A new pain clinic at the Providence Kodiak Island Medical Center aims to help patients address chronic pain, with the hope of reducing the number of instances Kodiak residents are forced to leave the island in search of medical treatment.
The clinic offers services such as targeted injections and physical therapy to patients dealing with chronic pain. Before the clinic opened, many patients had to leave the island to seek medical attention for pain caused by lower back issues, fibromyalgia, multiple sclerosis and arthritis, among other causes. Now these conditions can be treated on the island in a practice run by Megan Taylor and Scott Carver, nurse anesthetists at PKIMC. Carver has worked in Kodiak since 2012, while Taylor moved to the island last spring.
“When I started looking at jobs, Providence was looking to fill the need for pain management services on the island. They were looking for somebody who did both pain and anesthesia,” Taylor said. She fit the bill.
The pain clinic at PKIMC began operating the first week of January, with hours two days per week. In the first two weeks, the clinic has already treated new 12 patients, half of whom had been regularly traveling off the island to receive treatment for chronic pain.
“What we’re offering at the pain clinic is a comprehensive service that’s been missing on the island,” Taylor said. “Today alone, two out of my three new patients had been flying either to Anchorage or Wasilla for their pain management services on a regular basis.”
“Now, they can come to Providence to see us,” Taylor said. The clinic will not prescribe any medications, but will work with other care providers to supply prescriptions when needed.
While it is unclear if Kodiak’s opioid crisis originated from pain management prescriptions, the pain management clinic can help Kodiak residents avoid addiction, Taylor said.
“A lot of patients who develop addiction problems, started because they had legitimate pain. They either got a post-surgical prescription for pain medication, or they turned to buying medicine on the street to try to self-medicate their pain because they didn’t have adequate access to other options. I see a lot of patients who are either physiologically dependent on the medication or psychologically addicted,” she said. By treating pain, she said she can help patients avoid that dangerous route.
Taylor added that some Kodiak residents are particularly susceptible to developing chronic pain and letting it go untreated for extended periods of time.
“We live in a hard-working community here. People don’t take time off during crab season. They’ve got to make their money when the season’s open, and they push through and do what they have to do,” she said. “In a blue-collar community, patients can’t afford to be flying to Anchorage all the time, so self medication, whether it’s with alcohol or illicit substances is pretty prevalent. So being able to offer them something that they don’t have to leave home for to help minimize that is going to be a huge asset to the community.”
Patients’ first appointments at the clinic last an hour, and require filling out a 12-page intake form. Taylor said it’s important to develop a close relationship with patients because pain is an “intimate” experience.
“Many of these patients we’re seeing feel disenfranchised from the whole system. They’ve been living with pain for a long time,” she said. “They just feel like they haven’t been heard. That’s part of why we give patients an hour — they need to be able to tell their stories and then feel like they’ve developed a rapport with whomever their provider is. Because pain is really intimate for patients. It affects how they wake up in the morning, how they put their shoes on, how they do every day-to-day activity. It affects their relationships with their families, with their significant others. And they need to be able to relate that in order for us to get the best picture of how to help them.”
Carver and Taylor say they hope to grow the practice in the coming months, from two clinic days a week to four.
“This has been a service we’ve talked about for years,” Carver said, adding that in the past, the clinic wasn’t possible because they didn’t have enough nurse anesthetists on the hospital’s full-time staff. “We’re just trying to make this hospital help the people on the island, so they don’t have to fly off the island, and one aspect of that has been pain.”
For the first time in years, PKIMC has more than one nurse anesthetist on staff. In the past, there has been only one nurse anesthetist living on the island, with another traveling to Kodiak for temporary stays. Taylor and Carver hope a third nurse anesthetist will join the team in the coming months.
Taylor said it’s “really nice to have an extra set of hands” in the hospital, especially because they can take turns being on-call. “We’re all living on-island, so we all have a vested interest in how things turn out in the community.”
Patients interested in treatment at the pain clinic can ask for a referral from their primary care provider. According to Taylor, the early success of the clinic shows it is meeting an existing need on the island.
“If the last few weeks are any indication, I think this is a service line that is going to continue to grow within the hospital,” she said.