Florida Pain Medicine — When You Want Your Pain Managed Responsibly

Maulik Bhalani, M.D., knows that when some people hear of pain clinics, they think of the so-called “pill mills.” He understands that, after years of headlines about the abuse of certain pain medications, particularly in Florida, the reputation is tough to shake.

But, at Florida Pain Medicine on Windguard Cir. (across from Florida Hospital Wesley Chapel (FHWC), Dr. Bhalani says the perceptions are not even close to reality.

“The typical working class person doesn’t want to see a pain management doctor because they think that doctor is going to get them hooked on medication,’’ says Dr. Bhalani. “Little old ladies, grandmothers, will come in and tell us…I know those stories that are out there on the news. But, when they come in here, from minute one, it’s a totally difference experience.”

The Florida Pain Medicine offices are clean and lively, the doctors are open and friendly and the approach to managing your pain, which employs the latest technological advances, is always, they say, measured and restrained, yet effective.

“There’s not a bunch of guys outside in the parking lot smoking, looking disheveled, seeking pain meds,’’ Dr. Bhalani says. “That’s not the kind of practice we are.”

The kind of practice Florida Pain Medicine is, Dr. Bhalani says, is one that focuses on interventional pain management. “Start-to-finish pain care,’’ he says.

Sometimes, in the best cases, that means opioid management, ice and injections until the patient can complete physical therapy.

“Then, we wean them off pain meds, hopefully with the goal of we never see them again, which means they are doing great and back to living their lives,’’ Dr. Bhalani says.

In other cases, like patients with terminal cancer, Dr. Bhalani says his goal is not to let them live out their final days in misery.

Whatever the malady, “We never force anything on anyone,’’ Dr. Bhalani says.

Pain management means different treatments for different people. Every patient is unique, but the main goal for Dr. Bhalani and his associates at Florida Pain Medicine — Navdeep Jassal, MD, Arpit Patel, DO (Doctor of Osteopathic Medicine), and Stephanie Epting, DO — is to help their patients return to a normal way of life. Their motto is, “Restore Function, Relive Life.”

“We want to get you back to where you can live your life the way you like living it,” Dr. Bhalani says.

A Little Information About The Doctors

Dr. Bhalani, a huge local sports fan and 11-year Tampa Bay Buccaneers season ticket holder who dons a Jameis Winston jersey for home games, has followed in the footsteps of his father, who is a pain medicine physician in the Ormond Beach area of Florida, as well as several of his uncles and aunts.

In fact, Dr. Bhalani is one of 13 cousins in his family — and all are physicians.

“We don’t know how to do anything else,’’ he says, chuckling and joking that he might raise his kids, who are ages 4, 2 and 1, to be NFL punters instead.

Dr. Bhalani received his M.D. degree from the Creighton University School of Medicine in Omaha, NE. He also spent two years as a resident at Maryland General Hospital in Baltimore in 2005; was the chief resident at the University of South Florida (USF)’s Physical Medicine & Rehabilitation Residency Program; and completed an Accreditation Council for Graduate Medical Education (ACGME) Pain Medicine Fellowship in Interventional Pain Medicine at USF in 2010.

He is Board-certified in Interventional Pain Medicine and in Physical Medicine & Rehabilitation.

Dr. Bhalani’s credentials also include sitting on the Board of the Florida Society of Interventional Pain Physicians (FSIPP) as a Director-at-Large, and he says he is proud of the work the FSIPP did in helping craft Florida’s so-called “Pill Mill Bill” in 2011.

The bill forced clinics to register with the state and banned doctors from dispensing opioid prescription painkillers like Vicodin and Oxycodone from their offices. The Prescription Drug Monitoring Program also was implemented, which Drs. Bhalani and Jassal reference to look at a patient’s prescription drug history.

Dr. Jassal says he heard about all the “wild, wild west stories” about Florida’s pill mills when he was studying in New York.

“I didn’t believe it until I came down here,’’ he says. “But, it’s improved dramatically (since 2011), thanks to the efforts of Dr. Bhalani and others.”

A car enthusiast and avid runner who sometimes puts in 15 miles on a weekend as a way to relax, Dr. Jassal joined Dr. Bhalani in July 2015 after completing a Pain Medicine Fellowship at USF, where he was one of Dr. Bhalani’s students.

Before that, Dr. Jassal was a resident at North Shore-Long Island Jewish (LIJ) Health Systems and Hofstra North Shore-LIJ School of Medicine in Great Neck, NY.

Dr. Patel, who joined Florida Pain Medicine seven months ago, has known Drs. Bhalani and Jassal for years. A University of Maryland graduate with a Bachelor of Arts (B.A.) degree in Neurobiology and Physiology, Dr. Patel has worked with his fellow physicians at the University of South Florida, where he completed his Interventional Pain Medicine Fellowship.

In between his B.A. and fellowship, Dr. Patel graduated with honors from Virginia College of Osteopathic Medicine in Blacksburg, and completed residency training in Physical Medicine and Rehabilitation at Nassau University Medical Center in East Meadow, NY, where he was selected as Chief Resident. He also served as a Clinical Instructor for spine anatomy at Hofstra North Shore-LIJ School of Medicine.

A recreational tennis and basketball player, much of Dr. Patel’s work involves sports-related injuries, and he says he also has an interest in helping cancer patients with their pain.

