Jump Through Hoops
JULY 9, 2022
Imagine if someone that you never met told you that you had to wait to move into your house that you bought through a licensed realtor. Or suppose you could not drive your beautiful new car that was sold to you until some random person looked things over but not until 3 to 4 weeks after the sale. It just seems crazy, right?! Well, that’s how many of the tests and procedures are handled within pain management. As a doctor, I perform a thorough history and examination and document my reasons for ordering a test or interventional injection procedure. However, the patient’s insurance company is often giving the yes-or-no response before anything is done. Worse than a delay is the often confusing and vague reasons for denial.
This is unfortunately all too common in medicine as a whole and pain management in particular. There is medical evidence that serves as guidelines for treatment but often the decision-making control is wrestled from the doctor and is placed under the purview of bureaucrats. As a physician, much of my training goes into understanding of the person in front of me and how the pain is affecting his/her quality of life. From that interaction, my judgement and the scientific evidence inform the decisions that I make on behalf of the patient. Often, suffering is prolonged because of the hoops that must be jumped so that medications, testing and procedures are approved and paid for by the insurance company. Even so, I do my best as an advocate for the patient despite the convoluted processes we face. Both the doctor and the patient must answer to the faceless third party but the goal remains the same… Never give up on striving for a better quality of life.
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