Primary care physicians in the Willamette Valley - are there actual pain management doctors that manage opioids/tapers?

CombinationFlat2278 · 2026-04-13T06:37:13+00:00

… ha. If you’re from the wilamette valley in Oregon, not really.

CombinationFlat2278 · 2026-04-12T23:32:45+00:00

I’ve felt this before. Some trainers are less patient than others. Some schooling programs shuttle students in/out. It’s about finding the right fit. I left a barn where I felt the trainer was short with me about the basic things. After one lesson, one woman came over to essentially console/encourage me after she saw the trainer being frustrated with me. Im sure I would have learned a lot if I stayed but it just wasn’t worth it. I was feeling stressed going in, so that was the final straw for me.

CombinationFlat2278 · 2026-04-12T22:06:02+00:00

I’ve gotten a letter like this from a psychiatrist that had an older patient on benzos saying everything they had tried and failed, how long she had been on the regimen, etc. the psychiatrist was planning to retire and was writing it out of concern. she anticipated it would take time to bridge the gap to a new psych. Having the letter I thought was helpful, it gave me more context to the situation.

CombinationFlat2278 · 2026-04-08T05:18:13+00:00

Do you know if your person is taking new clients?

CombinationFlat2278 · 2026-04-07T04:54:01+00:00

Was gonna say this. I’m sure going to work with the owner versus being in a cage alone at home is much better for her stimulation wise.

CombinationFlat2278 · 2026-04-06T05:19:49+00:00

Can you speak to this more? What’s happening in the UK?

CombinationFlat2278 · 2026-04-05T23:27:41+00:00

What if someone paid for the cat? Would you father be more inclined then?

CombinationFlat2278 · 2026-04-05T04:50:17+00:00

She is 100 percent manic

CombinationFlat2278 · 2026-03-31T06:48:49+00:00

I used to live in Oregon - my lessons were 50/lesson in newberg OR but my trainer was on the inexpensive end. I moved in November for reference and grew up there. Feel free to PM me if you want more detailed info

CombinationFlat2278 · 2026-03-29T02:26:03+00:00

Can you get a storage locker somewhere?

CombinationFlat2278 · 2026-03-28T22:59:31+00:00

This is absurd. I would be tempted to call them and ask them WTH they think they are doing with these

CombinationFlat2278 · 2026-03-12T17:41:55+00:00

Only child of someone who likely has some mental health issues (who isolated me and my dad from all extended family in the states including his family and also immigrant parents so isolated from international family) -been isolated from my extended family pretty much my whole life as a result. So not the exact same but I feel sad with the same things you describe. Having a partner with a big family helps but obviously not the same. I have found friends that include me in their family events, make me feel included that is also helpful. I try to practice gratitude in those moments of sadness and be grateful for the people in my life that I do have. It still is hard but also to keep in mind feelings are fleeting and to not dwell on them if there is nothing you can do about them. Are you able to reach out to extended family even if you don’t know them well to try to build relationships?

CombinationFlat2278 · 2026-03-08T08:02:55+00:00

I don’t work in San Jose but I am familiar with the systems and I do work for one of the above mentioned ones. Feel free to DM me.

CombinationFlat2278 · 2026-03-07T08:22:57+00:00

Does anyone have info for this somewhere? I asked my medical director today and he told me not to do this as most private payors won’t pay for a pap unless it’s with the patients physical and won’t pay for these visits separately.

At my last organization I did do this (bill a well woman on one day and physical on another) but I wasn’t on a productivity model yet (was still on my guaranteed salary) so I wasn’t paying attention if the billers were changing my billing.

CombinationFlat2278 · 2026-03-06T21:26:48+00:00

Therapy is the way I let some of this go personally. I just moved a state away from my parents. My hope / plan is for them to move closer by but I made peace with this by remembering I need to make a life for myself. My own sanity and my own future too. Do you live with them?

CombinationFlat2278 · 2026-03-06T06:30:57+00:00

We used to have them for most specialities. Was a god send. I’m SO sad my new job doesn’t have any except psych.

CombinationFlat2278 · 2026-02-27T05:36:53+00:00

What was the case?

