As a doctor, you have the best understanding of your patient, their global medical condition, general health and stressors. My role is an advisor to you and your patient. Any recommendation I make should be explained and approved by you as well.
Your patients should not be taken on "injection adventures". Similarly chronic opiate and high dose opiate therapies have been tried with limited success. If you have a patient who uses opiates and you would like to explore other non-opiate options, we may have a solution.
Some patients need low doses or only intermittent use of opiates, but if you note that tolerance is limiting their lifestyle and activity level, we're here. If a patient needs an intra-articular injection, they usually need an orthopedic surgeon or their office practice for this. If it doesn't prove effective, the orthopedist will need to see them anyway.
Why add another step? Generally we require the approval of another treating physician, preferably their primary care doctor or specialist prior to seeing a patient.
