Phantom Knee Pain
Suspecting that this phenomenon might be the source of my nighttime pain, causing significant REM sleep deprivation, I reasoned that a neuromodulator such as a gabapentinoid might be helpful.
Opinion
OPINION
Case Highlights the Importance of Not Rushing Into Judgment With Patients
One physician assistant reflects on an important lesson in listening closely to your patients and why it is important to not jump to conclusions when making a diagnosis.
Medical Malpractice Payout Redistribution: Expert Insight
A recent bill passed in the US House of Representatives proposes a number of changes to malpractice liability rules, including a $250,000 cap on non-economic damages.
What Does the CVS/Aetna Merger Mean for Primary Care?
Aetna will have access to data on pharmaceutical usage patterns that will give the company the opportunity to figure out who is willing to pay more for healthcare. What does this mean for patients?
Can Wearable Fitness Technology Improve Our Health?
One physician shares his thoughts on whether wearable fitness technology is benefiting our health.
Using Conscious and Unconscious Decision-Making to Solve Medical Problems
One physician shares his thoughts on how conscious and unconscious thinking can help making difficult medical decisions.
What Role Should Computerized Decision Support Systems Play in Medicine?
Decision support systems in clinical settings can dramatically decrease the time and manpower needed to perform a variety of tasks, but are they more harmful than helpful?
Chronic Pain Management in Primary Care Settings
From helping patients with opioid addiction to finding pain management programs, one physician shares his experience with chronic pain management in the primary care setting.
The Streetlight Effect and Bias in Clinical Research
Evidence of the streetlight effect can be found across several fields, in which cases investigators draw suspect conclusions from analysis of irrelevant data.
Prescribing Habits: Are They Reflective of Swindling by Big Pharma?
One physician shares his insights on the culture of overprescribing medications and how prescribing habits are reflective of swindling by the pharmaceutical industry
Fired for Falling Asleep During Work Hours: Our Readers Weigh In
Two physicians offer their opinions on June’s Legal Advisor from Clinical Advisor about a female nurse that was fired for falling asleep while on duty in a hospital.
Can Embracing Our Natural Curiosity Improve Patient Care?
The natural curiosity provoked by looking at research and clinical care with a sense of wonder may help us find new ways to deal with old problems and, in turn, improve care for our patients.
A Doctor Reflects on an Early Lesson in Humility
A physician reflects on an early lesson he learned in humility.
Becoming a Better Physician: Make Time for Exercise
Setting aside time for exercise can make you a better physician by increasing your confidence to counsel patients and your perceived success to do so.
Six Lessons on Medicine You Can Learn From Your Patients
There is a lot you can learn from your patients that was never taught at medical school.
The Advice You Give Your Patients May Be Just What They Need to Hear
A primary care physician reflects on the advice he has provided patients over the years.
Energy Drink Consumption Affecting Cardiac Health?
Ingredients in energy drinks are contributing to adverse cardiovascular events, including angina and myocardial infarction.
How to Approach Your Patients on Vaping and Smoking Cessation
A physician’s insights on the growing vape market and whether or not vaping is a better option for smoking cessation.
A Doctor Reflects on His Past Medical Mission Trips
A physician reflects on his past medical missions to Haiti and shares what he could have done differently to make it a more satisfactory trip for him and his patients.
Leveraging Technology in Clinical Practice
An example of a simple use of technology that not only averted the inconvenience and discomfort for the child of a trip to the ER, but also avoided exposing him to additional illnesses and avoided exposing others to what he had.
Smartphones: Physicians’ Best Ally?
The smartphone was made for doctors, and there aren’t enough hours in the day to sing its praises.
A Surgical Intern’s Take on Primary Care
The very first thing you learn in surgical residency is that you are not a primary care physician.
Which Doctor Are You? The Hedgehog or the Fox?
Some patients want the doctor with the most knowledge about their diagnosis and they could care less if he plays well with others.
How Sustainable is Your Primary Care Practice?
If you want to survive today in primary-care medicine, you must have an extraordinarily low practice overhead.
Technological Advances That Improve Daily Clinical Practice
When it comes to charting our outpatient medical records, I have certainly seen the full-spectrum over the last 25 years.
The Lessons I Learned Practicing Medicine in Rural America
Over the course of my residency, challenging though it was at times, I was gradually transformed into a real doctor.
Concern Regarding Legislation Allowing Substitution of Biosimilars for Branded Drugs
Much concern has been voiced regarding legislation allowing the substitution of biosimilars for branded drugs.
Magnesium for Patients on Opioids for Pain
Opioid tolerance may be curbed by taking magnesium.
Is Meaningful Healthcare Reform On Its Way?
Healthcare reform, in its various permutations, has been a political hot potato since before 1993.
A Cardiologist’s Take on Providing Preoperative Clearance
Calling a preoperative evaluation a “clearance,” in fact, belittles the purpose of the assessment, and provides little in terms of meaningful information to the surgeon.
Residents: a Midwife’s Opinion
From day one, the residents welcomed me with respect and support.
