PAIN CLINIC MANAGEMENT OF MEDICOLEGAL LITIGANTS

A preliminary study was undertaken to determine the relationship betwe en a patient's compensation claim and their management in pain claims. Fifty consecutive patients with compensation claims and undergoing tr eatment in local pain clinics were selected from the senior author's m edico-legal practice. An initial postal survey of UK pain clinics was undertaken to establish the percentage of patients in pain clinics wit h musculoskeletal pain and also what proportion of clinics enquire as to the litigation status of their patients. Medical reports available from both plaintiff and defence were reviewed together with the hospit al's and general practitioner's notes. Musculo-skeletal pain contribut es on average 55 per cent of the pain clinic workload and the majority of pain clinics establish the litigation status of their patients. Of the patient series, the senior author assessed 98 per cent as having exaggerated disability, the local non-pain clinics identified exaggera ted symptoms in 44 per cent and 20 per cent were proven to be malinger ing via covert video evidence. The results suggest that many patients with compensation claims seek to cloak inappropriate symptomatology wi th verification and medical support in pain clinics. The wisdom and ex pense of treating such patients in pain clinics is questioned and the need for a nationwide study on this matter identified. (C) 1998 Elsevi er Science Ltd. All rights reserved.