Murray J. McAllister, PsyD
Murray J. McAllister, PsyD, is the editor and founder of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Its mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides Academic quality information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.
Last month, the United States Food & Drug Administration (FDA) issued a warning on the safety of epidural steroid injections for back and neck pain. Epidural steroid injections, they said, “may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death.” They advised providers who perform epidural steroid injections and their patients to discuss these risks prior to making the decision to undergo the procedure.
We are pleased to announce that the Institute for Chronic Pain website and blog has obtained Health On the Net Foundation (HONcode) certification. HONcode certification indicates that the reporting of health-related information on our sites complies with the Ethical Code of Conduct of the Health On the Net Foundation. You can find their seal at the footer of our website pages and the sidebar of our blog.
The Health on the Net Foundation is a non-governmental organization that provides certification to health information websites. They are the “oldest and most used ethical and trustworthy code for medical and health related information on the internet.”
Author: Murray J. McAllister, PsyD
Date of last modification: 4-24-2014
It’s an interesting fact about the field of chronic pain management that there is a safe and effective alternative to the use of opioids for chronic pain, but relatively few people know about it. The alternative to opioids is an interdisciplinary chronic pain rehabilitation program.
Correlation doesn’t imply causation. It’s a commonly expressed caution in the health sciences. What it means is that two things can tend to go together without necessarily causing each other.
It’s common to be upset when you’ve been told that you have degenerative disc disease. It’s an awful sounding diagnosis. It sounds like you have a disease that is deteriorating your spine. And on top of it all, it doesn’t sound like there’s much you can do about it. The spine, it seems, is inevitably degenerating.
What is your relationship to your chronic pain? At first thought, it seems like an odd question. But, if we stop to reflect on it, couldn’t we have a relationship to pain? Don’t you already have one?
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Author: Murray J. McAllister, PsyD
Date of last modification: 1-26-2014
It might be easy to conclude that anyone who wants to reduce the role of the profit-motive in healthcare must be either an extremist or a fool. Upon reflection, however, it becomes clear that we are experiencing an era of overtreatment in healthcare (see, for example, Dr. H. Gilbert Welch’s piece here) and one area where it is particularly apparent is in the management of chronic pain. While there are likely many causes of overtreatment, one of them surely is the profit-motive that occurs within a fee-for-service model of reimbursement.
In the last post, we looked at the influence of money on your healthcare providers’ recommendations. We saw that in a fee-for-service model of healthcare, which is the predominant model in the U.S., individual providers, clinics and hospitals get paid based on the number of patients they see and the number of procedures and tests they perform. In other words, the more patients a provider, clinic, or hospital sees or the more procedures or tests they perform, the more they get paid. As such, a fee-for-service model of healthcare incentivizes productivity – providing more care leads to making more money.
One of the more common sentiments that patients express to me is that they have come to the conclusion that money influences healthcare recommendations. After reflecting on all the years of chronic pain and all the years of failed treatments, many of which were tried multiple times, they have concluded that the business side of healthcare played too much of a role in their own care. They are now disappointed, angry, and jaded about how much they trust healthcare providers.
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