4th Annual A Thoughtful Approach to Pain Management: New Horizons. What Clearly Works.

[101N]

Continuing Medical Education
Of Southern Oregon
4th Annual
A Thoughtful Approach to Pain Management:
New Horizons, What Clearly Works
When: May 29-30, 2015, 8:00 a.m.–5:00 p.m., Registration at 7:00 a.m.
Where: Smullin Education Center
Rogue Regional Medical Center, 2825 E. Barnett Road, Medford, OR
Who: All Opioid Prescribers, Behavioral Health Providers, Nurses and Occupational Health Providers
Tuition: Physicians $195 for 2-day registration or $100 for 1-day registration;
Multidisciplinary/Other $165 2-days or $85 1-day
Early Bird Tuition: Save 10% on tuition if registering before March 15, 2015
Late Fee/ Walk-In Tuition: Add $50 to rate if registering after May 15, 2015
Scholarships available, contact Michele Schaefer at [email protected] before May 15, 2015
Purpose: The appropriate treatment of chronic pain is an evolving, and sometimes controversial, practice. This conference will present factual information concerning the use of opioids in Oregon, community effects of opioid prescribing, current best practices for the treatment of chronic pain, and how medicine and community justice interface around prescription opioids use.
CME and CEUs available. For information call: Continuing Medical Education, (541) 789-4837

Friday, May 29, 2015
8:00 Introductions / Housekeeping Jim Shames, MD
8:15 Understanding the Patient with Chronic Pain—the Patient Perspective Penny Cowan
8:45 Pain Overview: Chornic versus Acute Pain, Types of Pain John Loeser, MD
9:35 Structural and Functional Brain Properties of Pain Pascal Tetreault
Perception in Health and Disease
10:05 Break
10:20 Evidence for Appropriate Pain Treatment Guidelines Roger Chou, MD
11:10 Marijuana: Is It Appropriate to use for the Management of Chronic Launette Rieb
Pain?
11:40 Lunch
12:05 Lunch Speaker: Behavioral Approaches to the Management of Kevin Vowles, PhD, RN
Chronic Pain
1:10 Opioid Prescribing, How to Manage Chronic Pain in the Primary Care David Tauben, MD
Setting
2:00 PTSD, How Psychological Trauma Affects Pain and Influences Pain Mark Sullivan, MD
Management
2:50 Break
3:05 Panel Discussion
4:30 Conclusion / Closing Remarks

Saturday, May 30, 2015
Main Hall
Lecture 1
Lecture 2
Room 102
Room 104
Room 106
7:55-8:10
Introductions / Housekeeping
8:10-9:10 Vowels Tauben Sullivan Tetreault O'Kane Kunkel/Orosco
9:20-10:20 Tauben Cowan Rieb Glass/Rothfels Kunkel/Orosco Shames
Break
10:35-11:35 Cowan Rieb Thaler Razi/Marikos Heesacker O'Kane
Lunch Strawsky
Lunch
1:00-2:00 Loeser Baier/Haas Vowels Razi/Marikos Tetreault Shames/Heesacker
2:10-3:10 Sullivan Thaler Loeser Glass/Rothfels Sailing Baier/Haas
Break
3:25- 4:45
Panel Discussions
Conclusion / Closing Remarks and Reminder of Evening Activities
Behavioral Track Community Track Pain Education Track

Speakers Include:
Anne Alftine, Project Coordinator
Jefferson Regional Health Alliance Penny Cowan, Founder, Executive Director
American Chronic Pain Association Roger Chou, MD, General Internal Medicine, Oregon Health Sciences University Lee Glass, MD, JD, Associate Medical Director, Washington Department of Labor & Industries John Kolsbun, MD, Medical Director, Mid Rogue Independent Physician Association John Loeser, MD, Professor, Emeritus of Neurological Surgery, Anesthesia and Pain Medicine, University of Washington, Seattle Launette Rieb, MD, ASAM, Clinical Associate Professor, University of British Columbia Peter Rothfels, B.Ed, MD, ASAM, Chief Medical Officer / Director, Clinical Services; Worker and Employer Services Division, WorkSafeBC Mark Sullivan, MD, PhD, Psychiatry and Behavioral Sciences, University of Washington David Tauben, MD, FACP, Chief of Pain Medicine and Clinical Associate Professor, University of Washington Medical Center Jim Shames, MD, Medical Director, Jackson County Health & Human Services Pascal Tetreault, PhD, Dr Vania Apkarian’s Lab
Physiology, Feinberg School of Medicine, Northwestern University Joe Thaler, MD, Medical Director, Oregon Medical Board Kevin Vowles, PhD, Associate Professor, Department of Psychology, University of New Mexico
Committee Members Include: Jim Shames, MD, Co-Chair Lee Glass, MD, JD, Co-Chair Paul Coelho, MD Laura Heesacker, LCSW John Kolsbun, MD Walter Newman, Jr., MD Peter Rothfels, MD Cristi Skye, RN
Breakout Speakers Include:
Michael Baier Launette Rieb
Penny Cowan Peter Rothfels
Lee Glass Ryan Sailing
Erin Haas Jim Shames
Laura Heesacker Natalie Strawsky
Tara Kunkel Mark Sullivan
John Loeser David Tauben
Michelle Marikos Pascal Tetreault
Nicole O’Kane Joe Thaler
Carlena Orosco Kevin Vowles
Nadejda Razi

