Summarizing the Challenges of Pain Management in the Primary Care Practice

A front-page article in the March 17 edition of The New York Times offers a succinct and comprehensive overview of the dilemma confronting frontline practitioners nationwide—how to balance an increasingly restrictive prescribing environment with the continuing needs of their patients with chronic pain. Told from the perspective of rural Nebraska practitioner Robert Wergin, MD, the story also considers the challenges of delivering pain management in an environment of limited medical resources. Increasingly, it is falling to primary care practitioners such as Dr. Wergin to balance the enforcement of, and adherence to, ever-tighter prescribing environments and their obligation to provide care for their patients in pain. From the article, “The burden of monitoring patients for potential abuse, while still treating pain that is chronic and real, falls largely on these front-line gatekeepers.”

Most of the information contained will be familiar to PAINWeek readers. Dr. Wergin, who is also chairman of the board of the America Academy of Family Physicians, relates the challenges of pain management practice that include administering patient/prescriber contracts, conducting risk assessment, compliance with state-specific (and noncompatible) PDMPs, and initiation of opioid tapering while still being responsive to patient needs. If you identify with some or all of Dr. Wergin’s experience, you may want to consider attending PAINWeek 2016, or a PAINWeekEnd in your area, for constructive responses to this difficult scenario.

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Read the complete New York Times article here.



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