Doctors Caught Between Patient Pain, Prescriptions
The drug-pain scenario amounts to a "perfect storm" of two huge issues, says Glen Stream, MD MBI president of the 105,000-member American Academy of Family Physicians, which has been a major opponent of proposals in Congress to mandate continuing medical education (CME) related to the opioids as a prerequisite for licensing. The AAFP contends such actions would, among other things, place unfair "limitations on patient access to legitimate pain management needs that may occur."
Stream acknowledges that physicians may feel caught in the middle. "We want to make sure legitimate pain gets appropriate treatment and there is relief of suffering," he told HealthLeaders Media. "But we don't want to add to the opioid abuse problem by prescribing medication people don't have a legitimate need for."
Stream's own state of Washington has been among the strictest regulators involving opioid prescriptions, according to the American Medical Association. It includes rules with detailed instructions about how to evaluate and care for patients with chronic non-cancer pain, and requires "patient contracts" that call for mandatory, periodic urine screenings.
At least seven states, including Florida, require medical licensure contingent on whether physicians complete CME courses related to pain management or prescribing controlled substances, according to the AMA. Many other states have initiated prescription-monitoring programs.
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