Pain was widely under-treated in the 1980s. Two decades ago, pain was recognized as an important problem that needed to be managed by healthcare providers. Today, the opioid crisis has led to under-treatment once again. Professional recognition of pain as a symptom that needs managing was the eventual outcome of several decades of research. Again… Read More »
The current healthcare system is not built for individuals with serious illnesses. These individuals can benefit from palliative care, which focuses on quality of life and symptom relief. Alternative payment models that incorporate palliative care are in development. Yet, the challenges of expanding these models of care are substantial. Betsy recently died after a sixteen-year… Read More »
Reactions to the opioid crisis are affecting patients in need of hospice and end-of-life care in the United States. Hospice providers have been largely exempt from the increasing regulation of opioid and narcotic prescriptions, as most recent laws and regulations affecting opioid prescribing specifically exempt individuals receiving cancer treatment, palliative care, or those nearing their end-of-life. However,… Read More »
In narrative medicine, the clinician seeks to understand a patient’s story of their illness and their value system. Narrative medicine helps clinicians establish an empathic and therapeutic relationship with a patient, ideally resulting in a person-centered treatment plan. Rita Charon coined that term and approach in 2001 and expanded on it in numerous subsequent publications. Several sessions… Read More »
The population of the U.S is progressively becoming older; however, healthy aging is no longer an oxymoron. The availability of preventative medicine and health promotion programs have extended how long people can live healthy lives without chronic disability. Those aged 65 and over are projected to reach 83.7 million by 2050 [PDF]. While modern medicine has become… Read More »
High-quality evidence supports the use of medical marijuana for chronic pain, neuropathic pain, and other conditions. Yet, patients who live in some states can’t legally use it — and are threatened with loss of access to their prescribed pain medications if they do. I know this because a close family member of mine has chronic pain.… Read More »
The Centers for Medicare and Medicaid Services (CMS) wants to empower consumers to make informed healthcare decisions. CMS also wants providers to improve the quality of care they provide. One step towards accomplishing both of these goals is by public reporting of quality measures (QM). However, with multiple quality measures focusing on different care processes–all of which… Read More »
In theory, quality measurement and reporting generally benefits patients and their families, as (PDF link) public data on quality increases transparency and provider accountability. It also may benefit providers as a tool for quality assurance and improvement; however, the evidence does not always provide a clear picture. Unique challenges exist for patients receiving home care… Read More »