My name is Manhal Saleeby and I am living the dream! I am an anesthesiologist/pain specialist physician employed by a community hospital in the town of South Hill, Virginia.
Community Memorial Hospital affiliated with Virginia Commonwealth University in 2014. The affiliation enabled our community hospital to grow and expand to multiple specialty services which are now offered to the people of rural Southside Virginia. The outpatient practices are housed in the adjoining C.A.R.E. building (Clinics, Administration, Rehabilitation and Education). The hospital and C.A.R.E. building are brand new with a beautiful surrounding healing garden and most notably, a great parking lot.
I originally started an outpatient interventional pain management practice at Community Memorial Hospital in 2007. Eventually, I was able to add a nurse practitioner which helped tremendously. We see patients three days a week from 8:00 a.m. to 5:00 p.m., and I perform fluoroscopy guided procedures the other two days. Although my main practice is in the outpatient pain management clinic, I also help to cover anesthesia call. The hospital has a busy anesthesia department which includes one anesthesiologist who provides anesthesia services and five nurse anesthetists.
I provide a wide range of pain services at VCU CMH Pain Management Services along with a wonderful group of people, which includes a great nurse practitioner who earned her doctorate degree in nursing practice. She has helped to transform the practice to a well-organized, time efficient, comprehensive care model which is available to patients suffering from chronic pain. We offer services to a vast population which covers several surrounding counties in Southside Virginia stretching to North Carolina.
While every clinic handles the tedious process of insurance authorizations, making appointments, gathering documents from referring practices, and answering numerous phone calls daily, it is all performed at VCU CMH Pain Management Services by a dedicated staff in a seamless fashion.
With all the challenges that face rural communities in accessing health care resources, having pain management services available to an aging population with a variety of ailments such as osteoarthritis, osteoporosis, spinal stenosis, and cancer, to name a few, is essential. It is challenging to arrange transportation to appointments in a rural community. This is due to several reasons which may include the fact that public transportation is non-existent in rural areas. Medicaid transportation requires at least five days’ notice and the elderly population often times have to have their sons and daughters take time off from work in order to accompany them to appointments.
I take pride in our team in that we don’t just focus on interventional services, such as the usual epidural steroid injection, facet injections, radio-frequency ablation, intra-articular injection, and peripheral nerve block, we treat the whole patient. We also offer medication management when indicated and arrange for home health care, physical therapy, mental health, and addiction treatment referrals.
My belief when a pain practice advertises that it only provides interventional or limited medication management is that they are not treating the patient as a whole. Particularly when such practices tell patients they “don’t prescribe opioids”, I feel that these practices are looking for good income with less headache and liability.
Our outpatient volume is somewhat less in quantity compared to some years ago but I think that is a good thing. Everyone knows that we are not pill pushers. Our processes require patients to go through an exhaustive evaluation and risk stratification in order to formulate a plan of care. Our patients understand that we offer quality care with a comprehensive care plan that does not start and end with a prescription for opioids and “see you back in a month”.
We do not take “walk-in” patients. We acquire patients by referral only. Each patient must have a legitimate pain diagnosis that is properly worked up and that we feel will likely benefit from our services. Patients have rights but they also learn that they have responsibilities once they become established with us. We always discuss their diagnosis and plan of care. We don’t just explain what spinal stenosis is or which nerve is being pinched, we try to explain in simple terms the neuroscience of chronic pain and how they can have a true role in their pain control beyond taking a pill or getting a steroid injection.
Pain is a serious health problem with significant impacts on our society – psychological, functional, and financial. Chronic pain is even more of a burden in rural communities that lack the resources of big tertiary care centers. However, it doesn’t have to be that way! VCU CMH Pain Management Services, along with all our primary care and sub-specialty services, bring the experience of tertiary care to the local community. We offer safe, quality care close to home.