Timothy J. Gober is ready to go head-to-head with Baltimore’s academic hospitals.
The president and CEO of Baltimore Pain Relief Center — an interventional pain management practice — plans to open a fourth location — his first in the city— next month.
But Gober said he isn’t too worried about competition from other private practices that offer physical therapy, chiropractics or pain medication administration. Rather, when the center opens on Nov. 4 at 312 N. Martin Luther King Blvd., its competitors will probably be the region’s major hospitals.
That’s because few private practices bring a comprehensive array of pain treatment options under one roof, the way hospitals do. But Gober said that’s what sets Baltimore Pain Relief Center apart from other practices providing interventional pain management, a clinical specialty that uses medication and minimally invasive procedures, such as steroid injections, to provide pain relief.
“We offer not just pain management — procedures and medication — but also mental health counseling and physical therapy and chiropractics,” Gober said. “We want to cover the full spectrum of treatment options instead of trying to force the patient into one treatment model. … We believe we’re one of the only private groups out there bridging the gap.”
Dr. Thelma Wright, medical director of the Pain Management Center at The University of Maryland Rehabilitation & Orthopaedic Institute (formerly known as Kernan Hospital), said she’s never heard of Gober’s practice, which currently has locations in White Marsh, Pikesville and Dundalk. That surprised Wright, she said, because a clinic like that would have caught her eye.
“Usually when people want a multimodal approach to pain, they go to an academic center like us or Johns Hopkins [Hospital], where not only do you get the injections and the medications, you get acupuncture in the same building, you get the psychologist in the same building. Not a lot of practices offer all that.”
Most patients receiving pain treatment, for ailments like carpal tunnel syndrome and fibromyalgia as well as discomfort from backaches and joint pain, must occasionally see a clinical psychologist who specializes in the depression or anxiety that often accompanies chronic pain, Wright and Gober said.
“We realize there is a mental component to pain, and we can’t ignore that,” Gober said. “People in pain may have depression; they may have problems with addiction. Some may have been addicted to pain medications. Our job is to get to the root of their problem, transition them out of that and move them to different treatment options.”
Patients of Baltimore Pain Relief Center will have access to “rotating” clinical psychologists who move among the four clinics, Gober said. That structure could solve what Wright said is one of the most difficult issues for private practices: not having enough patient volume to justify hiring a psychologist for the office.
“There are billing issues associated with having a pain psychologist on board — it’s more work — so I think sometimes private practices don’t want to deal with it,” Wright said. “I think you’d have to be a big practice to maintain them in-house, because you have to keep that person busy, and then pay them, so I haven’t seen too many that do that. Usually, they’d just subcontract [those services] out.”
Not that there aren’t enough patients to sustain a new clinic in Baltimore.
Over the past year, the number of patients served at the three existing clinics has increased by 55 percent over the prior year, Gober said.
“As we’ve expanded, it’s always been out of necessity,” he said. “We’ll say, ‘Well, geez, we have a relatively full schedule,’ so we add the next location. We see a big need to serve patients from the [Baltimore] area.”
Wright said she thinks Baltimore Pain Relief Center will “do fine” even though most hospitals already have comprehensive pain centers. Volumes at the UM Pain Management Center have increased over the past five years, she said, and are now holding steady.
“Everybody has some sort of pain, and as they say — if you open it, they will come,” Wright said. “I’ve not heard of a pain clinic that has gone under yet.”
When the new clinic opens, the company will have 48 full- and part-time employees, including 12 physicians.
Gober is a licensed chiropractor, but he stopped practicing when he opened his first clinic in White Marsh in 2010, and management duties took precedence. Despite his background, he said chiropractics are just a small piece of what the clinics offer.
Around the same time, Gober also started a consulting firm, The Integration Group, with Mary Martelloni, the practice’s clinical manager and director of operations. Many of the firm’s clients are owners of pain management practices around the country who are interested in the multimodal approach to pain treatment, Gober said. The firm also does back-end billing and administrative work for clients.