Each person experiences pain differently, from an emotional perspective as well as a physical one, and responds to pain differently. That means that physicians like myself need to evaluate patients on an individual basis and find the best way to treat their pain. Today, however, doctors are under pressure to limit costs and prescribe treatments based on standardized guidelines.
Dr. Shalini Shah, the head of pain medicine at the University of California-Irvine health system, pulled together a team of 20 people in January to figure out how to meet patients’ needs. The group has established workarounds, such as giving tablet forms of the opioids to patients who can swallow, using local anesthetics like nerve blocks and substituting opiates with acetaminophen, ketamine and muscle relaxants.
Physicians are unsure of how exactly, or when, to begin their job search. "Like many aspects of medical education, this is one of the things that you don't formally 'learn,'" says Sunny Jha, MD.
The need to have practitioners that can quickly recognize the signs of deeper levels of sedation and have the skills, equipment, and support personnel to rescue the child from potential adverse responses to these unintended levels of sedation is critical.
Doctors in California are raising the alarm over a recent policy change from Anthem that they say could harm patients undergoing cataract surgery. The policy categorizes monitored anesthesia care as “not medically necessary” during routine cataract surgery, according to the California Academy of Eye Physicians and Surgeons, the California Society of Anesthesiologists and the California Medical Association.