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Understanding Suspicion in the Emergency Room continued...

But ER doctors also rely on instincts, Blumstein says. “It’s all perception. It’s the whole gut impression that the health-care providers get about you.”

So how can a patient with chronic pain convince the ER staff that his or her complaints are legitimate? Here are a few tips from the pain experts:

1. Make sure that you have a regular physician who treats your chronic pain.

That’s a relationship that all chronic pain patients should establish before they ever set foot in an emergency room, Blumstein says. But many people don’t have a doctor, he says, “and it looks really bad from a doctor’s point of view when a patient comes in and says, ‘Oh, I have this terrible chronic pain,’ and the doctor says, ‘Who’s taking care of this terrible chronic pain?’ and the patient says, ‘Oh, I don’t have a doctor.’”

“Before you get into a situation where there’s an exacerbation of your condition, make sure you have a regular doctor treating you,” he says.

2. Show that you’ve tried to contact your regular doctor before you go to the ER.

If you’ve been in pain for five days and have not alerted your doctor, the ER staff will question how bad your pain really is, Blumstein says. Even if the pain struck just that day, make an effort to contact your regular doctor first, he suggests.

ER staff will be more sympathetic to patients who have called their doctors and been told to go to the emergency room because the doctor was unable to see them, Blumstein says. “At least you’re showing you made an effort. You’re using the emergency room as your treatment of last resort, as opposed to the primary place you go for pain medication.”

3. Bring a letter from your doctor.

“A letter from your physician, with a diagnosis and current treatment regimen, is a reasonable thing to carry with you,” Fraifeld says. “Particularly if you’re on chronic opioids in today’s atmosphere, I would highly recommend that to patients.” 

Make sure the letter has your doctor’s name and phone number, Blumstein says. That way, if ER doctors want to contact your physicians, they can. A letter is especially useful if you’re traveling or going to a hospital that you’ve never visited before.

It’s fine to bring medical records, too, Fraifeld says. But don’t overdo it, Blumstein says. “I’ve had patients come in with tons of records -- I mean, you could measure the stack in inches. It just looks like you’re going overboard.” 

4. Bring a list of medications.

Bring a list of your medications, instead of relying on memory, Blumstein says.

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