New referrals are triaged by a team of three staff members: the medical director, a nurse and a psychologist. Typically, patients with cancer, some neuropathic pain types, postoperative pain and elderly patients are given priority and are seen as quickly as possible at the clinic, sometimes within a day or two. By contrast, normal priority patients, may wait a few months for their first appointment. Response to consults for pain management on wards is almost immediate. The MUHC Pain Centre receives referrals from family physicians and specialists in almost every medical discipline within and from outside the hospital. All patients must be referred by a medical doctor, preferably one who will continue to follow them. To ensure continued care after discharge from the Pain Centre, patients must have a family physician or to be registered in a family medicine clinic. Collaboration with the family physician during a patient's treatment at the Pain Centre is often helpful. Occasionally, a referred patient may not be seen at all if the problem is not appropriate for the treatments we have available.
After initial assessment, we establish a treatment plan on an individual basis for each patient. Typical multidisciplinary treatment at the Pain Centre is of 3-6 months' duration, although it can be longer or shorter, depending on the nature of the problem. During the patient's care at our Pain Centre an effort is made to implement all reasonable and appropriate treatments at our disposal. Once the patient is stabilized on a pain treatment regimen, he or she is discharged from the Pain Centre, and a summary letter with recommendations for continued care is sent to the referring doctor with copies to the patient's other doctors who may need this information. If the initial assessment reveals that the Pain Centre does not have the tools to treat the presenting problem, no further appointments are made and an explanatory letter is sent to the referring physician. This may occur if the patient has already undergone the same treatments elsewhere, or if the treatment required is not available at our Pain Centre.