Taking the Pain Out of Pain Care
By Steve Luker,
Like many of his fellow baby boomers, Carl Bennett is starting to feel the effects of nearly 60 years of active lifestyle. As a patient, Carl has received treatment for his low back pain -diagnosed two years ago as degenerative disc disease -mostly in the form of pain medications. With his dependence upon these medications and their ever-present side effects, the chance of ever returning to an active lifestyle seems impossible. But what are the alternatives? "I know a little bit about pain clinics," Bennett said, "but 1just don't want to be drugged up on more medicine." As Bennett and others like him seek an alternative to medication-centered pain care, a new kind of pain clinic is ready to meet the demand for quality clinical care of axial spine pain with minimally invasive procedures to reduce patients' dependence upon pain medication. Utah Pain Specialists
was founded as a natural progression of the pain clinic established by Dr. John English, M.D., in Salt Lake City, UT. These days, a team of three accomplished and highly specialized pain doctors is taking the clinic into a new and innovative direction to meet the needs of patients such as Carl Bennett -patients who want relief from spinal pain but are concerned about dependence upon medication.
MISSION AND PROCEDURES
Dr. Kyle Matsumura, M.D. -who joins Dr. Arun Rajagopal, M.D., and
Dr. Rajiv Shah, M.D., in heading Utah Pain Specialists –explained the mission of the clinic. "We try to find why the patient hurts, and where, and try to design a therapy that eliminates the pain to get them back to a normal lifestyle." Dr. Matsumura continued, "A lot of clinics ramp patients up on opioids and pain medicines and our goal is to try to get the patients off the pain medications in addition to getting their pain under control and return them back to more active lifestyles." The progressive advancements in pain care made by these specialists are not limited to their efforts to reduce dependency upon pain medication. Utah Pain Specialists offers a wide range of cutting-edge clinical procedures in one setting. A sampling of these procedures includes such specialty modalities and procedures as vertebroplasty, radio frequency lesioning, spinal cord stimulators. They also offer diagnostic procedures such as discography. Dr. Rajagopal added, "We do a lot of other procedures also, in terms of basic epidural steroid injections, selective nerve root blocks, and things of that nature. Our website- www.utahpain.com -has a little FAQ section that lists all the different procedures that we do, and what the patient can expect and so on."
Dr. Shah offered a specific course of treatment for patients who, like Carl Bennett, present with lumbar pain: "For degenerative disc disease in the lumbar spine that is causing pain in the lumbar spine. We can offer nerve blocks. Also associated with this degeneration of the disc is a joint which is narrowed and sometimes you see improvement by treating the facet joint in anywhere on the spinal column where you have degeneration." He concluded, "That is sort of the preliminary procedure we would do, along with the physical therapy. And if there is more degeneration which is causing more narrowing of the disc, we do consider spinal stimulation."
If his doctor orders it, these procedures will be "just what the doctor ordered" for Carl Bennett, progressive and thorough clinical pain management. Rajiv Shah, M.D. sets the goal to reduce dependence upon medication, returning Carl to an active lifestyle.
Of course, the procedures offered by Utah Pain Specialists are only as good as the doctors who provide them. The doctors who staff the clinic -each board certified by the American Board of Medical Specialties in pain management -bring with them diverse and accomplished backgrounds that enable them to bring to their patients the latest innovative treatments and quality of care that both patients and referring physicians seek in a pain treatment clinic. Of the three doctors at the clinic, Kyle Matsumura, M.D., is the only native Utahan. He was born and actually grew up in Roy, UT. The most senior member of the practice, he has been part of the clinic for about eight years and was a partner with Dr. John English during the earlier phases of the practice in Salt Lake City. He attended medical school for three years at the University of Utah and then studied at Stanford University for part of his scholarship year. He specialized in anesthesiology and pain medicine. Upon completing his specialty, Dr. Matsumura joined Utah Pain Specialists. Dr. Matsumura also sits on the Medicare Clinical Advisory Committee for the state of Utah, where he currently serves as Chairman.
We see pain management entering a very exciting growth phase. We're going to see a sort of groundswell of patients seen for the low back and other changes and the last thing we want to do is take these patients and dump them on a whole lot of medications and nothing else. So we're utilizing cutting edge, state-of the-art technology to help get them off medication and give them some degree of functionality.
Dr. Rajiv Shah, M.D., also a specialist in anesthesiology and pain medicine, is a newcomer to Utah, though he has quickly laid down firm roots in the area. He came to Salt Lake City three-and-a-half years ago after finishing a fellowship at Loyola University in Chicago. He stated, "At that time this practice was a really growing practice and I approached them here and it sounded like a really good practice to me.” So I came here and now we are not going to move since my wife is now doing her practice in Salt Lake."
