Structure

Anaesthetists are the most common practitioners, followed by neurosurgeons, nursing staff and psychologists. Tumour specialists from cancer clinics come next. Occupational therapists and surgeons are not usually associated with the clinics.

Most of the staff involved with the clinics are consultants. The core of the staff may be as few as two individuals. But, more often, it seems to be variable with the co-ordinator as the only constant member.

What may happen is that an anaesthetist, as co-ordinator, may consider that your pain is not of physical origin alone and you would be referred to a consultant psychiatrist. The psychiatrist, in turn, might refer you to a psychologist for further assessment for therapy.

The main drawback is that you would not be seen by this group as a team but in a series of individual interviews among the specialists in the unit.

A look at the number, and kind, of patients seen in the 15 clinics reveals that there are comparatively few in-patients. The seven institutes studied average only four a week. The numbers of in-patients range from none to ten for both males and females. For outpatients, the numbers range from two to eighty for males and two to 120 for females.

Referral between specialists is the most efficient way of organising a pain clinic. An alternative is a day clinic. For example, the Royal North Shore Hospital and the Melbourne Pain Management Clinic. The age of patients ranges from 12 to 60 plus.

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Chronic pain patients whose pain complaints often have no obvious cause and which are complicated by emotional distress and anxiety may respond better to a combination of acupuncture, psychological treatments and medication. With such patients, hypnosis may be the psychological treatment of choice.

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Unfortunately, Australia still has no legal restrictions on who can practice acupuncture — and how well they have to sterilise their needles.

Acupuncture should only be practised by a properly qualified medical practitioner. That is, someone able to make a proper medical diagnosis before using acupuncture, which is a treatment used in China only by trained practitioners.

There are no risks or disadvantages to the use of laser acupuncture as there is no penetration of the skin and no side-effects.

Acupuncture’s only real disadvantage is that it may be associated with a certain degree of discomfort as well as the more common side-effects of slight bruising and occasional fainting. There are no absolute reasons not to use acupuncture — though some practitioners will not perform acupuncture on patients taking cortisone-type drugs or with certain physical complications such as severe acne.

Acupuncture can be performed by many general practitioners trained through the excellent courses run in the various states of Australia for medical practitioners. Acupuncture costs vary from practitioner to practitioner.

Most doctors charge approximately $25 to $40 per treatment, with a Medicare rebate of approximately $17. Treatments will normally be performed either weekly or every two to three weeks until a response is established.

A list of doctors practising acupuncture can be obtained from the state branches of the Australian Medical Acupuncture Society.

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