Dear Patients:
For many years, we had you filling out a survey before each appointment. It asked a lot of questions that might have seemed only peripherally involved with your physical pain. However, thanks to your cooperation, the data we collected confirmed that how we feel emotionally has quite a bit to do with how we feel physically. This data base (note that your names are NOT attached to anything outside of your chart), which we dubbed “Prism”, is a gold mine of information. We had a doctorate level statistician working with that data until he moved on to a job in government doing something similar. We’ve not been able to replace him yet. Nonetheless, the work he completed before he left is very telling. We were eager to share our data with the world, and we started doing just that.
I’ve been disappointed and frankly sort of deflated to see that our data, which absolutely supports what you and I do together at MPC, is no longer of much interest to the insurance carriers, but I’m getting ahead of myself. Allow me to give some background.
A few years ago, things were different, or at least seemed to be so. In discussions with some of the big carriers in west Michigan, Prism was well-received. That was a relief to me, because it took a lot of effort, including effort on your part, to collect and analyze it. To me, that data was like my medical license or my board certification. It made me and my partners “legit”, so to speak. Pain management is still a very young specialty, and just as we all had to do in our own youths, it has to prove itself.
On the subject of needing to prove ourselves as pain specialists at MPC, I’d say we had a good twenty years of forewarning. Dr. Davis, one of our MPC founders and a driver behind Prism, told us long ago that sooner or later, money would get tighter, and we would need to prove our worth to the insurance companies in order to continue practicing as we do. So, with your help, we got ready to do that. In the process, we built what is probably the country’s largest data base on patients with chronic pain. We have over 100, 000 patients analyzed. Data with these sorts of numbers is considered statistically very powerful. Once that data was finally digested and presented to us, we felt genuinely proud of our body of work, and figured that our specialty, at least in our hands, would be on solid ground. We were more than happy to share our results with the insurance companies. After all, we had just proven, with real numbers, that beyond any doubt we are a positive force in medicine.
But the health care world has changed over these past few years, and the changes have apparently made our Prism data superfluous and unimportant. Doctor and patient are no longer the ultimate decision makers when it comes to pain treatment. I never thought I’d be writing that. But here we are, and pining away for the days when what we thought and how you felt mattered, above all else, does no good. What to do? Well, as I’ve requested of you in past blogs, if you have found that your pain management is less effective because the treatments or treatment combinations previously approved are no longer approved, tell people. Tell your elected representatives. Tell your insurance company. Send a letter or email to the Grand Rapids Press . Speak the truth. We as doctors no longer have any pull, but you as patients still do.
OK, now that we’ve spent time on disappointments, onto something that is sort of fun and, I think, truly worthwhile. I would call it an added dimension, albeit an informal one, to our Prism data base. Even if the data base is of no interest to insurance carriers, it is of great interest to me, and building on it is something I’d like to do. You see, the data contained in Prism tells me a lot about how you cope with pain. For instance, it helps me know if depression is becoming a major issue, or if stress at home or at work is increasing, etc. All good information, but it doesn’t tell me much about WHO you are. For that, I think the personality inventory/testing is the best tool. If you go online and type in “16 Personality Types”, you’ll find a website that has a FREE personality test.
When I took the test a few weeks ago ( it only takes a few minutes) I thought it would be the typical pop psychology, ie. Interesting in a limited sort of way. I was wrong. When I read the results of my testing, and then read about the typical traits, characteristics, thoughts, strengths, and weaknesses , I was creeped out. I felt absolutely pegged, as if someone had been observing me closely for many years and then summarized how I’ve lived my life, what I think about most often, what others seem to see in me (for better or for worse).
I then called a buddy and asked him if he would take the test. Already did, he told me. The testing declared him to be a “logistician type” of personality, and boy, is he ever! A numbers guy through and through. He has done a risk/benefit and profit/loss analysis on most everything in life, I’d say. I called another friend and asked him to do the test. He has been labeled as a “Consul type”, meaning extrovert/friendly/observant/judgmental. Bang! Another bull’s eye!
All of this is pretty light until you get to the strength and weakness analyses. Here, I can tell you, I saw even more of a mirror reflection of myself. I went ahead and purchased the “owner’s manual”, I’d guess I’d call it, which in detail describes my personality type and how it is likely to impact my life. Much of the impact, for better or worse, easily applies to how I most likely handle serious medical issues, including those that are likely to cause significant chronic pain. I’ve certainly seen how personality type affects individual patients. Id venture that you’ve all had similar experiences. We’ve all known folks who, in the face of affliction, remain optimistic and engaged and find ways to contribute despite it all. We’ve all known folks who are completely embittered by similar health misfortunes, who withdraw from life and stew in their own misery. Likewise, all of us have friends and family members who catastrophize, who seem to be waiting for that next misfortune to strike just so they can confirm that yes indeed, the world is against them. Personality type has a lot to do with this sort of thing, and here I am not talking about depression or anxiety, which are medical illnesses. Nor am I talking about personality DISORDERS, like borderline or schizoaffective, etc. Personality types are not illnesses. They are general categories, but pretty solid ones.
I’m not going to disclose my personality type here. I’d rather you test yourself first. Don’t second guess your answers, and don’t go back to change them if you feel the test is likely to tell you something about yourself that you don’t want to hear, because there are no “bad” personality types. Give it a whirl, and if you tell me where you fit in, I’ll reciprocate.
Thomas M Basch, MD