What follows is a guest post. James Patrick Murphy, MD, MMM is board-certified in Pain, Addiction, and Anesthesiology. He is President of The Greater Louisville Medical Society and the Course Director for OPIOID — Optimal Prescribing Is Our Inherent Duty.
Dr Murphy, a friend, writes on the matter of optimal prescribing of pain therapy. It’s a timely and important topic. As a bike racer, I have experienced the anguish of pain. From a patient perspective, the problem with pain is not just that it hurts, but also, that it’s hard to see the end of suffering. Thankfully, I have been lucky to have had compassionate caregivers, all of whom prescribed pain therapies that worked without causing adverse effects.
From the perspective of a caregiver, the treatment of pain is vexing. On the one hand is a fellow human in need of compassion. Caregivers are called to care. But as it is in many diseases, treatments for pain are far from perfect. Each comes with the potential for adverse effects. I’ve written extensively about the dangers of NSAIDs. Propublica has exposed the under-recognizedÂ dangers of high-dose acetaminophen. And we all now about opioids. My state of Kentucky has been an epicenter of opioid-related issues, including unintended consequences of well-meaning regulations.
Enough of me. Here’s Dr Murphy:
OPIOID Helps Caregivers Weather the Regulatory Storm
Healthcare is engulfed in a torrent of regulations raining down upon caregivers. Nowhere is this more evident than in the delivery of pain care. Perhaps OPIOID is the way to weather this storm.
Allow me to explainâ€¦
Recently, I was talking with a sales rep from a drug screen lab, and our conversation naturally veered into a discussion about how states were beginning to require urine drug screens for patients receiving pain medication.
To a drug screen lab these regulations are like liquid gold.
But as easily as regulations are passed, they can be erased. And if the success of a lab is based on the existence of a regulation, then the business model is built on thin ice and for the wrong reasons. If the regulations dry up, so does lab.
Iâ€™m a physician, and – like the lab – I expect compensation for what I do.
What I do is care for people by applying factual knowledge, energized by creativity, in accordance with evidence-based protocols, while remaining cognizant of the mysteries still misunderstood and the mysteries awaiting discovery. Itâ€™s a marriage of science and art.
I know that following regulations goes along with the territory. But following regulations does not make me jump out of bed every morning with passion and determination. A regulation never delivered a baby, bypassed a clogged artery, or discovered a cure. People do these things. People need these things. Iâ€™d rather work for people than a regulation.
The delivery of pain care is perhaps the most regulated activity in medicine. And depending on the state, the regulations can seem foreboding to the caregiver. The message is clear. Either get on board or the Board will get on you.
The thought of abandoning our suffering patients out of fear is bitter. The thought of losing our licenses is chilling. And the thought renouncing our calling as patient advocates to blindly follow regulations we don’t even understandâ€¦ is demoralizing.
It doesnâ€™t have to be this way.
Remember my lab rep? My advice to her was to go back to her supervisors and suggest that they promote their product primarily as a means to help patients by helping prescribers. Then they would be serving the best interest of millions of people, as opposed to serving at the pleasure of a few hundred lawmakers. In other words, make improved quality of life the real goal – not adherence to regulations.
Thatâ€™s what OPIOID is all about. OPIOID means Optimal Prescribing Is Our Inherent Duty â€“ a seminar conceived by physicians, approved by Kentuckyâ€™s Medical Board, and produced by the Greater Louisville Medical Society in association with the University of Louisville â€“ February 7 – 9, 2014. The goal of OPIOID is to empower prescribers to optimally care for suffering patients and adhere to the governing regulations. People can register by email: [email protected] or call: 502-736-6354 or visit online at: https://www.glms.org/Home.aspx (and click on the â€œOPIOIDâ€ tab).
OPIOID is a prime example of caregivers holding steadfast to their calling in the regulatory storm. Please spread the word. Together we can weather this.
James Patrick Murphy, MD, MMM
January 26, 2014
Dr. James Patrick Murphy is board-certified in Pain, Addiction, and Anesthesiology. He is President of The Greater Louisville Medical Society and the Course Director for OPIOID.