ACCREDITATION:
Continuing Medical Education of Southern Oregon is accredited by the Oregon Medical Association to sponsor CME activities for physicians
AMERICAN MEDICAL ASSOCIATION:
Continuing Medical Education of Southern Oregon designates this live activity for a maximum of 15 AMA PRA Category 1 credit Physicians should only claim credit commensurate with the extent of their participation in the activity
AMERICAN ACADEMY OF FAMILY PHYSICAINS:
This live activity has been reviewed and is acceptable for up to 15 (Prescribed) credits by the American Academy of Family Physicians.
NURSING CONTINUING EDUCATION CREDIT:
Provider approved by the California Board of Registered Nursing, Provider Number CEP 13000 for 15 contact hours
OREGON BOARD OF PHARMACY:
The Oregon State Board of Pharmacy approves this live activity for 15 continuing education units
NASW OREGON CHAPTER:
The NASW Oregon Chapter Continuing Education Program certifies 15 CEU credits
DISCLSOURE STATEMENT:
Continuing Medical Education of Southern Oregon adheres to ACCME Standards for Commercial Support with regard to disclosure.
CME leadership, planners and staff: have fully disclosed that they do not have financial interest with any manufacturers of medical commercial products pertaining to the topics presented
Presenters: are expected to openly declare financial interest, unlabeled, investigational or outside of FDA approved indications as such.
Continuing Medical Education
of Southern Oregon
2825 East Barnett Road
Medford, Oregon 97504-8332
ADDRESS SERVICE REQUESTED
CME holds no liability for outside reservations or recreational activities.
4th Annual ‘A Thoughtful Approach to Pain Management’:
What Clearly Works
Smullin Education Center, Medford, Oregon, May 29-30, 2015
TWO DAY TUITION: Physicians $195.00 / Multidisciplinary/Other $165.00
ONE DAY TUITION: Physicians $100 Multidisciplinary/Other $85 Scholarships Available
I will attend on Friday 5/29 Saturday 5/30
(Tuition includes: breakfast, breaks and lunch)
PLEASE REGISTER ONLINE
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Send Registration to: 2825 E. Barnett Road FAX: (541) 789-5215 Medford, Oregon 97504
ACCOMMODATIONS
We recommend the following accommodations. Please call to make your own reservations.
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2010 Hospitality Way 1389 Center Drive 1395 Center Drive
Medford, OR 97504 Medford, OR 97501 Medford, OR 97501
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Taste of the Rogue Valley
Join us on Friday and/or Saturday for an evening of special events!
And have a chance to relax and enjoy a wonderful musical put on by the Oregon Shakespeare Festival, or for an evening of fine dining with the speakers and committee members and your peers!
Friday 5/29 Oregon Shakespeare Festival
Sign up now through April 30th, tickets for Guys and Dolls at a reduced group rate of $53 per seat, only 100 seats available
Saturday 5/30 Gourmet Dinner at Larks,
$55/person all Inclusive
~~ Menu Options May Vary Based Upon Seasonal Availability~~
Fresh Baked Rosemary Ciabatta Bread
First Course
Choice of:
Smoked Beets, Micro Greens, Chevre, Horseradish, Balsamic
Or
Spinach Salad, Smoked Salmon, Shaved Fennel, Potato, Blood Orange-Pistachio Vinaigrette
~~~
2011 Ledger David Chardonnay, Rogue Valley, Oregon
Main
Choice of:
Braised Lamb, Tangerine Pan Jus, Lamb Merguez Sausage Spoonbread and Brussels Sprouts
Or
Rare Seared Oregon Coast Albacore Tuna, Olive Butter, Gnocchi, Wild Mushrooms, Green Beans
Or
Spring Vegetable & Wild Mushroom Pot Pie, Watercress-pickled Onion Salad (Vegetarian Option)
~~~
2011 Red Lily, “Red Blanket” Tempranillo, Applegate Valley, Oregon
Dessert
Dagoba Chocolate & Orange Pot de Crème

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Members don't see this ad.

