2021 Top Doctor: Rene Lucas, M.D.

Editorial StaffMay 5, 2021
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Photography by Steve Craft
Photography by Steve Craft

Pain Management

Med School/Year Graduated: University of California San Francisco/1985

Years in Practice: 30

You came into pain management through the field of physical medicine, but anesthesiology and neurology are also common entry points. Does this effect treatment? Is a physiatrist such as yourself likely to approach pain differently than, say, an anesthesiologist?

Physiatry training [is unique in that it] focuses on diagnosing and managing patients with musculoskeletal problems in a team setting… that being said, all pain management specialists do a pain medicine fellowship where we learn interventional techniques, so initial residency training does not have to matter.

How can chronic pain affect a patient’s mental health?

I would ask how mental health affects chronic pain. Everybody has a certain amount of pain, and since the goal is to maximize a patient’s function while reducing pain, one has to understand a patient’s mental health first. Mind-body issues, such as anxiety, depression and chronic fatigue, affect a patient’s perception of pain. Figuring that out starts with listening and really hearing what the patient is experiencing.

You went to medical school in San Francisco. What do you miss most about the Bay Area?

I miss the energy and buzz of the City by the Bay. Specifically, I miss having dinner in Chinatown and North Beach. I started cycling in San Francisco and continue to ride and race at a high level – but I miss riding [back there].

Which developments in pain management excite you the most?

Neuromodulation is an exciting frontier [and] spinal cord stimulation is becoming the standard of care for failed back surgery syndrome and neuropathic pain. Advances in waveforms, neural targets and smarter devices are critical to avoid high-dose opioids.

What is the best depiction of your field you’ve seen in TV or film?

Lenox Hill. It’s not specific to pain medicine, but the show adequately covers the privilege of delivering quality health care while balancing professional and personal challenges.

What was the last book you read?

Finding the Fountain (of Youth): Why Government Must Unlock Biotech’s Potential to Maximize Longevity by Breanna Deutsch.

What are you watching on streaming TV these days?

Fauda, an Israeli TV drama. I’ve seen all three seasons and am anxiously waiting for season four.

“If I wasn’t a doctor, I’d be…”

A professional cyclist, because cycling is a sport in which one can have great personal ambition and be successful but only if surrounded by a great team… just like in pain medicine.

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