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Mission of the

Pacific Orofacial Pain Consultants

A gap exists between medicine
and dentistry.

The goal of Pacific Orofacial Pain Consultants, LLC (POPC) is to close that gap forever. The diagnosis and treatment of chronic pain is a fascinating science. Billions of dollars are wasted on lost work or productivity and expensive treatment. This is frustrating for patients, their families, and their employers. As with most problems, communication issues are to blame. Doctors are pressed for time; the inefficiency of wading through medical charts and half-listening to lengthy histories causes mistakes. Health care is at a tipping point. I want to push it over the edge. The crisis in health care has nothing to do with lack of resources or technology or the skills of providers. Quality of care provided in the U.S. is amazing. Why is there such a “crisis”?

I formed POPC to answer this question for the small niche of chronic orofacial pain. We want to provide a model for excellence that doctors can repeat and administer in a cost-effective manner. From this model we can extrapolate into other areas of medicine and dentistry: a team of experts in various disciplines, a “knights of the round table” of sorts, who functions solely to improve the lives of the chronically ill and to inspire physicians to higher levels of achievement.

No, chivalry is not dead.

Education

Preventive care is the best care. Patient responsibility is lacking, and for too long the medical community has fed into this by using a sickness mode, not a wellness mode. Medicine can learn much from dentistry. We have been given several constraints in terms of reimbursement. This has forced dentistry to take a very proactive preventive tactic in dealing with dental issues. There are few life-threatening dental diseases. But the world has become a more complicated place and patients are becoming more complicated. Let’s disregard the current fascination with aesthetic dentistry for now. A dentist’s life is now complicated by ever-increasing pharmacological advances, the increased lifespan of patients, and new technology that has spilled over from medicine. Unfortunately, this receives little emphasis in dental education. We need to make oral pathology, pharmacology, and diagnostics glamorous. That is why POPC exists.

Research

We know little about the pathophysiology of chronic pain. There are a number of dedicated researchers who toil anonymously with limited funds. Check out the research diagnostic criteria for temporomandibular disorders (TMD) by Dworkin, et al. Brilliant work. Cutting through the “snake oil” perception that has plagued TMD practitioners for decades is long overdue. Few people know this landmark study exists. In my practice, 50 percent of TMD patients have degenerative joint disease. Why? I intend to find out. That is why POPC exists.

Diagnostics

In real estate, it’s location, location, location. In medicine, it’s diagnosis, diagnosis, diagnosis. Wading through complex medico-dental issues is tough work; a time-consuming mental challenge. Our team of practitioners has vast experience in searching for answers to complex problems. Diagnostic algorithms and flowcharts are being developed to help all practitioners reach differentials that make sense and could potentially save lives. Send us your tough cases. Are we perfect? No. But we will try harder. That is why POPC exists.

Litigation Support

We live in a litigious society. Unfortunately, mistakes happen. From simple record review and evaluation to expert testimony, we have the resources to provide unbiased opinions for complex medico-legal issues. If we do not have the answer, we will find someone who does. Let’s face it: most TMD issues are not life threatening, but they can be debilitating. Most often I am called upon to act as the treating provider through referral from physicians. I know about secondary gain and I feel that I can read people well. Most importantly, we get people better and make their lives manageable. So no matter which side of the case, plaintiff or defense, you can count on an honest opinion and frank testimony. That is why POPC exists.

Management Consulting

At the risk of sounding self-aggrandizing…I need to be cloned! There are simply not enough people like me to go around. We must develop other centers of excellence to bring the POPC message to the world. From startup, contract negotiation, education, mentorship, coaching, and potential partnership, I need a few dedicated warriors against chronic pain. If you have what it takes, call me. That is why the POPC exists.

We need to close the gap. We need to create a true team approach and we can do it in a clinic without walls. It’s all about communication and mutual respect between the physician, dentist, and patient.

Timothy Mickiewicz, D.D.S.