 

[lobelsteve]

Lets all go learn that no procedure works, no opiates ever indicated, and we need more funding to research.

I couldnt support anything where Chou was talking.

 

[drusso]

Lets all go learn that no procedure works, no opiates ever indicated, and we need more funding to research.

I couldnt support anything where Chou was talking.

Some of the speakers are very good...some I've never heard of...

Why aren't there any PAIN experts from the region's leading academic health science university on the panel?

 

[101N]

Here is how it works : research changes policy, policy changes payment, payment changes practice. That's not Roger's fault.

 

[drusso]

Here is how it works : research changes policy, policy changes payment, payment changes practice. That's not Roger's fault.

SCIENCE builds KNOWLEDGE. KNOWLEDGE is applied to PRACTICE. PRACTICE creates EXPERTISE. EXPERTISE informs POLICY. Policy should never drive payment (unless you live in China). And, payment should never drive practice.

I've heard Roger speak in many venues. Roger is credible when he speaks as a clinician. He is NOT credible when speaks on behalf of the Government agencies who are PAYING him consulting fees. He is SOLELY responsible for his career and professional choices as well as his personal affiliations.

Meta-analysis is not research. It's glorified intellectual composting. It's derivative by definition and should never be mistaken as science. The fact that a whole professoriate class has advanced itself on specious statistical methods that amount to no more than GIGO (garbage-in; garbage out) only speaks to the decay of Academe and not to the advancement of KNOWLEDGE.

 

[drusso]

Here is how it works : research changes policy, policy changes payment, payment changes practice. That's not Roger's fault.

...Despite him being a speaker, I'll probably attend...the rest of the content looks good.

 

[101N]

See ya there dude

 

[drrosenrosen]

Do they do this conference every year? Moving to Humboldt County, and it sounds like an interesting regional conference to attend.

 

[101N]

Yes. Humbolt, 420 land.

 

[drusso]

This would be an appropriate venue to discuss this: I wonder what accounts for the variance??

http://www.golocalpdx.com/news/INVE...Oregon-Doctors-and-Workers-Prescribed-Oxycodo

http://touchstonepain.com/our-medford-pain-management-team/

INVESTIGATION: Small Group of Oregon Doctors and Workers Prescribed Oxycodone 10,000+ times
Email to a friend Permalink

Monday, May 04, 2015

One Physician Assistant in Medford, who has been previously disciplined by the Oregon Medical Board, prescribed Oxycodone more than 780 times under Medicare in just one year.


Mary “Lorry” Huebner of Touchtone/Medford Pain Management prescribed 788 prescriptions and 26% more than the number two most prolific Oregon prescriber - Dr. Stuart Rosenblum of OAG Interventional Pain Consultants.

Oxycodone, morphine and opium are all highly regulated and highly addictive drugs — defined as Schedule Two drugs — under the United States Substance Control Act.

Huebner prescribes 78 times more Schedule Two drugs than her peers, according to new data analyzed by GoLocalPDX and was developed by the non-profit, investigative news organization, ProPublica. The problem of misuse and over prescription of pain medications is massive. The Center for Disease Control and Prevention (CDC) calls the over prescription of pain medicine an epidemic and Oregon may have the most serious problems in the country, according to one survey.

Whether Huebner’s prescribing is improper is unknown, but in 2008 the Oregon Medical Board took action against Huebner. According Oregon Medical Board's BOARD ACTION REPORT filed in October of that year., “Licensee (Huebner) entered into an Interim Stipulated Order with the Board on October 9, 2008. In this Order Licensee agreed to withdraw from practice pending the conclusion of the Board's investigation into her competency to practice medicine.”

Again in 2010, the Board unveiled that she had entered into a corrective Action Agreement, “HUEBNER, Mary Freericks, PA; PA00752 Medford, OR Licensee entered into a Corrective Action Agreement on April 8, 2010. In this Agreement, Licensee agreed to enroll in the Health Professionals Program. This Agreement is not a disciplinary action.”

According to the analysis of ProPublica, the retail value of the Huebner prescriptions is just under $500,000.

