lung auscultation during weekly checkups?
i'm already having having flashbacks to residency after having a few drinks tonight...
does anyone actually auscultate lungs routinely during weekly on-treatment checkups for their lung patients? i saw attendings do that often on the thoracic service, even at 2 Gy cumulative with no complaints or chest pain.
sure, you might "hear" a new malignant pleural effusion, but the cone-beam CT would probably spot it sooner.
has lung auscultation ever significantly altered your radiation management? (Source: Student Doctor Network)
Source: Student Doctor Network - January 1, 2021 Category: Universities & Medical Training Authors: FreakFlag Tags: Radiation Oncology Source Type: forums
Pill Mill Shutdown
I'm hospital employed. Recently, a local pain management clinic was shut down. It was cash pay, non-Interventional. MED doses ranging from 30-300, probably 80% of patients on Benzos, vast majority uninsured or "self pay" with a smattering of Medicaid.
These patients have now fled into the community and most are seeing their PCP's, who give one month refills of their old regimen and then "refer to pain management." All the local PP's in town block them at the level of the receptionist, so...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 8, 2020 Category: Universities & Medical Training Authors: Centurion38 Tags: Pain Medicine Source Type: forums
Help with tough case.
70 year old female with bad spondy. Predominant leg symptoms. Too osteopenic for TLF. Moderate dementia and depression.
Lyrica and Gabapentin worsen mental function to the point she can't use. SCS trial failed due to dementia limiting proper management of device. On SSRI for depression (sertraline.) I added tramadol with the hopes it would not worsen mental function and tapered off sertraline. Patient now having crying spells and worsening depression. It was thought if the pain improved...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - November 24, 2020 Category: Universities & Medical Training Authors: gator2886 Tags: Pain Medicine Source Type: forums
Pain Management Advice?
Current 4th year med student on an audition rotation in EM. Seems like it should be simple but for some reason I'm having issues when it comes to deciding which pain medications to order for my patients. Tylenol/NSAIDs seem like a safe bet and simple choice most of the time, but choosing when to jump to Norco/Morphine/Fentanyl/etc. and which one to choose at the time seems to be tripping me up. For some reason I feel hesitant to as I'm nervous about overmedicating the patient. Does anyone...
Pain Management Advice? (Source: Student Doctor Network)
Source: Student Doctor Network - November 1, 2020 Category: Universities & Medical Training Authors: Pokedoc Tags: Emergency Medicine Source Type: forums
Podiometric Referral Patterns
Why the hell do PCPs refer podiatrists patients with Chronic gout? It’s called medical management Dr. PCP MD. What am I going to offer the patient?
Why the hell do PCPS refer podiatrists patients with general neuropathic pain? I’m not talking neuroma or tarsal tunnel. I’m talking about chronic neuropathic pain. Why can’t their PCP order an EMG and medically manage the patient? If they can’t do that then why can’t they refer to neurology?
Why does it take a podiatry visit to put that all...
Podiometric Referral Patterns (Source: Student Doctor Network)
Source: Student Doctor Network - October 10, 2020 Category: Universities & Medical Training Authors: CutsWithFury Tags: Podiatric Residents & Physicians Source Type: forums
Med Mal Case: Meningitis [Do you use betadine or chlorhex for LP?]
So this is actually an anesthesia/pain management case, but has strong cross-application to EM (or anyone doing LPs).
Patient had a spinal epidural injection.
Died of meningitis about a week later.
Plaintiff attorney says its because they used betadine, not chlorhex for sterilization.
Expert witness claims the same thing in his opinion (likely paid a huge amount)
Only problem? Chlorhex says don't use near the meninges.
However, some research showing the Chlorhex is actually better at...
Med Mal Case: Meningitis [Do you use betadine or chlorhex for LP?] (Source: Student Doctor Network)
Source: Student Doctor Network - September 29, 2020 Category: Universities & Medical Training Authors: bbc586 Tags: Emergency Medicine Source Type: forums
Pain Anesthesiologists in Tampa Bay
Hey all!
M4 here who will be applying to anesthesiology this year. I was wondering if there are any anesthesiology docs on here who practice pain management who would be willing to take students in the Tampa area? (Source: Student Doctor Network)
Source: Student Doctor Network - September 29, 2020 Category: Universities & Medical Training Authors: Zzzosyn Tags: Anesthesiology Source Type: forums
Texas Pain Doctor Defrauds Medicare Using Stim Codes for Auricular Acupuncture
Which one of you D-bags is this?
