Should Doctors Try to Alleviate Pain? | Cato @ Liberty – Nov, 2017 – By DAVID BOAZ
The rising level of deaths from opioid overdoses is getting a lot of attention, including from a Nobel laureate economist and the White House.
In the rush to find a solution to the problem of opioids, I hope we don’t forget the problem that opioids were intended to cure: chronic severe pain. Living with that kind of pain is awful, and it’s wonderful that science has found ways to help people in pain.
But that’s not the way President Trump’s surgeon general sees it. Continue reading
Why Human Suffering Should Bother You – October 23, 2017 – By Margaret Aranda, MD, Columnist
A recent column in The Conversation by Dr. Andrew Kolodny bothers me because of two sentences:
“They (opioids) are also helpful when used for a couple of days after major surgery or a serious accident.
Unfortunately, the bulk of the opioid prescriptions in the U.S. are for common conditions, like back pain,” wrote Kolodny, who is a psychiatrist, not a pain management doctor.
Let’s look at the different ways that Dr. Kolodny is minimizing pain: Continue reading
Intimidated patients may act like hostages |Reuters Health News | September 07, 2017 | Carolyn Crist
Patients who find themselves “clamming up” during doctor visits may be similar in some way to hostages, a new study suggests.
Frozen in fear and confusion, patients may feel like they’re helpless and negotiating for their health, the study authors wrote.
“Hostage bargaining syndrome,” whereby patients feel intimidated by the doctor, “is a very real phenomenon that many patients experience, particularly those with a serious disease or in a state of great vulnerability,” said lead study author Dr. Leonard Berry of Texas A&M University in College Station. Continue reading
Clinical Dividends For Primary Care Pain Telemedicine – Pain Medicine News
About four years ago, the University of California, Davis developed a unique and novel tool kit to expand access to sophisticated and thoughtful pain care, in addition to tackling the opioid abuse epidemic.
The Center for Advancing Pain Relief (CAPR) has created a broad educational agenda to improve pain management.
“It is our contention that responsible opioid prescribing programs alone are not the answer, as this becomes synonymous with reductions in plausible opioid prescribing but leaves pain conditions untreated,” Dr. Copenhaver, MD, MPH, associate director of the Center for Advancing Pain Relief (CAPR) said. Continue reading
Post-surgical spine syndrome – free full-text PMC3205485 – Sep 2011
It is our view that the diagnostic terms post laminectomy syndrome (ICD-9 code 722.8) or failed back syndrome are inaccurate, misleading, can be construed as disparaging, and should be discarded.
Disparaging to whom? I suspect doctors do not like any term that insinuates their methods failed, no matter how true that is.
These authors couldn’t even bring themselves to call this painful syndrome by its *real* name: it’s not called “failed back syndrome”, but rather “failed back surgery syndrome” because, in this case, it is the surgery that failed, not the back. Continue reading
Chronic pain: The “invisible” disability – Harvard Health Blog – Harvard Health Publications – April 2017 – Laura Kiesel
Sometime back in 2010, a good friend of mine from college who had since become a pediatrician posted a complaint on Facebook about “made up” health conditions. “Fibromyalgia, I’m looking at you,” she wrote.
At this time, pain was more of an occasional visitor in my body rather than the permanent tenant it has since become
Fast forward to today and my life is all about pacing. This is because everything I do — cook, sleep, work, walk — takes time.
This gradual approach to every aspect of my life is not about enlightenment or mindfulness. It is about pain. Continue reading
Missing appointments? Skipping doses? You might get fired by your doctor – By Max Blau @maxblau – May 15, 2017
A new survey of primary care doctors reveals an interesting statistic:
9 out of 10 practices have told a patient not to come back.
The doctors have fired their patients.
The research, published in JAMA Internal Medicine on Monday, found that firing patients doesn’t happen often, but it’s making some health experts nervous that doctors will expunge difficult patients from their rolls as insurers move toward reimbursing them more for benchmarked health outcomes than actual services provided. Continue reading
Physicians ceded control of health care. It’s time to take it back– | PHYSICIAN | APRIL 21, 2017
This is such a truthful look at what’s happened to the practice of medicine that the author had to remain anonymous to protect themselves against punishment from the administrative powers that have taken over.
In the not-to-distant past, American health care was the gold standard.
It offered job satisfaction and autonomy, was financially rewarding and was considered by many to be the most honorable profession. But as we all know, over the last two decades, increasing health care costs and demands and increasing competition for insurance contracts have changed the face of medicine.
How Well Do You Know Your Patient? – By Jennifer P. Schneider, MD, PhD and Bennet Davis, MD – Mar 2017
Can you describe a day in your patient’s life?
As treating chronic pain with opioids comes under greater and greater scrutiny, one of the lessons that has become more evident to prescribers is that initial assessment and follow-up are no longer a matter of just gathering facts about the characteristics of the pain and its level.
We cannot provide safe and effective care unless we understand the patient’s context. Continue reading
A Psychologist’s Advice for Dealing With Difficult Patients – March 2017
During his talk, Dr Mariano sought to address a common situation encountered by pain physicians in their every day practice: should they reinstate opioid treatment in patients successfully taken off these medications?
The answer is: it depends on the patient,
- on whether they have a history of substance misuse,
- on their functioning, and
- whether they are actively involved in their own pain rehabilitation.
“This is the primary directive of opiate prescribing.
Yes, the primary directive of opioid prescribing is that it depends on the patient. That’s exactly why standard dose restrictions for opioids are not medically sound.