Epidemic Says the CDC


First dubbed as a epidemic by the CDC in 2011, the problem has only increased. “Deaths from prescription painkillers have also quadrupled since 1999, killing more than 16,000 people in the U.S. in 2013. Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013 (the most recent year of full data),” writes the CDC.

GoLocalPDX reviewed data collected by the non-profit, media watchdog group, ProPublica who has been collected and organizing federal data. The data collected by ProPublica and reviewed and categorized by GoLocalPDX comes from new federal reporting requirements impacting the Centers for Medicaid and Medicare (CMS).

A National Survey on Drug Use and Health found that Oregon leads the nation in abuse of prescription drugs. The survey found that 6.37% of Oregonians 12 years and older used painkillers for a non-medical purpose each year. The cost of hospitalizing overdoses was more than $31 million in 2012, according to a state report. This is just a small fraction of the total cost of emergency response, treatment and other significant private and taxpayer costs. As more than one-in-four in Oregon is prescribed a opioids, the likelihood of these cost decreasing is low.

The top 25 prescribers reviewed by GoLocalPDX, have prescribed more than 10,000 prescriptions of Oxycodone alone. Most overdoses involving narcotic pain relievers are caused by hydrocodone (Vicodin), methadone, oxycodone (OxyContin), and oxymorphone (Opana).

The Biggest Prescribers - 30 Scripts a Day, 365 Days a Year


Huebner prescription numbers are eye catching, but she is not alone. Huebner on average reportedly had 11 prescriptions (including refills) per patient, compared to a national average of 5. Moreover, for schedule Three Controlled Substances, 32% of Huebner’s 488 patients filled at least one prescription, compared to an average of 2%.

One physician made over 11,000 prescriptions in one year. Dr. Harry Rinehart who practices in Wheeler Oregon issued 11,224 prescription and refills under medicare Part D. He ranked 6th as the most prolific Oxycodone prescriber, but his 527 prescriptions are just a small fraction of his over scripts. On average, Rinehart prescribed 30.7 scripts per day for the entire 365 days of the year.


This data comes from an analysis conducted by ProPublica. ProPublica obtained prescribing data from Medicare’s prescription drug benefit, known as Part D, under the Freedom of Information Act. The data for 2012 includes more than 1.2 billion prescriptions written by nearly 1.5 million doctors, nurses and other providers. This database lists about 382,000 of those providers who wrote 50 or more prescriptions for at least one drug that year. Almost three-fourths went to patients 65 and older; the rest were for disabled patients.

 

[drusso]

"To stem the tide of the unintended consequences of the promotion of drug use it will be necessary for health systems, clinicians, academics, epidemiologists, patients,
pharmacists, communities, law enforcement, and pain specialists to work together. The state must engage partners across disciplines and business and community sectors to: reduce easy access to medicines in homes; promote the use of the PDMP as a best practice; implement guidelines for prescribing opioids; make patients responsible and accountable for safely storing prescribed controlled substances; institutionalize drug take back; increase insurance coverage and reimbursement for non-pharmaceutical pain control; provide access to evidence based treatment for addiction; improve the ability of primary care providers to identify drug misuse and abuse among patients and get patients referred for behavioral health care; and strengthen the integration of primary care and behavioral health in health care settings."

http://public.health.oregon.gov/Dis...ata/Documents/oregon-drug-overdose-report.pdf

 

[101N]

The folks who are involved with the program are aware of this. But, over all, prescribing
has improved in Jackson Co, in no small part due to the work of Jim Shames.

But this article is a good example of why I don't feel that there should be a double standard
for MED between pain specialists and other physicians. Pain specialists - or our PAs - have
no special mojo by which to ensure that our patient's medulla's don't shut down, or that they
become addicted, or become lost dysfunctional drug users, or that their largess of opioids aren't
stolen and consumed by the unfortunate neighborhood teenager.

Whenever there is a liberal opioid prescriber in a community he or she will be popular amongst drug seekers
and the many unfortunates looking for a quick 'cure' for their sad life syndromes. Then, when the board inevitably gets wind and shuts these practices down all of these now high dose patients with unrealistic expectations scramble - typically with feigned naivette and anger -to find someone who will "help them" with "pain management" by replicating the dangerous practice that they have been an eager participant in. These displaced patients will offer to drive hundreds of miles to find a new 'pain management specialist'.

