The Doctor’s Pain Points

 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...

  JULY 2, 2022 I have to admit that I had no idea what a pain management physician was when I entered medical school. Truth be told, I did not even know that such a specialty existed. It all makes so much sense now but at the time I had not a clue. It was not until my later years of medical school that my career as I know it really started to take shape. At first, I wanted to be a heart or brain surgeon but then changed and set my sights on being an orthopedic surgeon. However, through fate, misfortune, or God’s calling, I did not match into orthopedics and instead trained in anesthesiology. It was during my anesthesiology training that I set my sights on being a “pain doctor.” As an anesthesiology-trained interventional pain specialist, I serve patients at the intersection of orthopedics, rehabilitation, counselor, diagnostician, and coach. I enjoy the work that I do and how I am able to help people. The interplay of pharmacological and biological knowledge and the technical sk...

How do you move your body? That is an important question to consider because being active is important for so many aspects of our lives. I firmly believe that “a body in motion stays in motion.” And that is a main reason why I treat pain patients; I want to keep them moving. Pain can often slow down movement to a point that daily activities becomes greatly constricted. A person who can only walk a   few yards before the pain is too severe has trouble grocery shopping, going out with friends or doing many of the “simple things” in life. It is important to move as much as safely possible. Routine exercise encourages the body to strengthen and is your best chance to fight off the shackles that pain can bring. Building a solid base when you’re young is best, but it is never too late to begin an exercise program. I personally enjoy strength-training but I am a proponent of essentially any physical activity that can be done consistently. Yoga, Pilates, dance, walking, swimming, hiking, c...

As a physician, I am often faced with decisions that affect how someone lives. I work as a pain management specialist and it is my job to help diagnose and treat the person’s pain. There is never enough time or enough answers from the tests to make a perfect diagnosis or formulate a perfect treatment plan. Even so, within this imperfect system, I strive to develop a plan that makes sense for each patient. It is exciting and difficult. It is an honorable mission and I am thankful to use my mind and my hands to improve the lives of so many others.  Because of the subjective nature of pain and an individual’s experience, there is no such thing as a copy-and-paste approach to pain management. Yes, there are protocols and guidelines that inform physicians and medical professionals on how to treat similar disease states. But we have to apply that general knowledge to each patient to make a plan that makes sense. And over time, as the pain changes, so too, does the treatment plan. I coun...

I t is important for doctors to remember the reason that we have customers… Patients are the customers that seek out our services because of an ailment or physiological need and our job is to aid in the diagnosis and treatment of their condition. It is truly an honor to serve in this role. However, it is quite challenging! From time constraints to cumbersome electronic systems to declining reimbursement and increased oversight and liability, it is easy for the doctor to lose track of the ultimate reason that he/she has a job.  I, too, have felt the burden of the bureaucracy and external pressures that are ever-present. When that happens, I try my best to tune in to the most pressing issue before me: serving my patient and understanding his/her needs. I am a pain management specialist and as such I deal with physical (and emotional) hurt all the time. The weight of my patient’s needs is heavy for sure. But I smile because I bring a little light into the sometimes dark world that my ...

  Dr. Ruben G. Alexander, M.D. is board-certified in anesthesiology and the sub specialty of interventional pain management. He has been practicing in the Las Vegas area since 2017. Dr. Alexander graduated as the valedictorian from Morehouse College with a perfect 4.0 GPA in the rigorous biology department. The next stop for Ruben was in Philadelphia. While in Philly, he attended the Ivy-League institution, The University of Pennsylvania. He completed medical school at Penn as a 21st Century Gamble Scholar extolling the virtues of scholarship and community involvement. He served as co-chair of Penn’s chapter of the Student National Medical Association and as a member of the Student Standards Committee. He had fun while in med school too by playing on the intranet-mural flag football team. After Dr. Alexander completed medical school, he competed an internship in general surgery at the Hospital of the University of Pennsylvania. In 2012, Dr. Alexander left Philadelphia and went to B...