Most patients the physicians at Florida Pain Medicine see are what you might expect — those suffering from back, neck and joint pain. Others have more serious conditions, like poor recovery from back surgery, painful diabetes and even cancer. Each treatment plan varies with that patient’s particular needs.

The doctors at the practice say they prefer a conservative approach. Patients generally will not be prescribed any controlled pain medications on the first visit. The doctors are careful to give a full exam — surprising to some patients who have been to other pain medicine doctors — and look over X-rays and other images and notes from the referring doctor, as well as run a urine drug screen, before determining a course of treatment.

The physicians will sometimes suggest a smaller dose of medicine than the patient is currently taking. Others are often offered alternatives to stronger prescription drugs, like local anaesthetic injections (epidurals, for example), anti-inflammatory meds, physical therapy and even weight loss to help relieve their pain.

Sometimes, an injection, which can relieve pain for months, is suggested instead of a prescription. “Sometimes, they are like wow, I wish someone had recommended this 4-5 years ago,” Dr. Bhalani says.

And if that doesn’t work, he adds, “we’ll use more aggressive measures. We really try to be kind of conservative initially.”

Dr. Bhalani says he recently treated a 90-year-old patient who told him, “Well, Doc, if this works as good as the last one, that’d be great,” to which Dr. Bhalani replied, “Oh, the last one helped you?,” and the patient told him that was the reason he hadn’t been back to see him for seven months.

“And I’ve been golfing the whole time!,” the patient said.

That approach, by younger, Board-certified physicians willing to look at alternative treatments, was one of the things that Dr. Patel says originally attracted him to Florida Pain Medicine.

“We bring a new ‘taste’ of interventional pain medicine to the community,” Dr. Patel says. “I think a lot of (older physicians) around here thought opiates were the best way to go. We just have a different mindset. Today, I had a patient who literally had been seeing every surgeon in town, and finally we did a procedure called Radiofrequency Ablation (RFA) on a very special nerve, and for the first time in his life he doesn’t have the (same) pain. He has been able to return to what he loves, flying kites. He’s never been able to do that (after previous treatments). The satisfaction of seeing how patients do right after the procedure, and the fact that they are able to travel and spend time with their families, is the best part of my job.”

Dr. Jassal says that since joining Florida Pain Medicine, he has seen as many patients in six months as he expected to see in nine months or a year. On average, each physician sees 25-27 patients a day, a number they think is perfect to give them time to give each patient the individualized care they require.

“That’s what makes our practice very different,’’ Dr. Patel said. “There are other practices where you will be waiting for 4-5 hours at a time. Our goal, and really my biggest thing, is examining every patient and having a hands-on approach. That’s very important to me and (helps) me make the proper diagnosis, rather than just looking at an MRI.”

Business has been so brisk that Dr. Bhalani, who opened his second Florida Pain Medicine on Arbor Ridge Dr. in Zephyrhills in 2015, has since opened another office in the Brandon area and has been serving patients there since June 2016.

“We seek to expand to underserved areas of the state to provide quality pain management care to those who need it most,” says Dr. Bhalani. “We’re hopeful that 2017 takes us to additional markets where patients can benefit from our services.”

Dr. Jassal thinks the office’s reputation, which includes strong relationships with local pharmacists and doctors, comes from the way the patients are cared for at Florida Pain Medicine. Dr. Bhalani adds that he recommends for his patients the same things he would for his own parents: “Literally, that is how we treat every single patient,” he says proudly.

A soft, personal touch and firm recommendations are something Dr. Jassal thinks patients appreciate, as well as the physicians’ desire to help patients return to the things they love.

He has a 97-year old patient who receives periodic injections, which he says, “keeps her happiness, and her happiness is dancing with her son.’’

Most of the office’s business, Dr. Bhalani says, comes from referrals. He believes that the practice treats as many local physicians and their family members as anyone in the area.

Dr. Bhalani can do procedures at Florida Hospital Zephyrhills, where he is the director of the Intervention & Pain Program, Tampa Minimally Invasive Surgery Center, Brandon Surgery Center and at the Advanced Surgery Center of Tampa.

However, state-of-the-art pain management procedures are often performed in the Wesley Chapel office, as opposed to a hospital or at ambulatory surgery centers, which helps save patients money.

“The whole spectrum of care gives us flexibility,’’ says Dr. Bhalani.

For more information, visit FloridaPainMedicine.com. To reach the Wesley Chapel Florida Pain Medicine office (2553 Windguard Cir.), the Zephyrhills’ location (38011 Arbor Ridge Dr.), or the Brandon office (426 W Brandon Blvd), call 388-2948.

Weekend Note: Detour at Tampa Palms Blvd.

Yes, Bruce B. Downs Blvd. (BBD) is still being widened.

As a result, the portion of Tampa Palms Blvd. across the street from the City Plaza at Tampa Palms (where travelers would take a right to head north on BBD) will be closed beginning at 6 p.m. Friday, Feb. 3 through 6 a.m. Monday, Feb. 6. The contractor will be removing the wastewater force main, according to the City of Tampa public affairs director Ashley Bauman.

This won’t affect traffic on BBD, as its thru lanes will remain open during construction. Pedestrian access will be available at the intersection of Tampa Palms Blvd. and BBD at all times.