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Why do I have to fill out your packet that is more than 12 pages long when you have my chart notes?

That is a good question! Our health information questionnaire tells us about you from your own personal perspective. It gives us insight on how you feel about the treatments and medications you have tried. It is your chance to tell us your medical treatment journey, what you have done and where you want to go in the future. Your attention to detail and completion of the entire form is critical to achieving good results!
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What is a Treatment Agreement?

Your health and safety is our primary concern. This agreement outlines important safety and regulatory issues concerning proper medical use of controlled substances. Among other expectations, we stress the use of one pharmacy and one physician for all your pain medicine prescriptions. We require you to take your medications as prescribed, bring your pain pills and pill bottles to each appointment, and submit urine specimens for testing on a regular basis. You must not use other intoxicating substances such as alcohol or marijuana or other unprescribed substances. If you are impaired in any way, you must not drive or operate machinery. You cannot give or sell your medication to others, or take someone else's pills. Medications must be locked up at all times to protect others. These and other concerns are part of a treatment agreement necessary to safely prescribe narcotics and/or controlled substances for the management of intractable pain.
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Why do I have to bring my prescribed medications to every appointment?

Your health and well-being are our primary concern. We must be sure you have been prescribed the right medications, in the right quantities, and that you are able to take these successfully as prescribed.
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Why do I have to bring in all my medications, vitamins and herbal supplements in their original bottles?

We must be sure we know exactly what our patients are taking to avoid medication interactions or dangerous adverse effects. Original bottles help us avoid medication errors and interactions. We appreciate your cooperation. Bags, boxes or back packs are excellent for transportation on the day of your appointment. Remember to keep the controlled medications and narcotics in a locked container!
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Why do I have to give a urine sample?

It is not our intent to offend or embarrass you in any way by our request for a urine sample. Because it is vital that we know what is in your system before we prescribe medications, we do not discriminate nor do we single people out. We treat all patients equally. Everyone gives a specimen! It is also important to monitor medication levels in your body as your treatment progresses. This is for your protection, your health and your well-being. It allows us to give you the best care possible.
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Why do I have to make an appointment to get my prescriptions?

As stated in the Treatment Agreement, “regular office visits are required and a necessary part of pain treatment.” Use of controlled substances must be monitored very carefully. For your health and safety, we require regular appointments to monitor your response to your pain management program. There may be a need to change or adjust your medications, recommend other therapies, or try the newest and best treatments based on medical evidence.
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Why do I need to have a Primary Care Physician to be referred to your office?

Pain management is only a portion of the full spectrum of your overall medical care. It is important we work in concert with your primary care provider. We provide expertise in pain management while your primary care provider integrates that therapy into your broader medical needs.
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Why doesn’t the doctor prescribe narcotic medications on the first visit?

Initial visits are designed to diagnose and recommend treatments to you and your referring provider. This consultation provides suggestions that must first be approved by your primary provider. If you have been prescribed narcotic pain medications previously, that provider must continue to prescribe for you until these recommendations can be confirmed. In order for us to prescribe subsequently, you must be seen at a return office visit where you will participate in an informed consent discussion, sign a treatment agreement, submit a urine sample, and complete a material risk form as required by the state of Oregon. Exceptions require specific communication in advance from your referring physician.
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Do I have to have a lock box?

Yes. It is important to keep all medications in a safe place. This is for your protection as well as for the protection of your family, friends and neighbors. As stated in the treatment agreement, “you will take reasonable safeguards to protect medications from theft including lock and key.” And a lock box allows you to safely transport your medications to your appointment, as required by the treatment agreement.
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Can I fill my medications early?

No. Why? Because you must take your medications as prescribed. We stress in your treatment agreement that “you will not use up or run out of medication early. You will not allow medication to be lost, stolen, ruined, misplaced or left behind. You understand that medications will not be replaced or filled early. You will take reasonable safeguards to protect medications from theft including lock and key.” Be aware that most insurance companies will not allow you to fill your medications early. (In the occasional situation where travel out of town is required, your insurance company may allow an earlier fill. However, subsequent fills will be back "on schedule" and travel is not an excuse for deviating from your prescription directions.)
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What are trigger point injections?

Trigger points are usually small areas of tightly knotted muscle and connective tissue that cause localized and referred pain. By injecting anesthetic medicine into these points the muscle can relax so you can gently stretch the tissues back to normal length, bringing lasting pain relief.
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What is biofeedback?

Using specific, sensitive instruments you will learn about measurable body functions normally controlled by the "automatic" nervous system. Examples include muscle tension, heart rate, respiratory rate, skin temperature, skin resistance, brain waves, etc. With expert training you can consciously learn to control these systems that markedly influence your pain experience. Studies indicate a high success rate in treating specific pain conditions, from migraine to back pain to fibromyalgia and more.
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