Home Health Care for Pain Management

Posted by vicinsoflo @vicinsoflo, 4 days ago

Hello - I am having difficulty finding an in-home pain management physician for my husband. His current PM dr. is requesting that he get medically transported to his monthly appointments, since physically going there has become too painful for him. He has gone through the gauntlet of PT and injections. His condition is too severe for minimally invasive procedures and the surgery he would need (complex multilevel reconstruction) carries such a high risk (plus multiple surgeries) he wants to stick to pain management, however, with such strict opioid guidelines, his dr won't increase his dosage. He doesn't qualify for hospice and most concierge physicians won't provide on-going pain management. Does this not exist? Thank you.

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For a pain physician to leave their office practice to see one patient might require some juggling for the physician and their practice. There are a number of things the physician has to consider. Does their malpractice insurance cover them for services performed at a patients home? The loss of visit time in the office that travel would require may be too complicated for an office based practice to attempt. The Medicare world covers home care for visiting nurses if the patient is home bound. You are asking a very unusual question I must add. As you know most pain doctors require periodic urine tests to check for drug levels in their patients and to see if they are taking any other drugs they didn’t prescribe. To obtain a urine for drug screen a special process would need to be arranged and with great difficulty I will add. This is very unusual and requires very specific handling of the specimen. This just adds to the difficulty for the physician and their practice. I am sorry for your situation.

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Now a days, I do not know any doctor that does house calls. Even when I called my insurance company to find me such a doctor they could not.

The only option is ambulance transportation. Some insurances do cover this expense. Depending on where you live there might be a volunteer ambulance squad which might help for free. Otherwise a paid service is your only option.

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@vicinsoflo Hmm, maybe you need to think "outside the box" here to get what your husband needs? I wonder if it is possible to arrange a nurse-attended video visit with the doctor?
Maybe a visiting pain management nurse visit can be scheduled to coincide with video visit with the pain management doc? The nurse could then do assessments under the doctor's direction, and obtain any needed blood or urine samples. It would take some coordination, but better than taxing your husband with traveling while in extreme pain.

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