Is Telecommunicating With Patients Worth It?
Patient evaluations performed through teleconferencing may lack the accuracy of an in-person physical exam.
Discussing Off-Label Use of Medications With Patients
Though there is no law that says patients must be told that the medications they have been prescribed are for an off-label use, and the FDA does not regulate the practice of medicine, I feel it is important to provide at least a brief explanation to my patients.
Opting Out of Medicare: What You Should Know
Katherine A. Roberts, MD, FACE, ECNU, discusses her experience with opting out of Medicare and offers advice to those considering doing the same.
The Risks and Benefits of Decompressive Craniectomy in Traumatic Brain Injury
Careful selection of surgical candidates can have an impact on neurologic recovery and quality of life.
A Case for the Lidocaine Patch
While the lidocaine patch is still pharmacologic, it offers a different method of pain relief for patients.
Expert Feedback on the Surgeon General’s Report on Addiction
If we invest in providing addiction treatment that is evidence-based and fundamentally invested in the dignity of every person who needs that treatment, a lot more people are going to find themselves ready to seek it out.
Adequately Treating Chronic Fatigue Syndrome
An antiviral that targets all the Herpes family virus successfully treated a patient with CFS.
The Pros and Cons of the Chronic Care Management Program
“To write the program off saying it is too complicated or not worth it may be short-sighted,” Dr Shapiro concluded. “Almost anything that is incrementally beneficial to the practice financially becomes important in an era where there is pressure on declining reimbursement.”
Johns Hopkins Pain Physician: on the Need for an Inter-Disciplinary Approach to Pain Management
“As [a member] of the NIH Task Force on pain, I would say that one of the things that’s important to show is that an interdisciplinary model and a multimodal approach are effective and cost-effective, as they certainly are expensive.”
Are Public-Private Partnerships the Answer to the Aging Biomedical Workforce?
Promoting public-private partnerships to maximize resources, knowledge-sharing, and expediency in treatment development, as a way to attract emerging and established researchers.
A Pain Clinician’s Perspective on the Comprehensive Addiction and Recovery Act
There is a lot of opportunity to improve on what can be offered to patients.
American Headache Society Annual Meeting: Highlights
Huma Sheikh, MD, discusses stand-out presentations from the 2016 American Headache Society meeting
Can We Make Football Safer?
Changing the stigma around and frequency of injury in football requires a collaborative, educational effort involving all stakeholders.
Interventional Pain Management: 5 Things Primary Care Providers Should Know
Interventional pain therapies continue to play an important role for patients with chronic pain.
How Psychologists, Physicians Can Coexist in Pain Medicine
Psychologists have much to offer medicine as a profession, and pain medicine in particular.
Clinical Dilemmas: Prescribing Opioids Concurrently With Medical Cannabis
Does your pain clinic currently allow the use of cannabis in combination with opioid medication? If so, has a maximum THC threshold been identified? How have your patients responded to such treatment?
Discrepancies Between Physical, Radiologic Findings and Physical Limitations
This case study highlights discrepancies between physical and radiologic findings and physical limitations in a patient with cervical and lumbar pain complaints.
The Power of Emotion on Chronic Pain
The correlation between mental health and how well chronic pain is controlled has been well established, and this particular case appears to demonstrate this relationship quite well.
What You Should Know About Concussion, the Film
Dr Conidi discusses some of the major points addressed in the blockbuster film that could impact clinical practice.
Thanksgiving, Gratitude, and Mental Health
Gratitude can help people to become more social and develop deeper and healthier relationships, which in turn can improve their emotional health.
Setting Opioid Dosage Limits in Clinical Practice
Keeping opioid prescribing to 200 mg/d morphine equivalent or less may provide a measure of safety.
An Overview of ASRA Guidelines for Patients on Anticoagulants Undergoing Pain Procedures
The 2015 ASRA guidelines categorize procedures depending on their risk: high risk, intermediate risk, and low risk.
Opioid Precaution During Cold and Flu Season: Medication Adjustment May Be Required
A patient with debilitating chronic pain experiences an altered level of consciousness following a bout of the flu. Could his high-dose opioid regimen be to blame?
Clinicians Should Never Disrespect Patients
Medical practitioners should always treat patients with respect, no matter how stressed or annoyed they are.
Equalizing The Pain Pendulum
The tendency to overprescribe opioids and undertreat pain will swing back and forth until generalists and pain specialists can come to a common understanding about controlled substances and opioids.
Podcast: Overview Of Low Back Pain
Low back pain is one of the most common pain syndromes. In fact, about 69% of adults in the United States will have low back pain at some point in their lifetime.
Should We Be Concerned With Giving 11 Year Olds Oxycontin?
The FDA approval of a pediatric indication for Oxycontin creates a safer situation for terminally ill children.
Podcast: What Does It Mean To ‘Clear’ A Patient?
Clearing a patient for surgery is a clinician’s attempt to mitigate any side effects from occurring as a result of a surgical procedure
Podcast: What You Need To Know About Temporomandibular Joint Dysfunction
Two major symptoms of the function of TMJ problems are pain and dysfunction.
