Ask the Expert – Anesthesiologist
Q: Why is my Pain Physician an Anesthesiologist?
This is a great question, and is one that I am even asked by other physicians! Many people believe anesthesiologist just “put people to sleep” for surgery, but being an anesthesiologist has a much broader spectrum of responsibilities.
Anesthesiology is a unique specialty in medicine that involves caring for patients of all ages in the preoperative, intra-operative and postoperative periods (or said another way: before, during and after surgery). This includes examining and assessing patients before their surgeries to make sure that all of their medical conditions (everything from diabetes to high blood pressure to chronic pain) are in the best state possible for surgery. Then we care for patients during their surgeries and ensure that they are free of pain and safe by managing all of their medical conditions and as well treating anything that arises during surgery (which in and of itself is quite a broad list!). Once surgery is done, the Anesthesiologist’s job is not over, as we then manage our patients throughout their recovery in the Post Anesthesia Care Unit (or PACU for short). A vital part of this postoperative care is of course treating any pain that the patient may have after surgery. When possible, we even work to prevent pain from occurring in the first place by performing nerve blocks, epidurals, spinal blocks, pain catheters and/or other procedures before or during the operation.
In addition to the operating room, if you have ever had a baby, you most likely came into contact with an anesthesiologist as well because we play a big role in treating the pain of labor through our placement and management of epidural catheters and nerve blocks. You will also come across Anesthesiologists in Intensive Care Units (ICU’s) as Critical Care specialists taking care of the most seriously ill patients (of course this also includes making sure that their pain is well controlled). So as you can see, treating pain is an essential and large part of what every anesthesiologist does every day!
As leaders in the treatment of pain in perioperative medicine, it was only natural that anesthesiologists were among the first Pain Medicine specialists in the outpatient area as well. All of this knowledge and expertise in the treatment of pain surrounding surgery was further developed and applied to the treatment of those with chronic pain conditions. In fact the American Board of Anesthesiology was the first to offer subspecialty Board Certification in Pain Medicine (in 1993). Lately there has been a trend of other types of physicians (such as physiatrists or rehab physicians) seeking training in Pain Medicine as well, though the vast majority of Board Certified Pain Medicine doctors are still anesthesiologists.
In order to be eligible for Board Certification in Pain Medicine, a Physician must first complete four years of medical school, complete four years of an anesthesiology residency and then an additional year of specialized training in Pain Medicine (called a Pain Fellowship). Once done with residency and fellowship, Pain Medicine specialists must complete an extensive set of examinations (including several written and oral exams) to become Board Certified in Anesthesiology and as well in Pain Medicine.
I know that these terms can become confusing, but it is essential to seek the care of Pain Medicine Doctor who has completed an accredited Fellowship in Pain Medicine and is Board Eligible or Board Certified in Pain Medicine. The good news is that here at Arizona Pain Specialists, all of our Pain Doctors are Board Certified anesthesiologists who have completed accredited Fellowships in Pain Medicine at the top programs in the country (Harvard, MD Anderson, Cleveland Clinic, and Texas Tech), so you are in great hands…
- Arizona Pain Specialists
Q: My prescriptions are starting to cost more and more. Is it safe to buy my medications online?
Since you can buy practically anything online, and often for cheaper than in a brick-and-mortar store, it may seem like prescriptions would be a great item to purchase online. Additionally, many of us receive emails daily announcing that you can buy cheap prescriptions from their online pharmacy. With all of that advertising paired with the fact that many people are having a hard time affording their prescriptions, it seems like there can be no harm in purchasing your prescription medications online. However, it is important to be extremely careful, as there are some online pharmacies that can be very dangerous.
Some illegal online pharmacies may dispense medications that may have incorrect or dangerous ingredients, may be too strong or too weak, may have expired, and may not have been FDA approved. There have been cases of unmarked higher dosages causing fatalities, as people are unintentionally taking two or more times their regular prescribed dose of medication.
Even with the warnings against ordering your prescriptions from online pharmacies, there are legitimately safe online pharmacies and they can be extremely convenient and can save you money. Safe pharmacies often have recognizable names and are from the United States. There may be safe and legitimate pharmacies in other countries, but they often do not have to comply with the same FDA and safety standards that pharmacies in the United States must adhere to.
There is an online verification website where you can check the legitimacy of an online pharmacy. Hosted by the National Association of Boards of Pharmacy, this website will allow you to find out if the online pharmacy you wish to order from is in the national database, alerting you to the potential danger of a pharmacy that is not verified. According to the verification website, they have reviewed close to 7,000 online pharmacy websites – and only 280 or about 4% were verified as practicing safe dispensing practices and adhering to pharmacy laws and standards of care. With statistics like that, it is extremely important to make sure that the pharmacy you are ordering your medications from is safe.
The National Association of Board of Pharmacy website for verifying online pharmacies is: http://vipps.nabp.net/. Copy and paste the URL of the online pharmacy into the text box at the bottom of the webpage.
-Paul Lynch, M.D.
