Tag Archives: standards

The Opioid Crackdown: Have We Gone Too Far? (Part III)

The Opioid Crackdown: Have We Gone Too Far? Part III – November 21, 2017 – by Anne Fletcher 

Part three of this series examines what happens when government guidelines and recommendations such those in as the CDC Guideline for Prescribing Opioids for Chronic Pain are used to make rules and regulations about medications that leave little or no room for physicians’ discretion and individual patient needs.

How does this impact people who depend on these medications to avoid suffering and have a decent quality of life?   Continue reading


A Modern-Day Physician’s Pledge

The Revised Declaration of Geneva: A Modern-Day Physician’s Pledge Oct 2017

A newly revised version of the Declaration of Geneva was adopted by the World Medical Association (WMA) General Assembly on October 14, 2017, in Chicago.

As the contemporary successor to the 2500-year-old Hippocratic Oath, the Declaration of Geneva, which was adopted by the World Medical Association (WMA) at its second General Assembly in 1948, outlines in concise terms the professional duties of physicians and affirms the ethical principles of the global medical profession.   Continue reading

UN Says Untreated Pain Is “Inhumane and Cruel”

Editor’s Memo October 2017: United Nations Says Untreated Pain Is “Inhumane and Cruel” – Oct 2017 – Forrest Tenant

The national debate on the proper use of opioids continues to build as the high prevalence of addiction and overdoses fuel the continuing attention to this “public health crisis.”

Much of the anti-opioid rhetoric regarding the “opioid epidemic” implies that pain is a nuisance that really doesn’t require treatment.

Instead of making the focus one of achieving good pain relief, far too much attention has been directed solely at the risks of opioid prescribing and how we must provide naloxone on every street corner where an opioid might be sold.   Continue reading

Neuroimaging for Chronic Pain: IASP Consensus Statement

Neuroimaging for Chronic Pain: IASP Consensus Statement – by 

health and disability insurance companies seek methods to confirm the pain status of beneficiaries to corroborate self-report, which is the current gold standard for pain assessment in clinical and research settings.

All parts of our health system (and its interface to the legal and financial systems) have difficulties with self-reported symptoms because they are all based on numerical values that are independently verifiable.

A blood test or x-ray taken by your doctor will not yield significant differences from the ones taken by your insurance company or lawyer, so these are seen as “factual evidence”.   Continue reading

A classification of chronic pain for ICD-11

A classification of chronic pain for ICD-11 – Free ful-text /PMC4450869/ from NIH – 2015 Jun

Chronic pain is a frequent condition, affecting an estimated 20% of people worldwide and accounting for 15% to 20% of physician visits.

Chronic pain should receive greater attention as a global health priority because adequate pain treatment is a human right, and it is the duty of any health care system to provide it.

The current version of the International Classification of Diseases (ICD) of the World Health Organization (WHO) includes some diagnostic codes for chronic pain conditions, but these diagnoses do not reflect the actual epidemiology of chronic pain, nor are they categorized in a systematic manner.   Continue reading

The Secret Role of Insurers in Medicare Opioid Policy

The Secret Role of Insurers in Medicare Opioid Policy – October 2017 – By Pat Anson, Editor

This month marks the one year anniversary of a closed door meeting between law enforcement agencies, federal and state regulators, and health insurance companies in a Baltimore suburb – a “special session” of an obscure advisory group to the U.S. Justice Department and the Department of Health and Human Services.

Although the mission of the Healthcare Fraud Prevention Partnership – HFPP for short — is to prevent healthcare fraud, the October 20, 2016 meeting went much further.

It gave the insurance industry – so-called “Partner Champions” — a direct role in drafting recommendations that could decide how millions of pain patients will be treated by their doctors and what opioid medications will be prescribed to them, if any.   Continue reading

CVS Defends Rx Opioid Policy

CVS Defends Rx Opioid Policy — Pain News Network – Sept 28, 2017 – bu Pat Anson

I don’t like the idea that some corporation, in business purely to make profits, can make decisions about my medical care and, without a medical reason or even exam, limit the pain relief my doctor prescribes for me.

And if these limits don’t provide me the pain relief I had previously, if the actions of the drugstore corporation in reducing my prescription to some “standard” causes a deterioration in my quality of life, and if I then become despondent and suicidal… who will answer for my distress?

…Asked to comment on these and other concerns, CVS Health emailed a statement to PNN answering a series of questions we had about its new opioid policy.  Continue reading

The Conundrum: Individual Risk vs. Population Risk

The Risk-Prediction Conundrum: Individual Risk vs. Population Risk – CardioExchange CardioExchange May 21st, 2014 – by John W McEvoy, MB BCh BAO

How do you explain the difficulties of risk prediction with patients?

This is a difficult but necessary exercise. So much of what we do in medicine is based on risk.

Indeed, fully informing patients about the risks and benefits of their care depends on having at least a simple understanding of risk.   Continue reading

Pain Management in Patients With Hypermobility Disorders

Pain Management in Patients With Hypermobility Disorders: F… : Topics in Pain Management – Topics in Pain Management: July 2017Linda Stapleford Bluestein, MD – Continuing Education (CME) Activity

Learning Objectives/Outcomes: After participating in this CME/CNE activity, the provider should be better able to:

  1. Describe the various types of hypermobility.
  2. Identify signs and symptoms of hypermobility spectrum disorders.
  3. Develop treatment plans for patients with hypermobility disorders that address their specific and unique needs.

Chronic musculoskeletal symptoms account for a vast amount of health care utilization and are a leading cause of impairment and deterioration of quality of life.   Continue reading