everyone in the US simply does have the right to obtain copies of any and all records from ANYPLACE you have ever been seen or treated by anyone 'medical', this really would NOT be considered at all unusual or 'indicate' anything as far as you. and they also do KNOW they are not going to be treating patients for pain anymore so it really would NOT be any type of big deal for you to simply even do.
this just IS a better safe type of situation to do BEFORE going for any consults. esp with this woman who was so judgemental in charge of your ongoing care and the hassles you have had? your overall records simply do need to be looked at before you move on to the consults, since any NEW PM you end up with WILL ask for those very same records from your 'old' PM for alot of reasons. doing this now is simply covering your butt. and if she did state ANYTHING that makes YOU look bad, you CAN discuss this with the new PM(or her 'higher up") if it cannot get changed so he will also have YOUR side of things. while i do agree that you do not want to burn the previous bridges or badmouth the old PM here, whatever is actually written about you as her overall 'impression' of you and your conditions over time, can matter and kind of make you at least have to somewhat defend yourself as well(this IS the bigger reason you simply DO NEED to know whats even in those follow up clinic notes in your actual medical file). it at least gives YOU some time to think about answers to possible questions down the line, ya know what i mean? just BE prepared odd. its just that overall additude that you have been forced to deal with has the ability to also impact what she actually 'wrote" in your medical file that just can follow you too.
i wish you luck with this odd. maybe this first place you mentioned before will be the 'one' who can really help you in what YOU really do need from your PM. marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.