This should be an extraordinary story. The very idea of banning the establishment of new pain clinics should be absurd. Most informed opinion long ago accepted there is a need for an improvement and expansion in pain management services. Why should governments in South Florida and the Treasure Coast be among the forefront of a growing national movement to ban the establishment of new clinics? The answer is a sad reality produced by the for-profit approach to the supply of medical services. In a perfect world, there would be mixed teams of doctors, therapists and nursing staff based in every hospital, with emergency back-up in local clinics.
The best practice standards now accept that pain should be treated as a disease or disorder in its own right. So once people have been through the specialists for treatment of the underlying causes of the pain, they should be passed on to the pain department for counseling and advice on how to live life within the new physical limits. In public healthcare services, the high labor costs are absorbed by the state and paid through the tax system. This provides one-to-one care from doctors and therapists, and ensures people have the best chance of favorable outcomes no matter what their underlying physical problems. In a for-profit system, every part of the healthcare industry is for profit. That gives direct incentives to hospitals and clinics to adopt professional standards producing the highest returns, while the insurance industry finds every excuse to refuse or reduce payment on claims. The result is a system that is biased to provide the least possible care for the highest possible price. How does this work in the new pain clinic market?
In the parts of America where there are high concentrations of seniors or of people with chronic pain conditions, hundred of new pain clinics are opening. The majority operate as pill mills, i.e. their consultation system takes people off the streets, places them in a queue to see a doctor, gives the doctor a minute or so to write the prescriptions and then encourages the people back on to the streets. This would not be a problem if the doctors were only writing 72-hour prescriptions to cover people until their regular doctors can write the usual prescription based on their knowledge of their patient’s medical history. Sadly, the clinics are prescribing hundreds of tablets at a time and without limit on the more powerful and addictive painkillers.
The medical profession is refusing to rein in these outrageous prescription practices and using its lobbying powers to prevent state legislatures from imposing any controls. Individual counties are left with no alternative than to ban the establishment of new clinics. The moratoriums range between three and twelve months. Why a ban? Because addicts and pushers are using the lax prescription writing practices in these clinics to fuel an explosion in drug abuse. Responsible pain management teaches people how to live their lives with the least possible reliance on prescription drugs. For most practical purposes, this means using tramadol hcl over short periods of time to get the pain under control, and then cognitive behavioral therapy to help people cope more effectively. In this, the other advantage of tramadol apap is it is not a drug of abuse – it does not give a legal high. Without a ban on new clinics, people are simply encouraged into addiction. In the long term, this costs the healthcare services more to treat.