Home Forums Discussions General Discussion 1) hospital labs; 2) Pain clinics

Two unrelated questions. 1) Does anyone have any luck getting a hospital to release its lab results in HL-7 format? The mix of HL-7 and PDF makes me nuts.

2) What luck do you in other areas in getting pain specialists to see patients for non-procedure generating pain issues? I would dearly love to punt my chronic pain management problems (the more so with all the controlled substance scrutiny), but have no luck.

1) For a not so nominal fee--therefore the lab that gives us the HL-7 not only does not charge us but has a drawing station close by with a couple of wonderful phlebotomists that service most of our outpatient needs. 95% of my labs are gathered this way. However the local hospital has been extremely unhelpful in this arena. I suppose at some point the hospital's number crunchers will realize their unhelpfulness has cost them much more than the "nominal fee" they won't cough up, but I am not going to beg and plead for their business, and furthermore refuse to provide the money to make it happen.

2) It is extremely difficult to get non-procedure pain issues addressed.

1. No luck. My local hospitals are even bucking participating in the local HIE being formed.
2. I have the best luck finding pain docs who want to see chronic pain patients for medication monitoring in the big "chain" pain centers which are popping up, like Prospira Paincare. It might be that your area doesn't yet have enough population to attract a "franchise" (yet).

MY local pain clinic at the hospital is alwasy pumping someone with a shot or 2...I fear it only works 25 percent of the time and is never a permanent fix...when the patient runs out of money they are back in my lap wanting percocet, etc...those doc's drive BMW's and I have a van...dont figure....

Todd,

Does it perchance resemble my van?

thats funny..we think alike....but my E250 conversion van can squash his BMW roadster

We use Quest 100% of the time voluntarily. But when a patient has been in the hospital, or perhaps is a hospital employee and obligated to use their lab, we are stuck. It is as bad as (or worse than) paper trying to figure out the sequence of lab results in this mixed venue.

We use Clinical Pathology Laboratories and, to a lesser extent, Quest for 95% of our labs. We've had only a rare problem (always with Quest) with importing labs. Our downstairs hospital-owned lab - still faxed PDF's so they get almost none of my lab business.

And don't get me started about local "pain clinics". Around here there are just 2 kinds of pain clinics: the ones that sell pre-stamped prescriptions for the Holy Trinity (xanax, soma, vicodin) for $150 cash and the ones that will try an epidural for a hemorrhoid. ("Hey, we'll get paid nicely and maybe the steroid will circulate around to the patient's a$$ eventually!") Very frustrating. None of them are interested in managing chronic pain with meds and frankly I think I do a better job than they do anyhow.

Can't help on #1 but on #2 I have the same problem with pain clinics - most just want to do injections because that's where the money is. There is a pain clinic at the university hospital but they refuse to prescribe pain meds. Hey if I everyone's pain could be controlled with just gabapentin and tramadol that would be great but that doesn't always happen in the real world.

My hospital lab did get around and arrange an interface for AC, but it only works for the outpatient labs. When they are in the hospital we get PDF if we get anything at all.

Pain clinics don't appear to like managing narcotics any more than we do :^(
An interesting side note however, my local IPA in SoCal has more pain specialists under contract than dermatologists :^)

Greg

Thankfully our local pain clinic appears happy to oblige, possibly to keep the revenue generating procedures coming. I have even enjoyed a recent phone consult with the doctor on weaning someone off Soma. We also have a new IM doctor in town trying to get his business running, and he is glad to take over any pain management cases.

The other option is just to tell them you can no longer do pain management, as they are STRONGLY recommending special REMS training for this, and tell them they will have to find coverage elsewhere within 30 days.