In my career I was on staff at two “world famous” medical centers, The types of places you are referred to frequently as a last resort. Both had clinical surgical services based on training and experience, not commonly labeled specialties. For example, there was a spine service that picked from orthopedists, neurosurgeons, radiologists, etc. And there were people with MD degrees, DO degrees, and MBBS degrees from overseas. Spine is what they concentrated on as a clinical service. An orthopedist might not have spine surgery expertise but might be an expert in hand surgery, and so she might be on the hand surgery service that that had both ortho and plastics path surgeons who had elected to put their efforts into mastering hand procedures . There was a head and neck cancer service with selected plastics, ENT. oral surgeons, and dermatologists. Look for a place like these referral centers for you, especially if your locals have thrown in their towels.
And just IMO. since I trained at a medical center with one of the first ever multidisciplinary clinical pain services, it is a shame that the over-prescribing of opioids has resulted in reluctance to treat severe chronic pain with opioids. There was and is a place in pain control for long-term morphine or oxycodone.
