Dear Patients:

This will be brief. I’d like to ask for your help with something, and let me preface this by saying that I absolutely understand how the past few years have been particularly difficult ones for patients with chronic pain. Chronic pain is never good. We’ve talked about this, you and I. How once we have an accurate diagnosis and understand the anatomic and neurological issues at play , chronic pain no longer serves any useful purpose. From time to time, I’ve tried to find a New Testament biblical passage that clearly states “Chronic pain is part of God’s plan for you; He feels that you need to spend your life in pain” . Haven’t found that passage, but if any of you can direct me to it, please do.

I hope that I have never seemed to any of you to be callous and/or uninterested in knowing as much as you’d like to share with me about your pain, how it impacts you and your family, how it makes each day a challenge, and how discouraged you feel. MPC is one place where you DON”T have to put on the happy face and pretend that all is right in your world. Please, tell it like it is so that we understand where you are in your life story and how you’d like to see if, together as a team, we can change things for the better. After 27 years in this specialty, I can assure you that however bad things may seem, you are not alone. Chances are very good that at any given time, somewhere in one of our dozens of exam and procedure rooms, another patient is experiencing pain that is very nearly identical to yours.

It takes teamwork to take on chronic pain, and just as you and I are teammates, so too are the nurses, x-ray techs, medical assistants, prescription line and office personnel, business and billing specialists, housekeepers, and so forth, all of whom play an important role in helping me help you and without whom nothing can get done. We are all playing on the same team and are all shooting for the same victory: less suffering from chronic pain in this world, fallen as it may be.

And this is why we have to treat each other as teammates. Teammates bring each other up, back each other up, and recognize one another as important, valuable assets. If we don’t do this consistently and to the best of our individual abilities, we will lose. Long before I finished my medical training, I’d already seen and felt this principle in action in high school and college athletics. I’ve played on some teams that had talent to spare, and yet, simply by disrespecting one another, never made it to the quarter finals, much less the championship game.
I feel that until just a few years ago, nearly every health insurance company was on our team. In fact, until recently, one of my greatest confidence booster was the simple knowledge that if I came to work every day with a commitment to do my very best by you, to use everything I’d been taught in training and everything I’d learned from my partners and my patients, to always do for you what I’d do for my own family, I had the financial backing I needed to practice in this difficult subspecialty and to do for you, my patients, the necessary things that, quite honestly, my colleagues in other fields cannot or do not want to do. Read that last part again. I’ll tell you, enough of you have come as new patients to me or my partners over the years with just ONE last pain pill in the bottle. How did that make you feel? How do you think that made me feel? Backed into a corner? Desperate? One pill away from hopeless? If times were tough back then, they are much tougher now.

Until a few years ago, it was simply my nature to hit the ground running and to meet my opponent, your pain, head on, with all possible power and precision. Gain all the position I could right at the face off, get off of defense (that one last pill in the bottle) and on to offense. The strategy usually worked, and worked well. Unfortunately, more and more, I can’t use this strategy. More and more, I feel like you and I are always playing defense. You can’t win on defense. The only thing you can do on defense is NOT lose more than you’ve already lost. You have to get the ball onto the offense side of the field if you want to score points.
To effectively treat chronic pain, you need to shoot on goal time and time and time again. No let up. If one play fails, try another, and have about a dozen more to use after that if needed. One offense after another until the opponent’s weak spots are revealed. After that, well, it’s a lot easier, isn’t it? The score board starts spinning in our favor. Many of you have been there in years past, haven’t you? “Just do what you did last time. My pain control was great for seven weeks, and I can handle week number eight if I know relief is on the way”.
I didn’t change the rules. You didn’t change the rules. But they did get changed, and many of you, frankly, feel betrayed. I feel betrayed as well. It’s been one of my life’s greatest disappointments, and I’m not exactly sure what I’ll do with it. BUT…….I can tell you some things I simply WON’T DO.

  • I won’t yell at you.
  • I won’t blame you.
  • I won’t take my very real frustrations out on you.
  • I won’t upset my partners and my other patients by throwing a you-know-what fit at the nurse’s station.
  • I won’t chew you out over the phone.

Therefore, may I ask that YOU also place these things in the “I simply won’t do” category? You see, all of the above-mentioned staff, our teammates, are on our side in this thing. They’re as disappointed and discouraged as you and I. They HATE telling you that insurance won’t cover this or that. They HATE asking you for more and more of your money to get less and less treatment. They HATE calling you to tell you that this will no longer be covered or that can no longer get done at your visit. They HATE seeing you in more pain and more upset. And it’s all because they care about you and they care about me and my partners. THEY ARE OUR TEAMMATES, AND WE DON’T DRAG DOWN OUR OWN TEAMMATES. Not if we want to win.
Do you still feel like staying in this game and playing for victory? I do, and will, for as long as I can take it. So help me out here. Help me keep the MPC team together, because without my teammates, I can’t play the game.

Thomas M Basch,MD