Chronic pain, smoking, and obesity: a pain physician's perspective on patient selection.

摘要

When I evaluate a new patient, I view my initial role as being that of a consultant. As most of my patients are seen by referral, I generally consult to other physicians, nurse practitioners or physician assistants, and other healthcare providers. Occasionally, patients are self-referred and I consider my role in their evaluation as being a personal consultant for them. I take a comprehensive history, review records, perform an examination, and render an opinion. Other than attempting to formulate a differential diagnosis and treatment plan, I try to assess something very basic and fundamental before prescribing any treatment or scheduling a subsequent appointment. Do I believe I can help the patient? Are my goals for treatment consistent with those of the patient? Is the patient likely to follow my treatment recommendations?