For many physicians, the CDC’s tightened pain management standards are a real headache.
In fact, stringent guidelines for distribution of narcotics have created a shortage of physicians dedicated to helping patients manage long-term or chronic pain.
Baoluan Nguyen, MD, noticed this during his eight years at the Hutchinson Clinic and recently opened ICT Internal Medicine and Pain Management to help fill this void in west Wichita and surrounding areas.
Baoluan Nguyen, MD
“I was a primary internal medicine physician in Hutchinson,” Dr. Nguyen says. “At that time, if patients had pain, I referred them out to pain management. I found out there was a shortage.”
He says this is partially related to increased controls and accountability required when prescribing narcotics.
“It makes us do more, and it holds us accountable,” Dr. Nguyen says.
Still, he saw the need and wasn’t deterred. He became a member of the Academy of Integrative Pain Management, began training, attended conferences and learned all he could about the discipline before opening his own practice earlier this year.
As a specialist, Dr. Nguyen takes on the paperwork and controls while operating strictly within the rules.
“Given the fact that the CDC just came out with stricter guidelines and recommendations for pain, I try to follow those guidelines and be safe,” he says.
However, many of his patients live with chronic conditions, such as lower-back pain, worn-out knees, diabetic nerve pain or headaches, and need intervention and long-term case management designed to help them control their pain and live functional lives.
“We start out with mild narcotics or Tylenol, Advil and things like that,” Dr. Nguyen says, adding he also looks for other pain management approaches, including conservative, noninvasive treatments, physical therapy and injections.
These all help determine if his patients really need the pain medication, and he says many do, but with optimized doses.
“A lot of the patients I get are already on really high doses of pain medication. I’m trying to do a service to the community by bringing them down,” Dr. Nguyen says. “Basically, we try to make their life not pain-free, but more functional, so they can go about their daily activities and daily living. The plans are tailored to the person. Everyone doesn’t get everything the other person gets.”
“With narcotics, we have to set them up with a chronic-pain-management plan to monitor drug screens, risk for abuse and diversion. I try to make sure they really need the pain medication.”