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Editor’s Note:The author has evaluated and treated more than 25,000 patients with rheumatic disease and chronic pain syndromes, and spent 30 years in clinical practice and teaching medicine.  
Introduction As part of our special roundtable of women clinicians leading in pain management, we asked particpants what advice they would offer male colleagues who seek to be allies in the inclusion of female clinicians in the pain management field.
In this special roundtable, leading women clinicians discuss being outsiders in a male-dominated industry, making names for themselves in policy, research, and practice, representing the BIPOC community, and more.  
As part of our special roundtable on women leaders in the field of pain management, we asked experts working across academia, research, policy, and practice what they wished they had known when starting out. Here are their responses.
Medical education is not immune from perpetuating bias within its curriculum and clinical training. Such accounts are demonstrated when different perspectives are excluded from content, teaching is imbalanced or selective to only one interpretation of an issue, or stereotypes are assigned to specific groups at the cost of individual attributes or differences.
I completed my graduate degree in nursing and became an adult nurse practitioner in 2002. By that time, I already had more than 5 years of nursing practice under my belt and did not think too much about the need for focused training in pain assessment and management in my graduate training.
COVID-19 led to sudden and unforeseeable changes in every aspect of our lives. Hospitals and independent medical practices were forced to adapt to rapidly changing safety guidelines and left to make changes based on their individual circumstances. Many private practices faced severe financial difficulties and steadily declining revenues as patients were hesitant to seek medical care.
The COVID-19 pandemic has upended nearly every aspect of daily life, including routine medical care. In early April 2020, in-person medical practice visits were down 69% from pre-pandemic levels and, at the same time, telemedicine visits were at their highest levels in recorded history.
What you can – and cannot – assess in a virtual visit, and how to compensate. Plus, what to document.  
COVID-19 infection may cause a number of clinically significant cardiovascular events in connection with what is being called Post-COVID Syndrome or Long COVID. An indirect effect is related to the delayed diagnosis of urgent non-COVID conditions, because of concern with going to a hospital.
It has been just about a year since the United States entered into a variety of voluntary and mandatory lockdown measures in response to COVID-19, forcing the face of healthcare to change almost overnight.
I, Theresa, was recently approached by a woman who was new in her career as a nurse practitioner in pain management – she sought me out as a mentor.
Presenting:  PPM's Recommended Reading from the Editorial Advisory Board  
Since the approval of medical cannabis in New York state in 2014, there has been an increasing amount of interest in its clinical use. The role of medical cannabis has been particularly expanding in the pain specialty, where physicians have been seeking more non-opioid based treatments for chronic pain. 
With the COVID-19 pandemic continuing to rage around the world and additional waves of infection likely, education in pain medicine will have to change in different ways in the coming years to train future physicians.
Mistakes are not a problem – not learning from them is. A commentary.  
Introductory Note from the Authors In 2018, PPM introduced a new column called “Ask the APP” to bring awareness of the issues APRNs, NPs, and PAs face when practicing in the specialty of pain management.
Chronic pain is one of the most common conditions, affecting an estimated 116 million Americans, but it is not treated equally in this country – inside the data and perspectives from Michael Schatman, PhD, Terri Lewis, PhD, Sherra M. Watkins, PhD.
Editors Note: Although opioid-related overdoses appeared to plateau or even decline, recent data suggests that opioid overdoses may again be on the rise.
Prescription opioids play a vital role in the treatment of pain; however, unused pills may be diverted for nonmedical use, contributing to the abuse and misuse of opioid medications. Misuse is defined as taking prescription drugs for a different purpose than directed by the prescriber, and/or taking drugs more often, for a longer duration, or in greater amounts than prescribed.1
The field of pain management is undergoing changes like never before. With an opioid crisis and a pandemic, people in chronic pain are suffering on multiple fronts. Practitioners are similarly challenged with trying to help a growing patient population, largely from a distance, while also trying to maintain their own health – and sanity – without burning out.
Medical practices are facing growing pressure to provide value-based care, which is defined by a high ratio of positive outcomes to total cost of care.1 Increasing this ratio requires that the right patient see the right provider at the right location for the optimum amount of time at optimum cost.
What it takes to hold oneself out as a “pain specialist” is a question I began to ponder when I started working in pain management 20 years ago, with the larger question being, what exactly is a “pain specialist?” I thought the answer would be straightforward, but after two decades of clinical practice in the specialty, I still don’t have a clear answer.
To those unfamiliar with the current landscape of medical training in pain management, there are no pain management or pain medicine residencies. To enter a pain medicine fellowship, an applicant must have completed a residency in anesthesia, physical medicine and rehabilitation, neurology, emergency medicine, psychiatry, or family medicine.
Background: Pandemic-Related Hospitalizations Pose Potential Pain-Med Shortages Demands on the healthcare system have increased and evolved due to the COVID-19 pandemic.
During the 40-plus years of my medical practice, I have never observed disruption on the scale we are experiencing today. The changes we are observing could easily be compared to those faced by a community after a tsunami devastates their land and creates unimaginable chaos.