There is another problem that comes up as a subtext in this article. High prescribing PA's are often the front-end for a 'block shop' back end. The lure that gets the patients in the door is, of course, the opioid prescribing. But what keeps the doors open is the physician in the fluoro suite all day doing his or her 'series of three' on the
large clientele of addicts & chemical copers that their PAs manage. There are lot of these practices around, and
the model can produce a lot of financial success for the guy or gal in the fluoro suite. But it's bad care.

 

[ampaphb]

Conferences that feels the need to call themselves "thoughtful" rarely are. Also, Generally, most arguments require the adverb "clearly" (as in what "clearly" works) usually are far from clear.

 

[101N]

I didn't pick the title, and I'd have chosen another. However, the content is good.

Jackson County - like most of OR - is rural and poor. There are a lot of sad lives
in abandoned mill towns and thus the stage is set - like Appalachia - for over prescribing
in a misplaced attempt to placate the suffering that comes with being poor, undereducated,
the mill having closed, drinking too much, having had a rough life etc.

This is not a conference where you will learn how to do an injection, and there are no industry
sponsors. But it will give attendees a different perspective of pain and suffering and highlight
some healthier alternatives to the status quo: opioids.

 

[drusso]

I didn't pick the title, and I'd have chosen another. However, the content is good.

Jackson County - like most of OR - is rural and poor. There are a lot of sad lives
in abandoned mill towns and thus the stage is set - like Appalachia - for over prescribing
in a misplaced attempt to placate the suffering that comes with being poor, undereducated,
the mill having closed, drinking too much, having had a rough life etc.

This is not a conference where you will learn how to do an injection, and there are no industry
sponsors. But it will give attendees a different perspective of pain and suffering and highlight
some healthier alternatives to the status quo: opioids.

...In a State embroiled in it's liberal politics; a place once revered for its pioneer spirit and drive West, now sadly mired by special interests, bloated public employee retirement benefits, under-funded and failing schools, and misguided health policy enacted by liberal ideologues and Obama-Care apologists.

...A place where the Legislature has abdicated the advancement of public health to the interests of Big Weed and to the whims of a coterie of "alternative" medical providers such as naturopaths, chiropractors, and acupuncturists.

...A once bucolic libertarian terrain now shackled and enslaved by over-regulation, red-tape, and a flailing Government Payor Medicaid system that insists on doing business "the Kitzhaberesque old fashioned way" with no-bid contracts, quid-pro-quo, a nudge-and-wink-and-a-slap-on-the-back while insurance companies accumulate tens-of-millions of dollars in profits and the system's bureaucrats count down the days to getting their first PERS check...

...A place where the Content Experts from the Western Pain Society, Oregon Pain Society, Oregon Society of Interventional Pain Physicians, or the State-funded medical school's Comprehensive Pain Center are not to be found (nor invited?)... How can an authentic discussion about alternatives to the status quo occur when some speakers have been paid hundreds of thousands of dollars in Federal and State grants to advance an intellectual fallacy that "nothing works." What good are having "healthier alternatives" if no one has the balls to pay for them---they are essentially inaccessible to the patients who need them the most...Where's the evidence for CBT, SBIRT, CAM, massage, etc??

...But, isn't that what liberal politicians and their pubic employees have always promised "the People"---Everything?

Here is how it works : research changes policy, policy changes payment, payment changes practice.

...But not here...Here, one must first "start with an end in mind..." the Data will do the rest...

 

[drusso]

I didn't pick the title, and I'd have chosen another. However, the content is good.

Jackson County - like most of OR - is rural and poor. There are a lot of sad lives
in abandoned mill towns and thus the stage is set - like Appalachia - for over prescribing
in a misplaced attempt to placate the suffering that comes with being poor, undereducated,
the mill having closed, drinking too much, having had a rough life etc.

This is not a conference where you will learn how to do an injection, and there are no industry
sponsors. But it will give attendees a different perspective of pain and suffering and highlight
some healthier alternatives to the status quo: opioids.

http://www.gazettetimes.com/news/lo...cle_d3344ec6-3b5d-5500-aa86-ad339a8791a4.html

Pain clinics fill local niche

• Dr. Patrick Rask of Corvallis Pain Management performs an injection at the practice's Philomath office.
• 

Dr. Patrick Rask of Corvallis Pain Management performs an injection at the practice's Philomath office.

58 minutes ago • BENNETT HALL Corvallis Gazette-Times
(0) Comments

According to the National Institutes of Health, pain is the most common reason that Americans seek medical attention.

It can also be a bear to treat: The NIH lists chronic pain as the leading cause of long-term disability.

