Lessons From a County Hospital: Pain Management How-To

Author: Elaine S. Date

Dr. Date works at a county hospital in San Mateo, California, where a lack of practitioners and the limited resources of patients contribute to the pain management difficulties in this setting.

I think the unique concepts or unique problems that we have at the San Mateo County Medical Center is that there's limitation of resources, first of all. There's a limitation sometimes in the number of hours that we can have at our clinic, the total number of clinicians that we can, the number of hours. But more than that, I think, is really the patient population and that sometimes they're very limited in their resources. For example, some of them are even homeless, many of them don't have the ability to get the fare to get on a bus to get to our hospital on a frequent basis. So we do work with that; we work with that very hard to try to get them the proper resources so they can attend our clinics on a regular basis.

I think pain management is very difficult to manage if the resources are limited. There are ways to get around it. There are very inexpensive modalities that we use, for example, at our pain clinic that are not expensive, that are non-pharmacologic mostly. For example, we use mindfulness, we use meditation methods, we use acupuncture, we use some non-invasive procedures to try to have patients... therapy is huge - physical therapy and mental health therapy to try to manage pain. So we try to work around it by using group settings - limitation for resources by using group settings, for trying to get patients in, in a setting where they themselves can come in a small time period so they can participate in a lot of different conferences, a lot of different classes without having to go back and forth. So that's how we try to manage with limited resources.

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