| One-Minute Clinician

Lessons From a County Hospital: Pain Management How-To

I think the unique concepts or unique problems that we have at the San Mateo County Medical Center is 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 we can use, the number of hours in general. 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 homeless, many 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 work very hard to try to get them the proper resources so they can attend our clinics on a regular basis. Pain management is very difficult to manage if the resources are limited. There are ways to get around it. There are modalities that we use at our pain clinic that are not expensive, that are nonpharmacologic mostly. For example, we use mindfulness, we use meditation methods, we use acupuncture, we use some noninvasive procedures. Therapy is huge--physical therapy and mental health therapy--to try to manage pain. We try to work around our limited resources by getting patients in group settings, where they themselves can come in for a small time period but participate in a lot of different conferences, a lot of different classes without having to go back and forth. 

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