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Pain management starts at the door

Article-Pain management starts at the door

For Ranella J. Hirsch, M.D., the process of pain management starts the moment a patient enters her office.

"To us," she says, "It includes more than just the obvious."

In addition to offering patients cold packs, topical anesthetics and where appropriate, anesthetic injections and dental blocks, Dr. Hirsch explains, "It goes beyond that. When you walk into our office, you would never know it's a doctor's office. It intentionally looks like someone's living room," with comfortable couches, soft music and soothing decoration. "In every treatment room," Dr. Hirsch adds, "there's always something a patient can squeeze or someone's hand the patient can hold."

Likewise, Dr. Hirsch says that she's had storage areas covered with dark-tinted glass cabinet doors to ensure that no patient sees a needle prematurely. "When my assistant lays out the table," she adds, "she'll put a drape down to cover the needle."

Dr. Hirsch says her philosophy is catching on. Whenever other doctors shadow her for the purpose of learning specific procedures, she says that what they frequently call back about weeks or months later is to learn how she accomplishes impressive results while causing minimal pain and post-treatment bruising.

"It's not something one can necessarily put into writing. It's the overall gestalt of it — the fact that patients come in, and we put such a premium on their comfort," she says.

Patients, too, have embraced Dr. Hirsch's painstaking approach. Since her practice began offering dental blocks before injections such as fillers in the lip area, Dr. Hirsch says some patients actually ask to see her for these blocks before visiting their dentist.

Whenever a practitioner such as a dentist goes too far without warning a patient, she says, "No matter what that practitioner does, everything he or she does after that hurts because the patient is on guard."

In contrast, "We stress doing everything in a gentle fashion. The other key to pain management is don't rush — everything you do in a rushed fashion hurts more," Dr. Hirsch says.

The goal of Dr. Hirsch's office accoutrements and kid-glove approach is to keep the mood light. She explains, "We're always joking around and having fun, because from the moment someone walks in the office, we want them in that frame of mind. A tense patient is a patient who's going to feel pain."

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