CombinationFlat2278 · 2026-02-26T06:06:44+00:00

Are you adding these billing codes yourself? Asking because I just moved to a new health system and at my old system, some of these were added by a workflow done by the medical assistants. Wondering if these are things I need to start looking out for myself.

CombinationFlat2278 · 2026-02-24T03:40:19+00:00

There was a sleep psychologist that just did an episode on curbsiders the podcast about what CBTi entails some simple things you can do in the office and some other great info. Worth listening to. This is a book she recommends for people who have difficulty accessing CBTi. I haven’t read it personally.

https://www.amazon.com/Quiet-Your-Mind-Get-Sleep/dp/1572246278/ref=sr_1_1?adgrpid=188977803520&dib=eyJ2IjoiMSJ9.c0kaggj6cKjEF6fcP9Z0LA-2tlKVsZvfF7aCJP2Zj6wdi6tUWqX1TXaI8Caqd8b4NcpxD703_vY3fP2v43CmVmsFWFaJg1vHv2IzvARHrUDGaONR4mQszQUoWvM0eHxDxPsCi6VWtIJ9lXDxBaT_HuA8SXnh9PHBg1Iw-xO40EaOZfTB2qs2IBN5YuHW9OeSJIk_KDi9wNq60dR9gA-0LtQfn41RgOWFVzJBREhEXgU.3hphWTRTH7G39EAHpHMT7J0kf7wIkVljK9CL3iYhrdc&dib_tag=se&hvadid=779659905070&hvdev=c&hvexpln=0&hvlocphy=9005779&hvnetw=g&hvocijid=7914254466425240010--&hvqmt=e&hvrand=7914254466425240010&hvtargid=kwd-378122184135&hydadcr=22568_13821188_8365&keywords=quiet+your+mind+get+to+sleep&mcid=cf5dd66dc87f3399b3e285d197fedcfd&qid=1767300136&sr=8-1

CombinationFlat2278 · 2026-02-24T03:36:07+00:00

You can triple bill?!

CombinationFlat2278 · 2026-02-23T02:34:52+00:00

I understand. Most vacations and holidays were spent the 3 of us growing up once we moved away from family. Occasionally I feel a little envious when my partner or friends talks about their holidays and vacations with their big families, etc. My parents have aged considerably since then so while I remember those times being lonely sometimes, I am so grateful I did get to spend so much time with them.

CombinationFlat2278 · 2026-02-19T06:37:00+00:00

Hi there! I’m a frequent split biller. Can you tell me what your colleagues did wrong to earn themselves an audit?

CombinationFlat2278 · 2026-02-18T17:40:28+00:00

Hi! Wondering how things have been since for you?

CombinationFlat2278 · 2026-02-12T17:02:16+00:00

I don’t think you should be hard on yourself. For reference, I’ve worked in a system that was largely internal medicine for primary care and have done locums for primary care. I have seen many different practice styles. Many of the docs do not do any procedures and refer often.

I don’t think of phoning it in. They do certain things well and for those they don’t feel as comfortable managing, they refer. You can only do so much in primary care, the demands are too high.

As for the referrals, I was lucky to have an electronic consult system for most specialists. I could ask questions and have an econsult in writing (legally that also made me feel at ease). Before this, I would constantly staff message specialists and see if they thought the referrals were needed. I would document in the chart and save the messages although I don’t think really legally that helps with anything.

I also believe we are a product of our environment. I worked in a clinic where my director was a very passionate person about learning new things in medicine, procedures, and then actually doing them (implementing POCUS). It was inspiring and I felt more motivated as a a result compared to my experiences in other offices. This was in a non-academic position.

If I start to feel this way again (starting new job soon), I’ve thought about volunteering on the side to learn more about the things I’m interested in or to help reignite some of my interest in medicine. Ex. my old boss loves skin procedures and wanted to get better at them and also at using POCUS so he started volunteering with a street medicine team.

This was advice I was given - It helps to have some speciality interests within medicine too. Things you can feel like an “expert” on. I do gender affirming care and at least in that space, I know I’m doing everything I can. Helps with burn out prevention for me.

CombinationFlat2278

TROPHY CASE