On Finding (and Keeping) a Pain Management Doctor

Five days ago, Jenny Ryan posted the following Tweet:

Has anyone here ever seen a pain management specialist? If so, do you have any advice on how to find one, what to ask, etc.?

This is my response:
Pain management doctors (PMDs) purposely try to avoid calling attention to themselves lest they attract drug seekers, fond of self-injury, carrying altered prescriptions. But you can ask for referrals to PMDs at the usual places you'd find folks who are familiar with drugs: your PCP, health insurance providers, support groups, and your local high school parking lot.

Your PMD will refuse to call in prescriptions for you. And every prescription he/she will write will have no refills, even though he will go on vacation when a refill is needed and forget to tell you. He/she has no idea how you will react to a certain med, so some experimentation is in order initially. The dose is intended to "manage" pain, not cure it, and PMDs tend to think that pain at 5 or below is good.

You must be a delightfully compliant patient, with an alert yet relaxed disposition. During your appointments, you should endeavor to make good eye contact and resist the urge to glance furtively at your watch or the window or especially the cabinet that houses the drug samples. Suppress all nervous tics, hand wringing, rocking, scratching, tapping, shaking, etc. Otherwise you will be suspected of an addiction.

It's okay to ask for a specific drug. But when the PMD mentions the name of a drug, "Vicodin," for example, it's not a good idea to respond with, "OOOh yeah, that's good stuffcanigetthatpleaseohpleaseohplease!" Perhaps you should not bring your husband with you.

Some of this is in jest, but not all of it.

One last thing. My wife despises her PMD.