I have been in the field of pain management since 1997. Since that time I have seen it explode from a relatively unknown specialty into an extremely popular field. There are several reasons for this. The most important is that there was a need for physicians with such specialty training. Pain management physicians can treat any and all pain causing ailments using various methods. This can involve managing the condition, from implementing physical therapy, to prescribing medications, and if needed recommending surgery. Our forte also involves performing minimally invasive therapies: such as injections and nerve blocks, to more specialized laser assisted treatments for disk herniations, and radiofrequency ablation for vertebrogenic back conditions, among others. Pain management came about to bridge the gap between more conservative treatments such as physical therapy and more aggressive ones such as surgery. Unfortunately the field has also grown because of less altruistic reasons, such as financial gain for doctors and centers.
I recently attended a conference and there was a large discussion about the rise in complications of such procedures. While a majority of these are minor, some can be permanent and life threatening. The major reason attributed to this is the performance of such procedures by poorly trained physicians. Unfortunately, once a physician has obtained a license to practice medicine, there are not many boundaries to prevent that physician from performing procedures that he/she may not be formally trained. There are many companies that offer weekend courses training doctors to perform procedures from epidural steroid injections to the more aggressive endoscopic diskectomy procedures. They rarely check the credentials of those who sign up for these courses. Mostly these are refresher courses for those of us with proper training. But some of these physicians have not even had any previous training in these procedures, or may not have even done them before! Unfortunately what drives this is bottom line, and many centers welcome these doctors but unfortunately take a blind eye to their lack of credentials. Physicians who are performing procedures that they are not qualified to do can result in poor outcomes, or worse: complications!
So how do you protect yourself and what should you ask when you visit your doctor. The most important question is whether that doctor attented a ACGME accredited program in his/her field of sub-specialty, and whether he or she is board certified. Many anesthesiologists are performing advanced pain interventions without any formal fellowship training. They tout themselves as being board certified, having passed examinations from organizations that do not require such level of training.
Fortunately, much of this information is available on line. You can check if your physician has the proper training and expertise. In New Jersey, you can go to the link: http://www.state.nj.us/lps/ca/bme/ and click the link “find my doctor”. You can also call 866-275-2267 (certificationmatters.org). Only by ensuring that your doctor is fellowship trained and board certified in pain management can you be comfortable that you are receiving the highest level of care.