(Re: Volume 25, Issue 4, Page 35) Hi. Steve: I read your interview in The American Chiropractor, and I applaud you for stepping "out of the box" and deciding to render the very best care you can muster to your patient. Keep up the good work. [At Pain Management Specialists of Indianapolis], we've been doing something similar for eight years now, and I can say quite unequivocally that this is one of the pathways to mainstream medicine for the chiropractic profession. We have 20,000 sq. ft. of office space with an Am- bulatory Surgery Center (ASC) that addresses both acute and chronic pain patients, by means of a vertically integrated, single-site, team-medicine approach. Our Medical Department is integrated with our Rehab Department, and Psychology Department, and they all address the patient in contemporaneous fashion. Our outcomes over these past eight years have been quite surprising, if not outstanding. I am convinced that this method is one way of accessing those patients who have never been to a DC, or who have misgivings about chiropractic care. Once they are evaluated in our office by any one of the medical staff physicians, be it MD, DO, or DC, they are challenged to stick it out for an introductory period of at least two weeks, and then decide whether they are being helped or not. The use of prescription medications, trigger point injections, or interventional procedures by our anesthesiologists in the ASC. together with undergoing concomitant functional restoration in our Rehab Department usually will move the patient to the next level. Our patient "Satisfaction Surveys" and "Outcomes Measures" tell us that we're on the right track—and I think that you are too. We've been at this particular game for a lot longer than you, and we are still refining internal pathways. However, I agree with you that this kind of practice is an exciting one, and one that I can't wait to get to every morning. I start at 7:00 AM and finish at 7:00 PM—and I've been in practice for thirty-two years!! It's unfortunate that some of our colleagues have tainted this concept of MD/DC by trying to take advantage. However, once all those folks have been prosecuted and put in jail, we can continue to do the right thing for the patient. Good Luck, and keep on keeping on! Peter G. Fitnw.D.C. Indianapolis, IN www.amchiropractor.com