FOR IMMEDIATE RELEASE
Tuesday, August 25, 2020
Pain doctor pays to settle allegations of deceptive Medicare billing
HOUSTON – A 52-year-old pain management physician from Houston has paid $530,000 to resolve allegations he falsely billed Medicare for the use of electro-acupuncture devices, announced U.S. Attorney Ryan K. Patrick.
From March 1, 2019, to Oct. 31, 2019, Dr. Syed Nasir billed Medicare for the implantation of...
Texas Pain Doctor Defrauds Medicare Using Stim Codes for Auricular Acupuncture (Source: Student Doctor Network)
Source: Student Doctor Network - September 2, 2020 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Building a new fluoroscopy suite and requirements
Hi everyone,
I am here to ask for a specific advice. Some background information...
I am the sole pain doctor in an ortho spine group in TX who had sought out a pain specialist with intentions of broadening the practice include pain management. I joined the practice last year out of fellowship and have so far been very happy with my job. They have been very happy with me as well. Because there was no pain practice prior to me joining, there was no fluoro suite. I have been taking all of...
Building a new fluoroscopy suite and requirements (Source: Student Doctor Network)
Source: Student Doctor Network - August 19, 2020 Category: Universities & Medical Training Authors: RamPain Tags: Pain Medicine Source Type: forums
Private Practice vs. Managed Care
I would really appreciate anyone's advice about this: have been working with a managed care organization for the past 3 years. I make into the upper 500k. Good benefits. Good lifestyle. Got an opportunity to work in a private practice with significant more salary (probably double), good contracts in place and with PI work. I don't know if it's worth jumping ship? The current job does have potential to move into management positions as well. (Source: Student Doctor Network)
Source: Student Doctor Network - August 17, 2020 Category: Universities & Medical Training Authors: mohandess Tags: Pain Medicine Source Type: forums
Gabapentin and Lyrica
Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain:A Systematic Review and Meta-analysis | Anesthesiology | ASA Publications
In this new meta-analysis in this months’ Anesthesiology, the use of these drugs is very much called into question. Will this change your practice? (Source: Student Doctor Network)
Source: Student Doctor Network - August 4, 2020 Category: Universities & Medical Training Authors: kmurp Tags: Anesthesiology Source Type: forums
TouroCOM-NY (Harlem) vs Albany Medical College
Hi all - I just got in off the alternate list at AMC and they gave me only 24 hours to make the decision! Any advice would be much appreciated.
I'm currently holding an acceptance at Touro. I'm hoping to do IM with a focus on pain management, and I have 2 years experience with a pain research lab. Although that might make Albany seem like the obvious choice, I'm passionate about holistic patient care (ie incorporating integrative therapies when appropriate, assessing the patient's...
TouroCOM-NY (Harlem) vs Albany Medical College (Source: Student Doctor Network)
Source: Student Doctor Network - July 21, 2020 Category: Universities & Medical Training Authors: IntegrativeDO Tags: Help Me Decide: X vs Y Medical School Source Type: forums
Courts Rule Against Hospital $O$ and Hospitals Want to Fight...
HHS site-neutral payments are legal, appeals court rules
The decision is a major loss for hospitals that are already facing revenue reductions due to the COVID-19 pandemic.
www.modernhealthcare.com
The court presented 2017 data showing the evaluation and management reimbursement rate for new patients was $184 in outpatient...
Courts Rule Against Hospital $O$ and Hospitals Want to Fight... (Source: Student Doctor Network)
Source: Student Doctor Network - July 20, 2020 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Sign NANS Petition to Fix CDC Guidelines to Include IPM
Petition Call to Action – CDC Opioid Guidelines
www.ipetitions.com
"As part of the process of creating the next edition of the guidelines, we urge the CDC to recommend that patients with chronic pain lasting for more than 3 months, be referred to a pain management specialist, who can assist in determining the precise cause of the pain and thereby best help guide treatment through a multimodal platform that may include nonopioid medications, minimally...
Sign NANS Petition to Fix CDC Guidelines to Include IPM (Source: Student Doctor Network)
Source: Student Doctor Network - June 8, 2020 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Cancer Pain Fellowships?
I am a new-in-practice pain physician, having recently completed fellowship. I'm in an academic setting, but our center is looking for more experience with cancer pain management, and I didn't receive a ton of specific cancer pain management during fellowship. I'm wondering if you have any recommendations for specific cancer pain fellowships, or centers with really good exposure to cancer pain management? Thanks in advance! (Source: Student Doctor Network)
Source: Student Doctor Network - May 29, 2020 Category: Universities & Medical Training Authors: Rocuronium18 Tags: Pain Medicine Source Type: forums
