Diagnostic Consultation for Complex Pain Cases
Some pain cases resist resolution. The imaging doesn't match the symptoms, the treatments that should work haven't, the medication regimen has grown without clear benefit, or the diagnosis has changed three times across three specialists. These are the cases PainDx exists for.
Dr. H. Rand Scott provides diagnostic consultation to primary care physicians and specialists on complex, ambiguous, and refractory pain presentations. The goal of a consultation is not to absorb your patient into another practice — it is to answer the specific clinical question you're facing and return the patient to your care with a clear diagnostic impression and a practical, evidence-based plan you can execute.
When to Refer
Consider consultation when the diagnosis remains uncertain after standard workup; when a patient has failed multiple courses of treatment that should have helped; when pain, function, and objective findings don't align; when a medication regimen — particularly one involving opioids — needs an experienced second opinion on necessity, optimization, or tapering; or when you need documentation-quality support for a difficult management decision.
What to Send
A brief referral note stating the clinical question, relevant imaging and reports, the current medication list, and prior treatment history. Our office will contact your patient directly to schedule, or coordinate scheduling through your staff — whichever you prefer.
What You Receive
A written consultation report addressed to you within [X] business days of the evaluation, covering diagnostic impression, an assessment of prior treatment, and specific recommendations — including, where relevant, which interventions are worth pursuing and which are not. Dr. Scott is available by phone to discuss findings directly, physician to physician.
Dr. Scott has particular depth in opioid tapering and opioid-to-non-opioid transition, having developed protocols in this area and trained primary care physicians and nursing staff in their use. If you have a patient on long-term opioid therapy and are unsure how — or whether — to change course, that is a routine consultation for this practice.
Dr. Scott is board certified by the American Board of Anesthesiology, subspecialty-trained in pain management, and has practiced in Newport Beach since 1996 — longer than any pain specialist in the area. He has taught pain assessment and management to physicians at more than one hundred hospitals and medical organizations nationwide and was twice named an Orange County Medical Association Physician of Excellence. Full credentials are on the About page.
To discuss a case before referring, call 949-759-8400.