Providing chronic pain patients with seamless access to non-pharmacological therapies and self-care skills requires clinics to re-think business as usual. Dr. Vinny Francio, DC, MS, practices Integrative Spine Care and Integrative Pain Management for Essential Integrative Health in Oklahoma City, an integrative spine and pain management clinic, in collaboration with orthopedic spine surgeon and integrative physician Dr. Art Conley, MD. Continue reading “Team Approach Improves Chronic Pain Care in Oklahoma Clinic” »
Tag Archives: whole person care
Problem-solving is a key skill at work, at home and in the classroom. But problem-solving is also important for patients when managing chronic pain.
Samueli Institute’s Chronic Pain Breakthrough Collaborative teams met in January to celebrate and share what worked to increase the number of patients using non pharma and self-care therapies for chronic pain—one of the goals of the 2015 learning collaborative. Participants found that moving from a clinician-driven model of care to one that empowers patient’s self-management of chronic pain required a new outlook and skill set for both the providers and the patients.
Measures of Success in Chronic Pain Care: Empowering Patients with Self-Care Strategies
“Pain care doesn’t always involve providers,” explained Martha Menard, PhD, LMT, Executive Director of the Crocker Institute, and a faculty member for the 2015 Chronic Pain Breakthrough Collaborative.
In a recent study (published Jan 2016), Menard found a common characteristic of those living well with chronic pain was their perseverance and openness: “People were very open to trying new things and kept trying until they found what worked for them, putting together these highly individualized packages of care for themselves. They became skilled at noticing the connection between feeling stressed and making their pain worse, so they found lots of ways to incorporate self-care into their daily routine.” Continue reading “Increase Patient Power In Pain Care” »
Wellness without any pills, potions, or procedures? It can be possible according to CAPT George Ceremuga, DO.
Before his current assignment, Dr. Ceremuga was the Chief of the Integrative Holistic Medicine program at Fort Belvoir Community Hospital. He led the inpatient substance abuse program where they had a saying:
“Just for today, do the next right thing and good things happen.”
New health data released late 2015 shows that we need this advice now more than ever.
A Generation in Distress
For the first time in decades, mortality rates have increased for middle-aged non-Hispanic white men and women.[i] Mid-life distress is on the rise as can be seen by “declines in self-reported health, mental health, and ability to work, increased reports of pain, and deteriorating measures of liver function” (Case et al., 2015, p. 1).
But in the midst of this distressing news is a kernel of hope.
Overwhelming evidence shows that good lifestyle choices in diet, physical activity, tobacco and alcohol use, stress management and social connections improve overall health and reduce the impact due to chronic illness and mental disease.[ii]
This means that the choices you make today matter.
5 Steps to Wellness
Dr. Ceremuga’s prescription for wellness includes 5 simple and common sense choices. But choosing healthy habits takes discipline especially since our medical system can make you feel that your health is outside of your control. But most of this time, that’s not true. Studies have shown that up to 70% of health comes from everyday decisions.
As the New Year brings a moment of reflection, consider Dr. Ceremuga’s 5 Pillars of Wellness:
1. You are what you drink.
The human body is made up of 60-70% water. Sufficient water intake impacts weight loss, muscle fatigue, skin health, kidneys, bowel function and more. Remember to drink water by carrying it with you everywhere you go and drink it with every snack and meal. Continue reading “5 Steps to Wellness: A Commonsense Rx” »
“How many of you know what this is?” said Chef Woods, the instructor of the Samueli Institute’s Teaching Kitchen program at Joint Base San Antonio, as she held up a bulb of fennel.
A few tentative hands went up and the rest of the room was befuddled. Many of them had just unknowingly devoured a dish of poached tilapia with fennel and white beans. That is, after they had whipped out their iPhones to take photos of the beautiful healthy feast.
Learning about healthy ingredients as well as how to cook them, is part of a multi-faceted approach to lifestyle education that focuses on building culinary, nutrition, exercise and mindfulness skills to increase health, resilience and wellness.
Making Food Approachable
Expert chefs, one military and one civilian, make ingredients and cooking approachable. Participants learn the whys and hows behind previously intimidating cooking techniques like sauté, short-poach and en papillotte; dishes/ingredients like homemade stocks, aoli, court-bouillon and chia seeds; and kitchen tools like fish spatulas, cartouches and immersion blenders. Continue reading “Building Confidence in the Kitchen” »
It’s time we got rid of the SOAP note.
The SOAP note is the subjective-objective-assessment and plan around which every medical encounter in the country is framed. The priority is to identify the disease, measure it to confirm that it is a disease, and develop a treatment plan to try to control and eliminate it. This disease-based approach frames everything that goes on in health care.
It works well when a cause of a disease is easily identified and eliminated. However it works poorly for the factors that are now seen to impact most of health— prevention, lifestyle and holistic practices.
We now know that 80 percent of health care actually comes from outside of the clinic, and it won’t fit into that particular diagnostic plan that we create with SOAP. Patient’s goals and their decision-making are crucial for the creation of health and healing, even more so than the specific treatments of disease medical professionals sometimes provide.
Putting all encounters into a framework of subjective-objective-assessment and plan, around a specific diagnosis and verification of treatment, is no longer the model needed in the health care box.
From SOAP to HOPE
We need a new model for structuring the visits within the health care system. To achieve patient-centered care this new model must include the factors that change behavior and create health. These include social determinants of disease, holistic and integrative medicine, the importance of lifestyle, as well as the key role of purpose and meaning in the patient’s life.
In this new Healing Oriented Practices and Environments (HOPE) model, the patient and their own goals in life would be part of the diagnosis and the plan – all components that don’t currently fit into a standard SOAP note. Expectations and beliefs are a key part of healing, and so are social support and the relationships that are essential for recovery and the optimization of any kind of treatment. Thus, the social components must be part of the note.