From Confrontation to Collaboration: Collegial Accountability and the Expanding Role of Pharmacists in the Management of Chronic Pain

2001 ◽  
Vol 29 (1) ◽  
pp. 69-93 ◽  
Author(s):  
David B. Brushwood

Federal and state laws create a tightly controlled system for distribution of those drugs that have recognized value in therapy, but also have the potential for abuse. The challenges pharmacists face in keeping controlled substances within the closed system are many and complex. Drug abusers and drug dealers have at times seen pharmacists as easy marks for access to abusable drugs. Unfortunately, pharmacists often find themselves in a game with criminals, who use both sophisticated and dangerous methods of inducing pharmacists to divert controlled substances. The effects of this problem on the health-care system have been judicially noted:The frequency of these crimes has terrorized the community of dispensing pharmacists. Some pharmacists have ceased to carry drugs that are highly desired on the black market, although this interferes with their patients’ ability to obtain necessary medicine. This has a serious potential to impede the delivery of health care in many communities around the nation.

Haemophilia ◽  
2020 ◽  
Vol 26 (5) ◽  
Author(s):  
Leonard A. Valentino ◽  
Mark W. Skinner ◽  
Steven W. Pipe

2013 ◽  
Vol 41 (S1) ◽  
pp. 42-45 ◽  
Author(s):  
Andrea M. Garcia

According to the Institute of Medicine, chronic pain affects at least 116 million adults in the United States (U.S.), which is more than the total affected by heart disease, cancer, and diabetes combined. Pain costs the nation up to $635 billion each year in medical treatment and lost productivity. It has been conceptualized as a public health problem due to its prevalence, seriousness, disparities, vulnerable populations, the utility of population health strategies, and the importance of prevention at both the population and individual levels. For many patients, treatment of pain is inadequate due to uncertain diagnoses, societal stigma, the lack of effective treatments, and inadequate patient and clinician knowledge about the best ways to manage pain. This article explores the inadequate treatment of pain in the U.S. and the subsequent rise of prescription painkiller abuse, misuse, and overdoses. This is followed by a review of the actions taken by states to regulate the prescribing of controlled substances.


2001 ◽  
Vol 32 (4) ◽  
pp. 605-610 ◽  
Author(s):  
L. B. Reller ◽  
M. P. Weinstein ◽  
L. R. Peterson ◽  
J. D. Hamilton ◽  
E. J. Baron ◽  
...  

2008 ◽  
Vol 13 (6) ◽  
pp. 484-488 ◽  
Author(s):  
Philip Peng ◽  
Jennifer N Stinson ◽  
Manon Choiniere ◽  
Dominique Dion ◽  
Howard Intrater ◽  
...  

PURPOSE: To examine the role of health care professionals in multidisciplinary pain treatment facilities (MPTF) for the treatment of chronic pain across Canada.METHODS: MPTF were defined as clinics that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain, and had staff from a minimum of three different health care disciplines (including at least one medical specialty) available and integrated within the facility. Administrative leaders at eligible MPTF were asked to complete a detailed questionnaire on their infrastructure as well as clinical, research, teaching and administrative activities.RESULTS: A total of 102 MPTF returned the questionnaires. General practitioners, anesthesiologists and physiatrists were the most common types of physicians integrated in the MPTF (56%, 51% and 32%, respectively). Physiotherapists, psychologists and nurses were the most common nonphysician professionals working within these MPTF (75%, 68% and 57%, respectively), but 33% to 56% of them were part-time staff. Only 77% of the MPTF held regular interdisciplinary meetings to discuss patient management, and 32% were staffed with either a psychologist or psychiatrist. The three most frequent services provided by physiotherapists were patient assessment, individual physiotherapy or exercise, and transcutaneous electrical nerve stimulation. The three most common services provided by psychologists were individual counselling, cognitive behavioural therapy and psychodynamic therapy. The major roles of nurses were patient assessment, assisting in interventional procedures and patient education.CONCLUSION: Different health care professionals play a variety of important roles in MPTF in Canada. However, few of them are involved on a full-time basis and the extent to which pain is assessed and treated in a truly multidisciplinary manner is questionable.


2010 ◽  
Vol 7 (13) ◽  
Author(s):  
Marie Østergaard Møller ◽  
Lise Kirstine Gormsen

The structure and organization of health care is a salient political issue across nations and welfare states. It is important not only from an economic perspective, but also from a social and political perspective regarding the possibility of maintaininga proper qualitative level of health care as well as a system that is broadly accessible to the citizenry. Equal access to health care and social care is thus a key factor when the general quality of public life is discussed, not only in Denmark but also in many other welfare states. A common prerequisite for the existence of such a system is a strong general norm of reciprocity in social and political contexts. The norm states that everybody should contribute to our common welfare by working, paying taxes and participating in political institutions and in return be treated as equal members (citizens) of the state. However, not all citizens are capable of working, and far from everybody has equal access to health care and social care. In theory everybody should enjoy the same rights and access to common services, but in reality the boundary between being considered entitled to and deserving of public assistance and being perceived as responsible for one’s condition is more a political than an objective measure (Stone, 1984: 26; Møller, 2009b: 235). In practice, the principle of equal access is interpreted and implemented by doctors who treat patients, health care professionals promoting health strategies, caseworkers who manage clients and schoolteachers teaching children and at the end of the day it is professionals like them who decide who is given access to services, transactions, preventive interventions and treatments.In health care the diagnostic system works as a platform for deciding who should treat which citizens with what, but in social care such a system is more invisible. Instead the main criterion for access to services and transactions is a systemdesigned to detect and measure the workability of every assistance-seeking citizen. The method of evaluating assistance-seeking citizens’ workability seeks to differentiate between needs and claims because an absolute main reason why citizens cannot maintain a job and need to apply for public support is health problems such as chronic pain, for which they seek medical, psychological or therapeutic help. On an economic level this demand of public support is often seen as creating incentives to exploit the social sector to reduce labor costs; on a practical level it constitutes a difficult and paradoxical interplay between the role of the doctor, the social worker and the idea of the independent citizen, in theory, the equal member of the state. This volume focuses explicitly on the case of chronic pain in such different social and political contexts.


PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 592-597
Author(s):  
Kurt Gorwitz ◽  
Donald C. Smith

Currently declining birth and fertility rates in the United States are having a significant impact upon both the absolute and relative size of the child population. The magnitude and extent of this impact are described and its implications for the practice of pediatrics are discussed. The timeliness of reexamining the role of the pediatrician in the delivery of health care services is emphasized.


Sign in / Sign up

Export Citation Format

Share Document