Patient FAQ

The physicians of Valley Pain Consultants maintain the highest standards for patient care. We recommend that patients use the criteria listed below in their search for the ideal pain management physician/practice:

• Board-certification of physician (s) - The practice's physicians should be board-certified (or board-eligible) in Pain Medicine* by The American Board of Anesthesiology. Only physicians who have completed a 1-year fellowship approved by the American Board of Medical Specialties are eligible for this Certificate of Additional Qualifications in Pain Medicine.
• While there are other organizations that issue certificates in pain management, none of these require a physician to complete an additional year of training.
  *Approved ABMS Member Board General and Subspecialty Certificate
• Physicians are fellowship-trained at a program accredited by the Accreditation Council for Graduate Medical Education (if they completed residency after 1993).
  All Valley Pain Consultants physicians who completed anesthesiology residency after 1993 are fellowship -trained at ACGME-accredited institutions
• Practice has at least a 10-year presence  in the greater Phoenix area
  Valley has been a stable presence in the greater Phoenix area for more than 28 years
• Practice has a reputation for excellent patient care
  A patient's best resource for information about a pain management physician/practice is his/her primary care physician
• Practice takes a multi-disciplinary approach to pain management
• Patients are seen by a physician at their initial visit and their care is supervised by physicians throughout their time in the practice (link)
• Practice takes a comprehensive approach to treatment
• Documenting a detailed medical history and thorough physical examination at initial visit
• Offering patients and performing a wide array of treatment options
  Valley's interventional pain management physicians offer patients the widest array of treatment options in Arizona.
• All physicians are credentialed at hospitals throughout the community (Phoenix, Scottsdale, Glendale, East Valley and West Valley).
  Valley's physicians are credentialed to provide services at hospitals throughout the greater Phoenix area, including Scottsdale, Glendale, Peoria and Mesa. What this fact means to patients is that if a Valley patient is admitted to a local hospital, a Valley Pain Consultants physician can provide interventional pain management care to them.

From the American Society of Anesthesiologists:
"Interventional pain management by unqualified providers presents serious risks to patients, such as persistent or worsened pain, bleeding, infection, nerve damage, brain damage, paralysis or even death. Therefore, it is the position of the American Society of Anesthesiologists that interventional pain management of patients suffering from chronic pain constitutes the practice of medicine. Appropriate medical training is necessary to evaluate, diagnose and safely treat patients suffering from chronic pain and to respond to complications of treatment should they arise. The public safety requires that interventional pain management in statute and regulation as clearly recognized as the practice of medicine and the interventional treatment of pain is provided only by qualified MDs/DOs."

Acute pain is of short duration, usually the result of an injury, surgery or illness.

Chronic pain is an ongoing condition, often in the back, neck, head, as wells as neuropathic pain (nerve injury pain), musculoskeletal pain, and pain related to illness. Your physician may refer you to Valley Pain Consultants because your chronic pain condition has not responded to conventional therapies.

Treatments for acute and chronic pain are generally quite different. In some cases, acute and chronic pain can be stopped or alleviated by a single procedure or series of procedures. Sometimes, chronic pain is part of a widespread disease process, and the specific cause may be difficult to pinpoint. Once we have identified the specific factor causing the pain, we may be able to treat it so that the condition no longer occurs. In some patients, the specific factor causing the pain--such as cancer--cannot be changed, but we may be able to reduce the pain or help the patient to better cope with the pain through a combination of medical, psychosocial and rehabilitation techniques.

While there are a multitude of conditions that may lead to chronic pain, we have found the following to be most prevalent conditions in our patients:

• Back pain
• Failed Back Surgery Syndrome
• Headaches
• Fibromyalgia
• Joint Pain
• Muscle Pain (Myalgia)
• Neck pain
• Nerve Pain
• Osteoarthritis
• Sports Injuries
• Work-related Injuries

Detailed information about chronic pain conditions is found in the Conditions and Treatments section.

