In Health Care, just like most areas of life, “more” is not “better.” In fact, some of the latest research by health services scholars has uncovered that too many treatment options can be as bad as too few. That’s where the “art” of medicine comes in: Balancing options, weighing risks and benefits, choosing from among many competing alternatives to find one that meets the needs of the patient, is safe and effective, and helps people lead as normal a life as possible despite pain. The providers at Columbia Pain Management, PC embrace this whole-patient approach to health and wellness and work collaboratively with you to find alternatives that work and help you reach your goals.

A doctor discovers an important question patients should be asked


March 9
This patient isn’t usually mine, but today I’m covering for my partner in our family-practice office, so he has been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, he is 88. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failure and renal failure. It’s a medical Catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.

Hemodialysis would break the medical stalemate, but my patient flatly refuses it. Given his frail health, and the discomfort and inconvenience involved, I can’t blame him.

Now his cardiologist has referred him back to us, his primary-care providers. Why send him here and not to the ER? I wonder fleetingly.

With us is his daughter, who has driven from Philadelphia, an hour away. She seems dutiful but wary, awaiting the clinical wisdom of yet another doctor.

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