The COVID pandemic has changed the practice of medicine in numerous ways, and its effects are experienced not only in the day-to-day critical care and emergency medicine settings but also in the area of pain management. In Steven H. Richeimer’s clinical practice, for example, which is a tertiary care center, patient care has been significantly altered.
Telemedicine, also known as telecare or telehealth, has been used for many years to ease communication between providers and patients, and offers a convenient option for patients that require regular follow-up observation but are unable to ambulate easily due to medical comorbidities.
A June 2019  Issue PPM Online Exclusive
Providing effective pain care to special population groups, including members of the LGBTQ community
The author shares his clinical experience with the use of nerve growth factor (NGF) antagonists in the management of chronic pain.
September/October 2019 Letters to the Editor, including a dialogue around pain practitioner credentials.
It's become increasingly clear that males and females require unique assessments of their chronic pain conditions.
What HCPs need to know regarding the prescribing of controlled substances, including refills and DEA registration.
A new book by Peppin, et al, offers pain practitioners, policymakers, and regulators clarification around prescription opioids.
The University of Florida's Meryl J. Alappattu, PT, DPT, PhD, on why HCPs need to be asking about sexual pain.
Individual biomarkers may change the way pain is reported and managed.
Despite low supportive evidence, certain advanced wound therapies may benefit patients.
How to implement behavioral pain medicine strategies across the continuum of chronic pain care.
June 2019 PPM Letters to the Editor, featuring CGRP (Aimovig) complications, CRPS, and slipping rib syndrome.
As an advanced practice provider (RN, PA, APP) working in pain management, can I contribute to clinical research?
The April/May 2019 Letters to the Editor focus on opioid conversions (morphine to methadone) and scrambler therapy for CRPS.
A Q&A with UCSF Neurologist Howard L. Fields, MD, PhD, on pain signals, pathways, decision-making, and optimism.
Further investigation into instructional interventions and their impact on pain chronification are necessary.
March 2019 Letters to the Editor: AIPM ceases operations, pain catastrophizing with Beth Darnall, and more.
Is there value in having an Acute Pain Service, and can APPs take the lead? Our resident APP responds.
Tips for encouraging patients with chronic pain to complete an exercise regimen.
Practitioners and peers discuss the CDC guidelines, plantar fasciitis, cannabis for migraine and rheumatoid arthritis, and light therapy.
Industry experts Jianguo Cheng, Stefan Evers, W. Clay Jackson, Lynn Kohan, William Maixner, Paula Marchetta, and more share their visions.
The US Department of Health and Human Services established the Interagency Pain Research Coordinating Committee as part of the Patient Protection and Affordable Healthcare Act (Public Law 111-148) to coordinate all pain research efforts within HHS and across other federal agencies.
Fitting into a new practice may be tough, but there are several measures you can take to ensure a smooth transition.
Early interactions with chronic pain patients are key to treatment acceptance trust, and ongoing communication.
Practitioners and peers discuss naloxone access in schools, converting products to buprenorphine, and OUD / MAT management.
Practitioners and peers discuss how recovery centers may rejection medication-assisted treatment for OUD, the prospect of cannabis for chronic headaches, and more.
The Society of Palliative Care Pharmacists shares a vision for enhancing the pharmacist’s crucial role in chronic pain, palliative care, and hospice care.
Inside the roadblocks affecting the pain care industry’s use ofabuse-deterrent opioids, including insurance coverage and prescribing tactics.
New PPM Co-Editors-at-Large Jeff Gudin, MD, and Jeffrey Fudin, PharmD, reflect on the collaborative nature of the pain management community.
Clinicians answer reader questions and comments regarding ACT Therapy and topical analgesics.
JPS Health Network and the American Society of Clinical Oncology share their experience in improving pain documentation and plans of care.
Many non-pharmacological therapies have limitations that stunt their progression into therapies for chronic pain.
Clinicians treating patients with a variety of chronic pain conditions may improve overall outcomes by reaching out to other practices and specialists.
Clearway Pain Solutions Institute sought an outside partner to grow its advanced pain solutions both nationally and regionally.
Individual factors related to the patient make abuse- deterrent opioids a worthwhile consideration.
When taking over the management of a high-dose opioid patient, follow these steps to update their treatment plan.
mHealth apps and other digital technology could make practitioner-patient communication smoother.
A Virginia-based study provides insight into pharmacists' perceptions of pain practice, knowledge gaps, and the realities of dispensing scheduled pain medications.
Pending legislation from the House of Representatives promises to offer more treatment alternatives for patients in chronic pain.
An excerpt* from the preface of It Hurts: A Practical Guide for Pain Management (WellBridge Books, 2018).  Read more about Kern A. Olson, PhD, the author.
There have been unintended consequences to the regulatory measures of reducing the quantity of opioids prescribed.
Technological advances in wearable medical technology have optimized delivery and efficiency of healthcare, including within the field of pain management.
The ASRA World Congress meeting will cover multiple therapies, as well as advocacy in pain practice.