Pain is a complex medical problem that can have profound effects on your physical and mental well-being. The goal of pain management is to help you decrease your level of pain and suffering, to return you to your maximum level of functioning and independence, and to help you restore your quality of life.

Seek out a pain management specialist when pain does not respond to the usual and customary treatments within a reasonable period of time. All too often, people see pain management as a last resort for pain, instead of a first stop on the road to wellness. Be aware of your body and take note when you are in pain. If that pain persists — contact your doctor or a board-certified pain management specialist immediately.

Due to the complexities involved in the treatment of pain, pain medicine is recognized as a separate medical subspecialty by the American Board of Medical Specialties. Physicians choosing to specialize in pain medicine must now complete a one-year multidisciplinary pain fellowship in addition to successful completion of four years of medical school and four years of anesthesiology residency or appropriate residency training in physical medicine and rehabilitation, neurology or psychiatry. Medical school is a four-year program, where the first and second years are spent learning the scientific principles of human anatomy and physiology, biochemistry, pharmacology, genetics, microbiology, immunology, pathology of disease states, and similar courses in both the natural and behavioral sciences, as well as in introductory clinical experiences. The third and fourth years of medical school are devoted to full-time clinical rotations and clerkships where the medical student is introduced to the comprehensive clinical care of patients, primarily in the hospital inpatient setting. After successfully completing a residency program and a one-year pain medicine fellowship, they may apply to enter the examination process leading to board-certification in Pain Medicine. The requirement for multidisciplinary pain medicine fellowship training is recognized by the Accreditation Council for Graduate Medical Education who oversees and accredits the programs.

Chronic pain can become so intense and overwhelm the body and mind to such a degree that it can affect all areas of life. People become so afflicted that they often cannot work. Their appetite falls off. Physical activity of any kind is exhausting and may aggravate the pain. Often, the person becomes the victim of a vicious cycle in which total preoccupation with pain leads to irritability and depression. Adding to these ailments is the fatigue sufferers experience from not being able to sleep at night.

In other cases of chronic pain, issues of secondary gain may arise. This may develop when patients associate pain with some form of benefit — as when a sufferer has a coworker help out at work, or a spouse is extra- supportive. In these cases, the sufferer may receive a benefit for not treating the pain effectively.

At Valley Pain Consultants, we work with our patients to identify and alleviate these issues.

While drug therapies differ for each person, the most common are:

• Adjuvant pain medications, including: antidepressants, anticonvulsants and muscle relaxers.
• Opiates or "pain killers" used to treat acute pain or cancer-related pain, and often prescribed for chronic pain.
• Anti-inflammatory drugs to alleviate pain by reducing swelling and irritation.

There are alternative delivery methods for medications. Common methods used by Valley Pain Consultants are oral medications, topical creams, sublingual medicines, nasal sprays, injections and patches.

Most payers provide guidelines for pain management treatment. Please contact us for more information.

At the initial visit, you will be evaluated by a pain management physician. You will be asked questions about your medical history and a thorough physical exam will be performed to evaluate your areas of pain. Please bring all MRI, X-Ray results (written reports, NOT films) to your visit. If you have the films, we encourage you to bring them with you. Also, make sure you bring your insurance card and driver's license.

Patients of Valley Pain Consultants are appointed with a pain management physician at their initial visit. All of our patients are assigned a pain management physician to supervise their care.

The decision to prescribe a medication at the patient's initial visit is at the discretion of the Valley Pain Consultants provider; factors impacting the provider's decision include:

• the detail and quality of the health records provided to our practice
• whether further diagnostic testing is required

Patients choosing to use physician-prescribed "Medical Marijuana" as a treatment for chronic pain or other conditions will not be prescribed oral or transdermal opiate medications by Valley Pain Consultants providers.

