SIT and the co-disciplinary pain clinic

Clinicians in California described their clinical practice, which uses the simultaneous interview technique (SIT).

First the details.

• Goals
  • Evaluate and treat cases of complex, refractory chronic pain
  • Guide patients toward a shift in mind-set, from cure to self-care and preservation or improvement of functionality, despite pain
• Process
  • 3 healthcare providers were present to meet with the patient — SIT.
    • Anesthesiologist, board certified in pain medicine
    • Behavioral medicine psychologist
    • Physical therapist
  • After the interview and examination, a treatment plan was generated.
  • Treatment options included physical therapy, acupuncture, chiropractic, procedural interventions (including nerve blocks, epidural steroid injections, radiofrequency lesioning, etc), medication adjustment, behavioral medicine follow-up, and referral to other specialized mental healthcare treatments (eg, posttraumatic stress disorder treatment).

And, the results.

• Many patients had feelings of not being understood in consultations and high levels of anger toward providers in pain clinics.
• Patients were generally satisfied with the quality of care they received.
  • Excellent or Very Good regarding with the visit (84%)
  • Quality of care received (90%)
  • Perceived competency of the treatment team (90%)
  • Accuracy of the diagnosis given (90%)
  • Explanation provided about the treatment plan (94%)
  • Understanding the treatment plan provided (92%)
  • Effectiveness of the treatment plan (50%)
• Similarly, patients endorsed the responses Extremely or Quite a Bit in regard to…
  • Following through with the treatment plan (96%)
  • Perception that the team took their pain seriously (94%)
  • Listened to them (98%)
  • Courteous (100%)

The bottom line?

The authors believe, “by providing a different—better—experience at the first visit, providers can encourage patients to restructure their treatment goals and adopt more realistic expectations.”

The authors tell us, “It is believed that there is a fundamental difference between sequential and simultaneous interviews.” And, their practice is unique in that it’s not only multi- but also co-disciplinary, using SIT.

8/12/12 22:33 JR