Pain Rehabilitation Center in Minnesota

Resources For Physicians

Referral Process

Admission to the Pain Rehabilitation Center is a two-step process. First, a patient must be evaluated by one of the pain rehabilitation center staff to ensure appropriateness and motivation to participate in the program. Evaluations are typically available within 48 to 72 hours and are done on an outpatient basis only. If an external physician wishes to refer a patient, including Mayo Clinic physicians in Jacksonville and Arizona, please call (507) 255-5921. Arrangements will be made to have the patient's records reviewed via fax records and phone interviews.

Admission criteria

• Chronic pain of sufficient severity to bring about increased dysfunction in daily social, vocational, and/or interpersonal activities
• Chronic pain duration of six months or more or clinical indication that pain of a shorter duration will likely manifest into a chronic condition
• Adequate control over behavior and not judged to be imminently dangerous to self or others
• Demonstration of adequate motivation to proceed with a rehabilitation approach to management of pain, which often implies awareness or some level of acceptance that medical or surgical treatments are not a present option

Exclusionary criteria

• Unwillingness to discontinue use of narcotic medications, other psychotropic medications, or substances of abuse as recommended that would preclude meaningful participation in the program.
• Insufficient motivation to address the necessary components which make up the general scope of pain rehabilitation. These include medication management, physical and occupational therapy, and group therapy.
• An acute physical condition or illness exists and is currently being treated in a manner which would preclude adequate participation in the program.

An admission date is scheduled based on the outcome of the evaluation. During the scheduling, which can take up to six weeks, the necessary insurance predetermination is sought by Mayo Clinic staff and patients have time to make lodging and travel arrangements.

Upon admission to the PRC, patients undergo an initial evaluation by a nurse care coordinator, a physical therapist, and an occupational therapist. This evaluation includes a comprehensive assessment of the patient's health including a medical and psychiatric history, functional status, current and past medication use and a mental status exam. A pain assessment is also completed, including a history of the pain, defining characteristics and treatments. On the day after admission, all disciplines present their initial findings in team rounds. The consultant physician then interviews the patients and focuses on the patient's goals for treatment. The treatment team and patient collaborate to develop the patient's treatment plan and meet regularly to assess and give feedback on goal progress.

Follow-up for Referring Physicians

Coordination with providers in the home community is an integral part of a successful return home. Upon admission to the Pain Rehabilitation Center, patients will be asked to identify providers in the home setting and sign an Authorization to Release Information. The patient's nurse care coordinator will contact providers and provide information related to the PRC plan of care.

Providers for whom Mayo Clinic has authorizations will receive a written dismissal summary outlining care during the three-week program. This summary will include the PRC treatment course as well as any medication changes, laboratory test results and consultations. The written summary will also provide behavioral strategies taught to cope with chronic pain and specific follow-up recommendations.

If indicated, a care conference may be held in person or via a telephone conference call. PRC nurse care coordinators are available for consultation after the three-week period for both patients and referring physicians.