pallitive care and busy doctors

I believe that I have a fairly good relationship with my pain doctor, okay I admit I have a much better relationship with her nurse Sharon, while having her own medical problems never seems to not have enough time to be encouraging and I love her for it.

I am wondering how many of you out there in cyberspace have the same relationship?  We plan our visits with an almost religious fever, what we are going to say and not say (and somehow the not going to say becomes the most important) We hope that the doc can read our minds about how we really feel and aren't telling.  And sometimes we just want to talk, we want this doctor whose lives we have willingly put in their hands will just put the pen down and listen to us, to read between the lines of our lives and see the real person who is ill, who hurts, who is sad, or have a laugh at something funny that happend, or an accomplishment we had that we couldn't have had last month, or even last year.

I know for myself the scenerio of my office visit goes like this, I start the worry about a week before the visit, counting down the days, I plan what I am going to say, what I want, how I want to be treated, how she is doing herself if all is well.  The morning of the visit, (I always have my appointments early in the morning) I walk in pay my deductible and in truth never ever wait for more than ten minutes (Now I have jinxed myself :) ) when called in I chat with Sharon who is always listening and willing to lend a shoulder.  The wait in the exam room also is never more than a few minutes my doc walks in quickly goes over her paper of what drugs I've been on and asks me how I am.  I get the distinct impression she has so many patients that in truth she doesn't really know me as a person, she knows me as a patient, and then only in what she has gone over from past visits on an exam sheet the few minutes berfore walking in the door of the exam room and not a living breathing person who is hurting, who is afraid, who is sad.  I know that part of it, is most of us, me included put a smile on our faces and tell them that we are doing okay.  We don't tell them that over the last two months  we have had to have someone come in and take over the care of our grandkids because we hurt so bad.  There is to much to go over about pain meds and whether this one will work or whether the paper you have read on the internet has any substance or not.  You know that you only have ten minutes to talk to this person because she has taken on numerous new patients that want to get off of pain meds and she is the only doctor in your town that has the new drug that helps people.  You are deflated when you get your prescription for more drugs but nothing is settled and you are sent on your way to plan what you are going to say for the next appointment that you know you are never going to say.

I am wondering, as I sit here wait for my appointment next week, if maybe having a laison between the doctor and patient is warranted for pain patients.  I would like to have someone that is available to me that I can talk with safely and in confidence about what is going on in my life, how afraid I am in the morning and my legs work a little less, how I don't see the point in being given the same drugs over and over that don't help only to hear that this is what is best for you because I don't believe in some of the drug therapies you have suggested. I would like to have a laison that can be a go between patient and doctor and maybe this person can see deeper into the patient than the doctor can.  I understand that palliative care doctors are these people and in the past  have primarily been used for end of life help but have slowly been moving into the area of chronic illness. I would like to know if any of you are using this area of care.