Dr. Arun Rajagopal, M.D., moved to Utah three years ago. Before that he was on faculty at the MD Anderson Cancer Center in Houston, where he was the director of a fellowship program for five years before joining Utah Pain Specialists. "The reason we moved up here is because my wife's family is from here and we decided this was a better place to raise kids, so it was more of a family decision." Dr. Rajagopal brings with him a unique academic background, having published papers in the field of pain medicine. This background, in part, contributed to his views on controlling patients' pain while reducing their dependence upon medication. Referring to a study he published in the journal Pain Medicine citing the improvement of sexual function in cancer patients after reduction of opioids (Volume 4, Page 379 , December 2003), Dr. Rajagopal stated, "That study was about the cancer population but certainly applies to any chronic pain population . That's another reason why we offer these procedures in our practice, instead of offering just pills. People just don't take into account the side effects of these things." He continued, "A lot of times you never talk to your doctor about things like sexual dysfunction. So we think that with the product that we offer-to try and restore function and not rely on too many pills-we will at least get them to function better."
These three specialists formed Utah Pain Specialists and found that, together, they had a chance to make progress in the treatment of axial spine pain. Dr. Rajagopal explained, "We realized about maybe a year or two ago that the three of us are: a) good at what we do and b) have the same common goals. As our practice here became busier and busier and we were offering some of the more current modalities and also getting a lot of relation ships with other docs, we decided that it was high time we established our own practice. There's nothing else like this in the valley, anywhere."
Another member of the team is nurse practitioner Tracy Call-Schmidt, FNP-c. She was previously on faculty at the University of Utah, has extensive experience in pain management, and is a certified addictionologist. Tracy has extensive experience dealing with challenging patients in a compassionate and knowledgeable manner.
Of the various paths in medicine, academia and clinical pain care have led these three doctors to the Salt Lake Valley. Now, along with the new direction they are taking in pain care comes a brand new facility for Utah Pain Specialists, located at 6300 Medical Plaza (6321Redwood Road) in Salt Lake City. Situated in a central location in the valley, this brand new building was completed just a few months ago Arun Rajagopal, M.D. and was built from the ground up and designed as a medical office building. Utah Pain Specialists has leased about half of the first floor -just about 8,000 square feet. "It's going to be sort of the flagship pain clinic for our practice," Dr. Rajagopal stated, "We've also planned for future expansion by having three procedure rooms and expanded facilities for possibly adding a CT scanner down the road and other things like that." The maxim in real estate is also true in medicine, it seems -location is everything. It is about less than a 10 minutes drive from the new facility to at least four of the major hospitals, including the new IMC hospital on State Street. Prior to the building of this medical office building, a demographic study of the whole valley was conducted that took into account location, proximity to hospitals and the expansion of the city on the west side. "The builder wants to establish this building with young practices that are sort of complementary," Dr. Rajagopal stated, "so we're the ones who have sort of planted the flag for pain management in the area and we're going to eventually use that to build some synergies with other practices." With its first-floor location, handicap access, electronic records systems and expanding clinical space, Utah Pain Specialists is painlessly and effectively meeting the needs of their patients on many levels.
A lot of clinics ramp patients up on opioids and pain medicines and our goal is to try to get the patients off the pain medications in addition to getting their pain under control and return them back to more active lifestyles.
The growth and progression of this clinic seem to be necessary steps in the management of patient axial spine pain, as well as most medical specialties in general. Clinics that cannot effectively increase patient load and quality of care will find it increasingly difficult to build trust with referring physicians and their patients. This is in large measure due to patients such as Carl Bennett -baby boomers who are beginning to see signs of wear and tear, and who desire to relieve their pain and resume an active lifestyle.
Dr. Rajagopal has foreseen this challenge and is, along with his partners, ready for it. "We see pain management entering a very exciting growth phase. We're going to see a sort of groundswell of patients seen for the low back and other changes and the last thing we want to do is take these patients and dump them on a whole lot of medications and nothing else. So we're offering cutting-edge, state-of-the-art technology to help get them off medication and give them some degree of functionality."
An example of the strategy Utah Pain Specialists has in place to deliver quality of care is an online program called Fast Track. This program enables a referring physician to order a procedure with one click, which prints an online form to request the procedure. The form is then faxed to the clinic, which will have the patient's procedure done within 48 to 72 hours.
All of that is good news to Carl Bennett, except that he lives four hours away from the new clinic and is not sure his physician can refer him to Utah Pain Specialists. "We get patients that come to us from all over -Northern Utah, Wyoming, Idaho," Dr. Rajagopal stated. Dr. Matsumura concurred, "We actually get referrals from San Francisco, Phoenix and Oklahoma. It's pretty amazing. It's word of mouth or something, but we get a lot of referrals." With the new clinic opening up this month, maybe Carl will be one of them.
Utah Pain Specialists, 6321 S. Redwood Road, Suite 102, Taylorsville, UT 84123. Phone: (801) 685-PAIN (7246). Fax: (801) 747-5487.