Drug Testing—Getting it Right

Payer policies have recently changed to address medical necessity for drug testing. They’re focusing on individualized testing and proper utilization of drug test results and basically what that means is, don’t test everything under the sun but instead do some more rational patient-centered balance...

Endometriosis: Getting the Message Out There

Although endometriosis is the most common condition identified among women with dysmenorrhea and chronic pelvic pain, its evaluation and management presents many challenges to practicing clinicians. Dr. As-Sanie emphasizes diagnostic and treatment strategies for the primary care clinician.

• Endome...

Putting the Patient First When Making Policy

A lot of bills are being introduced to combat the opioid crisis. But rather than just focusing on opioids or taking opioids away, we need comprehensive solutions to help manage pain long term. Medicare made several changes in terms of how opioids are prescribed, namely certain hard stops for opioid...

Back and Forth… and Back Again

The opioid pendulum probably has been swinging back and forth for thousands of years. How incredibly polarized opinions about opioids has been at various points in time—from “They are a gift from god” to “They are the devil personified.” And whenever I speak on it, I’ve started virtually every talk...

Lessons from the Military—Acupuncture + Microcurrent

Battlefield acupuncture protocol is an auricular protocol where 5 acupuncture points in the ear are stimulated for the purposes of calming the nervous system, pain management, and decreasing stress. The protocol itself was created for soldiers who were having traumas while they were on the...

Aberrant Drug Behaviors and Responsibilities of Primary Care

Primary care has a great opportunity to assess patients’ drug taking behaviors when they enter the healthcare system. It’s very rare that a patient would start their care with a specialist, and primary care is where most people would go outside of some sort of acute care setting. So, their ability...

Pain and the Geriatric Pain Population

The average geriatric patient, about 80% of them, have some chronic illnesses that they live with day to day. Because they take a lot of medicines, there are drug-drug interactions, and unintentional misuse and abuse. Studies have shown that the geriatric population… a lot of times they are getting...

Words Can Hurt, or Help

Many publications have been put out into the public space and in the scientific research on how the nocebo effect is generated from patient-provider interactions, and there are some really important things to read about how words, which we, as clinicians, might consider really innocuous, could in...

Helping Informal Caregivers to Give Care

We ask informal caregivers to do things that 20 or 30 years ago, we would have hesitated to ask a nurse to do at home. They struggle with these issues such as “How do I assess the pain to determine are they really having pain?” “How much of the medication do I give?” “Which medication do I give?”...

Prescribing Guidelines: Where to go From Here?

The CDC guideline was a good idea, but the way that it was brought about, the procedure that was used, the people that were invited, the process itself, negatively impacted the end result. And that continues to create problems in the areas of misinterpretation, not only by policymakers, but also by...