Enter the pain management specialist, an offshoot of anaesthesiology that has caught on around the country over the last two decades or so, but was slower to take root here in the mid-valley. The area’s first freestanding pain clinic didn’t open until four years ago, after a traveling pharmaceutical sales rep named Manny Cruz spotted a business opportunity.

“I lived in Corvallis, and there were no pain management physicians in Corvallis,” Cruz recalled. “Most patients were having to go to Salem or Eugene.”

Cruz teamed up with Dr. Patrick Rask, a pain management specialist from Portland who was relocating to Corvallis. He already knew Cruz from his Portland practice, and the two opened their first clinic in Philomath in March 2011, with Rask as medical director and Cruz as growth strategist.

Their timing was right.

There are now at least half a dozen pain management physicians in Corvallis and Albany, and there appears to be plenty of business to go around.

The clinic founded by Rask and Cruz, Corvallis Pain Management, has grown steadily. It now has a staff of 32 employees and offices in Philomath, Corvallis and Newport. A second physician, Dr. Dan Sudakin, has joined the practice, along with two physician assistants and a nurse practitioner.

“One of the things we decided is we wanted to be a comprehensive clinic, where we would manage the patient’s medication as well as decide whether an intervention would be helpful over time,” Rask said. “It allows the referring doctors to focus on their specialty … rather than having to deal with the pain.”

Most patients are referred to Corvallis Pain Management with chronic pain, most often of the back or neck. Other conditions the clinic treats include migraines, arthritis, phantom limb or post-surgical pain, and pain from sports injuries or car accidents.

Usually, patients already have prescriptions for pain medication when they get a referral to the pain clinic, and they’ve often tried various treatments without success.

“We usually get the people who have tried everything,” Rask said.

Most treatments involve injections with steroids to provide long-lasting pain relief. Rask also performs radiofrequency ablation, which uses radio waves to cauterize nerve endings and shut down pain impulses. And for some patients, he can perform a surgical procedure to implant a spinal cord stimulator that emits electrical impulses to manage back pain.

But a big part of the job is medication management. A shift by the national medical establishment toward more aggressive pain management in the 1990s was followed by a surge in the abuse of opioid painkillers, along with a tragic spike in overdoses. According to the Centers for Disease Control and Prevention, more than half of all fatal overdoses in 2010 – 22,134 of them – involved prescription drugs.

While Rask believes that prescription pain relievers can be highly beneficial for many patients, he also recognizes that the risk of addiction with opioids is significant. Because the experience of pain is highly subjective, it’s not always easy to tell when some patients genuinely need ongoing medication or when they’ve turned into “drug seekers” trying to satisfy an addiction.

All Corvallis Pain Management patients who are on pain medication are required to sign a “pain contract” aimed in part at curbing abuse. Patients must agree to use one pharmacy, not go to the emergency room for meds and follow the dosage instructions on their prescriptions. In addition, the prescriptions are written for only as many pills as patients are expected to need until their next appointment.

If the clinic staff suspects a patient may be abusing medication or selling it on the side, Rask may take additional steps such as doing random pill counts, performing covert drug screens or contacting their pharmacist, and the newest addition to the clinic, Dr. Sudakin, is a specialist in addiction medicine.

Occasionally, if the problem can’t be worked out, the clinic will refuse to keep treating a drug-abusing patient.

“If we feel that it’s no longer a safe environment for narcotics,” Rask said, “we will no longer prescribe narcotics.”

The need for better medication management is one reason why pain clinics are on the rise. Following the lead of a number of other states, the Oregon Medical Board has issued guidelines calling for any patient taking 120 milligrams or more per day of morphine – or the equivalent amount of other narcotic medications – to be referred to a pain clinic.

With referrals on the upswing, Cruz said Corvallis Pain Management is looking at additional expansion options. The clinic is currently recruiting for a third physician as well as another nurse practitioner or physician assistant, and Rask is planning to open an ambulatory surgery center in Albany in partnership with two other area doctors.

“There’s a high demand for it,” Cruz said.

Rask appreciates the high patient volume, of course, but he said he also gets a lot of personal satisfaction from his work.

“I used to be an emergency room doctor, and when patients came in with back pain we really couldn’t do much for them,” Rask said. “On this side of the tracks, I can really home in on what’s causing the pain and do something about it, really make someone’s life better. That’s really what I like about it.”

 

[101N]

From OHSU, the State-funded medical school:

 

[drusso]

From OHSU, the State-funded medical school:

I didn't know that he was working in the Spine Center these days...