The rationale for Valley's policy is listed below:

• The use of marijuana remains in violation of federal law.
• Tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana, concurrent with prescription medication use, has been associated with dangerous and unpredictable drug interactions, unpredictable behavioral changes and psychosocial changes in people.
• THC  has been studied for the relief of pain. In study of patients with dental pain, it was determined that the pain-relieving dose of THC also produced dysphoria (bad or uncomfortable emotional feelings).
• Medical Marijuana, like alcohol represents, a drug that the patient uses to self-medicate, without any dosing guidelines, and is potentially intoxicating and addictive.
  • Self-medicating with marijuana is frequently mood altering, and can be unpredictably unsafe at times.
  • While a "medical marijuana" card may be issued in Arizona by a physician to a patient to document a disabling condition leading to legal use of marijuana, such use still represents, by its very definition, marijuana that is being used to self- medicate, often leading to intoxication.

The Valley Pain Consultants policy relative to positive Urine Drug Testing (UDT) for patients with marijuana prescriptions will be identical to that for patients with positive UDT results for non-prescribed marijuana.

Exceptions to the Valley Pain Consultants medical marijuana policy may be made, at the physician's discretion, for patients with a terminal illness.

Yes, Valley Pain Consultants is a referral-based practice. Therefore, even if your insurance doesn't require a referral, our physicians required a referral from your primary care physician or other medical provider in order to schedule an appointment.

Please refer to the individual procedure description on the Procedure Information page.

Because many medications are controlled, you need to be seen on a regular basis to continue getting prescriptions for these medications. We are unable to refill or prescribe controlled substances after hours, on weekends, or on holidays. Also, we are unable to give prescription refills at surgical facilities on dates of procedure.

We are unable to replace lost or stolen prescriptions.  You will need to be evaluated in the office by a provider in order to receive an alternative medication. Certain medications can cause withdrawal-like symptoms if discontinued without titration.  You may need something to help with the symptoms that might occur.

We recommend that you allow the new medications up to 2-6 weeks to take effect. Due to adverse effects, we are unable to change controlled substances on a frequent basis.

You will need to send a written request for your medical records, by mail, to your primary Valley Pain Consultants office address. The typical response time is five (5) business days following receipt of the request.

All pain medications should only be prescribed by a Valley Pain Consultants provider. Medications other than pain medications can be prescribed by other physicians. Please let us know as soon as possible if you have received any medication from another healthcare provider (including dentist, emergency department).

A provider is on call 24 hours a day, 7 days a week to assist with emergent situations. To contact us after hours, call the office number. Please remember that we are unable to prescribe controlled substances after hours, on weekends, or on holidays.

Your pharmacy will contact our offices if there is a problem getting a medication approved through your insurance company. We will then attempt to get approval on our own; however, there is no guarantee that a medication will get approved. We may need to change your medications and/or you may need to pay for your medications on your own.

While we prefer to provide care at a single office, our electronic medical record enables our providers at all offices to access your health information. Within reason, our schedulers can appoint you at an office that is most convenient to you.

All controlled medications and many other medications we prescribe can cause drowsiness and alter your judgment. It is recommended that you take great caution and avoid if possible operating machinery that may cause harm to you or others. Please follow the pharmacist's instructions carefully as well as those listed on the prescription.

Yes, as a courtesy to our providers and our patients, Valley has implemented a "Cancellation/No-Show" Policy.

For the healthcare provider or health plan, the Privacy Rule requires activities, such as:

1. Notifying patients about their privacy rights and how their information can be used.
2. Adopting and implementing privacy procedures for its practice, hospital, or plan.
3. Training employees so that they understand the privacy procedures.
4. Designating an individual to be responsible for seeing that the privacy procedures are adopted and followed.
5. Securing patient records containing individually identifiable health information so that they are not readily available to those who do not need them.

A copy of the Notice of Privacy Practices can be found in the Patient Information section of the website and on the bottom of every page of the website. Patients may also request a copy of the Notice of Privacy Practices brochure at the front desk of VPC offices.