That seems to be the reality. I have a pain doc(anesthesiologist)who manages my pain pump. I have never gotten any pain relief to date. So, how does he actually "manage" my pain"? Beats me. After more than two years, I am in more pain than when I first saw hi. No amount of asking, begging, pleading seems to make any difference. He lacks any empathy and usually brushes me off as quickly as possible.