While the physician may conduct the IT trial and implant, PAs, NPs, and RNs often provide follow-up, patient education, and technical care of the pump.
It is clear that physicians spend too much time on administrative tasks.
Physician burnout is a reality, and it comes at the expense of many pain patients.
Recognizing, preventing, and treating physician burnout should be a priority to all pain practitioners.
The Share the Risk model focuses on providing chronic pain patients with a more comprehensive look, including legal and ethical considerations as well as cognitive and psychological profiles, at why and when they may require opioids.
Two new pain management technologies make it easier to take prescriptions and respond to opioid overdose, including through administration of naloxone and direct observational therapy.
ADC Chair Dan Cohen calls on the use of abuse-deterrent technologies to help deter patients and users from opioid misuse, abuse, and addiction.
The American Society of Clinical Oncology aims to improve pain practice guidelines and management with new initiatives.
CDC opioid prescribing guidelines continue to make it difficult for pain management practices. This report provides an inside look at what chronic pain patients and their practitioners are facing.
Clinic guest-dosing and advance planning may help pain and addiction treatment centers to continue providing services when a natural disaster strikes.
Big data and new devices may allow for practitioners to track patient adherence to medication, change payment models, and improve health outcomes.
Dr. Forest Tennant addresses public and practitioner concerns over morphine equivalent dosing, opioid tapering, and depressed testosterone levels.
Physicians who listen to and heed patient functioning and feedback will assure quicker, more effective pain management.
REMS, TIRF, CDC Guidelines—there is a lot that pain specialist must manage outside of their daily practice. To help, Jeff Gudin, MD, and other pain specialists rely on the expertise of specialized pain pharmacies.
A preview of American Academy of Pain Medicine's goals and expectations for their annual meeting, being held in Palm Springs, CA, February 18-21, 2016
Some physicians have turned to a Concierge Medicine model (fee-for-care) to better serve their chronic pain patients. Learn more about this type of health care model/
The Pain Research, Education, and Policy (PREP) program at Tufts University School of Medicine, Boston, Massachuesetts takes a unique approach to pain education. Practical Pain Management spoke with founding director of the PREP program Daniel B. Carr, MD, about the goals and vision of the program. Dr.
The VA Pain Education School consists of 12-weeks of 1-hour classes with an additional 1-hour introduction class during the first week (total of 13 hours).
An evaluation of the VA's Pain Education School for healthcare providers who treat patients with chronic pain.
I congratulate the authors of this article on a new screening tool for their research and lucid writing.1 It is clear today that risk assessment and stratification are essential to mitigating risk with opioid use, and improvements in this area are
Pain is one of the most common reasons patients visit a health care professional. Professionals spend a great deal of time learning how to diagnose and treat pain-related medical problems but much less time learning how to document the process.
Over a dozen years ago, the United States Congress proclaimed the “Decade of Pain,” and the infamous 1 to 10 visual analog pain score became the 5th vital sign. At just about the same time, Marvin Rosenfeld—not a physician but a publisher—believed that practicing physicians who treated pain patients needed a tutorial magazine that contained practical tips on case management.
5 Things You Need to Do to Remain Compliant With AMA CPT Coding Change
  • Have you reviewed the coding changes for 2012?
  • Have you updated your super bills and templates?
Article describes the benefits of using computerized patient-reported outcomes data in the clinical pain practice.
Article discusses the role of primary care within a system of integrative multi-disciplinary pain management.
With limited opportunities of pain management residencies, and fellowships, alternate means must be employed for practicing physicians to train in the basics of pain management.
A potential strategy for addressing the conflicting ethos of business-oriented insurance and corporate healthcare vs the ends and means of right and morally sound patient care.
Originating in San Diego, CA, the Share the Risk Model is an example of successful collaboration among doctors to mitigate professional risks while improving care for pain patients.
This article explains the some of the basic, common-sense criteria for referring a patient to a pain treatment clinic.
Article explains how to understand unconscious interpersonal defensive responses in a chronic pain practice to improve interactions.
The former head of the largest pain clinic in Central Europe offers observations on multi-disciplinary treatment modalities evolving over the past 25 years.
Casa Palmera has become a model center for the treatment of comorbid chronic pain, substance dependence, eating disorders, and emotional trauma by bringing together the best of Eastern and Western medicine with neuroscience.
Article addresses the multidisciplinary pain medicine fellowship: Will it change the practice of pain medicine?
Article explains how the Share the Risk Model is used in pain management in a dedicated facility. this article is a first in a series of case reports.
In the last article, I discussed medical necessity since the OIG 2008 Work plan will focus on pain management clinics. Medical necessity definitions vary from one payer to the next. Fortunately, Medicare—and most Blue Cross and Blue Shield plans—publish their definitions.
As the healthcare world transitions to EMRs, it's more important than ever to have consistent documentation in proving compliant patient care.
With a designated pain professional and appropriate safeguards, a pain management program can be successfully integrated into a multi-physician primary care clinic.
A pain management specialist reviews billing and coding requirements for the interventional pain management field.
Are You Really Utilizing Your EMR
Share The Care—Not Just The Risk
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