Taxonomy I Part VII-C (Pain Management)

(05 May 2006 17:00)

NATIONAL PROJECT ON THE COMMUNITY BENEFITS

OF FAMILY MEDICINE RESIDENCY PROGRAMS

CUMULATIVE QUESTIONNAIRE RESPONSES

Taxonomy Section I Part VII-C

Pain Management

SD I.13v(1.1) (new) Does your residency provide the following kinds of specialty care: v. Pain Management? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13v(1.2) If you do provide pain management, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

SD I.13v(1.3) If you do provide pain management, are these services provided during special clinics?  Yes __ No __

If so, what is the number of patients seen?  What revenues are generated in each specialty service?

Yes:

Fresno                          (15 patients/week @ $20/ea)

No:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Springfield

Glasgow

Lexington

OHSU Portland

NPCB P2 I.13.2v (SD I.13v(1.4)) Describe the kinds of pain management that typically takes place within the family medicine center (whether as normal appointments or during special clinics):

Natividad                     (we prescribe a lot of narcotics; low back pain; chronic pain syndrome from multiple etiologies)

Klamath Falls               (well-defined and orchestrated chronic pain management program)

Lehigh Valley                (managing chronic back pain; pain syndromes; fibro mialgia)

Mercy Toledo              (trigger point injections; medical management; behavioral approaches to pain, including psychotherapy)

Kaiser LA                    (we do a lot in the family medicine center; the medical center’s pain management center is under the anaesthesiology department)

Tyler                            (trigger point injections; other joint injections; oral pain medication; exercise prescription for back pain)

Las Vegas                    (Injections – joint and trigger point; opoid management; other pharmacologic management; OMT; referral for psychotherapy, antidepressants)

Fresno                          (full scope)

Springfield                    (medical pain management)

Glasgow                       (chronic pain due to degenerative disc disease, spinal stenosis, cancer, hospice, pain with NOS; neuropathic pain; diabetic neuropathy)

Lexington                     (develop contractual relationship on chronic pain management, monitoring efficacy, treatment plans; OMT; injection therapy; trigger point injections; facit joint injections)

OHSU Portland            (chronic pain; fibromyalgia)

Phase 2 Responses:

Sparrow                       (chronic and acute paid management; chronic back and headache pain; pain medication guidelines; contracting for narcotic use; oral medications)

Huntsville                      (injections, including steroid injections to various joints; NSAIDS and narcotic oral therapy)

Ventura                        (all kinds, except for epidural injections; chronic and acute cancer pain; chronic non-malignant pain)

Long Beach                  (the spectrum of medical management; physician referral; OMT; trigger point injections; narcotic prescriptions)

U Penn                         (normal appointments)

Crozer-Keystone          (injection therapy; OMT; prolotherapy; narcotic prescriptions; pain management therapy)

Jefferson                       (chronic pain; malignant and acute pain; neuropathic pain)

McKeesport                 (prescription of pain medicines)

Oahu                            (steroid injections; pharmacotherapy; behavioral management; sports medicine pain management; trigger point injections)

NPCB P2 I.13.2v(1) For what conditions would your residency program refer patients to pain management specialists? What is the expected wait time before the patient is seen?

Sparrow                       (pain that is difficult to manage; any invasive procedure such as injectibles; facet blocks, etc.; headache clinics)

Huntsville                      (physical and occupational therapy; 1 to 2 weeks)

Ventura                        (anyone requiring epidural injections; 1 week or less wait time)

Long Beach                  (sometimes if they need an epidural or nerve block; 4-6 weeks)

U Penn                         (physician specific; same day to 1 month)

Crozer-Keystone          (chronic narcotic usage; pain with psychological components; 1 month wait)

Jefferson                       (spinal injections; some chronic pain; 6-12 weeks)

McKeesport                 (pain centers at University of Pittsburgh and other locations; 3-4 weeks)

Oahu                            (physical therapy/physiatry; neurosurgery)

*NPCB P2 I.VII.B1 Does your residency program manage the following disorders for your family medicine center patients either in the inpatient or outpatient settings (or both):

a.      Chronic Back Pain? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa                   (too much)

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VII.B2 Does your residency program utilize screening and surveillance procedures consistent with professional guidelines for chronic pain?

Yes:

Shadyside                     (we do have pain contracts; we use JCAHO guidelines to check for pain)

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

* NPCB P2 I.VII.B3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

a.      Acupuncture? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

Fairfax

Santa Rosa                   (some of our faculty group are certified to do this)

Reading

York

Lebanon

Billings

Monroeville

Latrobe

No:

St Margaret

Beaver

Erie                              (we used to, but our acupuncturist left)

Lawton

* NPCB P2 I.VII.B3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

b.      Gangliatic Block? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret                  (have access to it, but rarely use it)

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

* NPCB P2 I.VII.B3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

c.   Intrathecal Injections? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret                  (have access to it, but rarely use it)

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

* NPCB P2 I.VII.B4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

a.      Advanced treatment methods for chronic pain? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York                            (there is a good pain center within the Wellspring system)

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

Last Updated (04 September 2006 15:24)