The Graduate’s Guidebook To PA, NP Job Offers
PAs and NPs often receive several job offers after graduation, but there is more to consider than just salary.
Career Advice: Don’t Wait For Happiness
When forced to re-evaluate your career, forewarned is forearmed.
Podcast: Should Doctors Be Videotaped?
Videotaping becomes a problem when the intent is punitive.
Podcast: Understanding Somatic, Visceral Abdominal Pain
Even though movement causing exacerbation of pain can happen with both somatic and visceral abdominal pain, asking patients to do a sit-up or a twister can identify trigger points in the rectus muscles and the obliques
Opinion: Why ICD-10 Will Do More Bad Than Good
Steven Croft, MD, lays down his reasons why ICD-10 will do more bad than good for physician and patient communities.
Healthy Patients Refer Your Practice To Their Friends
Finishing a fellowship means it’s now time to find the right job. Not every practice model is the the perfect fit for everybody, so it’s rather important for physicians to understand which structure will work best for them.
Alternatives To Surgery For Back Pain
Many patients with back pain stop treatment due to dissatisfaction with treatment.
An Overview Of Postherpetic Neuraglia
Postherpetic neuralgia is defined as pain persisting for more than three months after zoster’s onset.
Several Considerations When Prescribing Opioids For Patients With Cancer
There are key factors to consider when determining the best treatment strategy for pain in patients with cancer.
Various Neurosurgical Options Available for Chronic Pain
It is important to review the most recent data available before performing some of these options to make sure these techniques are not out of date.
Assessing Pain: Do the Scales Measure Up?
There are many ways to assess pain in patients.
A Book to Ease Worry About Surgery
Welwyn Ardsley and the Cosmic Ninjas are on a quest to help you ease your pediatric patients’ fears of surgery.
Illicit Substance Abuse in the Elderly: A Growing Problem
Cocaine, heroin and marijuana are the most popular illegal drugs abused among seniors.
Careful Consideration Warranted for Obese Patients In Pain
In one study of 3,000 twins, after adjusting for variables, twins who were overweight were more likely to report painful conditions.
Get Set for Coding Changes
Many of the pending codes are orthopedic in nature, which holds significance for clinicians dealing with patients with pain.
Ultrasound For Your Pain Practice: A Good Idea?
Although flouroscopy is still key, ultrasound has its place,
Avoiding Complications During Interventional Procedures
When dealing with a patient with a previous iodinated contrast agent reaction, pretreatment should be considered.
Be Mindful of Your Own Pain Triggers When Counseling Patients
Investing in a “good chair” for the clinic, that encourages good posture, could help you avoid painful back problems.
Picking the Best EMR For Your Pain Practice
Most of these systems have online videos, which can be very educational.
Pain Management During Pregnancy Warrants Special Consideration
Opioid use in women of reproductive-age has been a hot topic in the news of late.
The Price of Pain in Your Practice
Take a closer look at your work, exercise, rest, and stress factors during a typical work week.
Better Sleep, Less Pain: Studying the Links
Study investigating treatment to improve sleep and address pain related to fibromyalgia and PTSD.
A Round of Applause For Kind Patients
Patients who remain cheerful, despite personal drama, deserved to be recognized.
Pain and Connection
An essential part of our job as health care practitioners as one of bridge building; encouraging our patients to shorten the distance between the world of the ill and world of the well by enhancing connection.
Emerging Mobile Technology for Concussion Detection and Management
Advancements in mobile detection technology allow immediate assessment, but can’t replace a medical professional’s diagnosis.
Orofacial Pain: An Interprofessional Effort
Since pain is a subjective experience for which there are no accurate objective measurements, patient-derived information regarding their pain experience is important to analyze
Interpersonal Relationships Integral to Managing, Treating Pain
Perspective-taking is a way to help foster empathic feelings in observers and to help people when they are experiencing pain.
Pearls To Reduce Needlestick Pain
Ease pediatric patients’ anxiety about needles by talking with them about what to expect.
Brain Injury Can Lead to Mental Health Issues
Concussions resulting from contact sports injuries can impact cognition, behavior and mood.
Concussion Detection, Management Varies Widely
All too often, physicians, coaches, and athletes are swayed into making a quick conclusion after a hard hit.
Welcome to Clinical Pain Advisor
Key features include: concise daily news, drug monographs, full length clinical features, continuing medical education courses, and coverage from major conferences.
Education Key in Pre-Surgical Discussions
Many medical centers are now developing multi-professional teams who will identify patients likely to have post-op problems.
Cannabinoids May Provide Pain Relief in Oral Cancer
Oral malignancies can be associated with increased pain, but current research suggests that a cannabis-based medication may reduce this morbidity.
Sleep Issues Common in Patients with Chronic Pain
A night with inadequate sleep may result in increased pain the next day, which may disrupt sleep even further. Learn how to help patients break this detrimental cycle.
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