This has just my experience and interpretation. They just want to bounce you around and each specialist only has a very narrow lens that they look through, so nobody really can put together the whole picture. I saw the Chief of Pain Medicine there, and he was more interested in telling me about stuff he has published than actually creating a plan for me. He just ended up saying "you could try this, or this I guess", and it was up to me to find a clinic who would do the things he suggested. That was it. There's is some variability. I've had some luck with one or two of their orthopedists actually trying to do something, and an occasional resident PCP who cares enough to actually try to look.