3 Day scripts a good idea?
With Governor Hogan’s Heroin and Opioid Prevention, Treatment and Enforcement Initiative being announced in early 2017 there has been a lot of talk recently about the appropriate number of days a narcotic prescription should been written for.
An informative and timely article, dated January 28 2017, written in the Frederick News Post by Frederick physician Dr. Julio Menocal, addressed many of the issues relating to narcotics and opioids prescribing he suggested that a 3 day rule be instituted. One of our Frederick and Leesburg based pain doctors Dr. Chirag Sanghvi and our senior staff have pondered this suggestion.
The opioid epidemic is a very real concern. As the Surgeon General pointed out in his letter to physicians dated August 25 2016, “Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed.”
However, expecting your internal medicine/ primary care physician to have the tools to manage genuine long-term chronic pain is unreasonable considering the huge variety of ailments they skillfully treat and juggle daily.
What are the unintended consequences of the 3 day narcotic/ opioid script?
There are many complexities involved in treating pain responsibly. The proposed three-day rule certainly addresses the need for increased monitoring of opioid and narcotic prescriptions.
However, will this rule itself achieve the desired outcome?
With the assumption that terminally ill patients, such as patients with cancer, would not be subjected to the three-day restrictions we must also look at the unintended consequences this rule may trigger:
- Large burdens on waiting rooms and provider schedules as patients fill the books with prescription refill, UDS screen and pill count appointments,
- Additional monthly cost for patients who pay co-pays for every visit,
- Increase in overall health care costs (which may be passed on to all patients eventually),
- Emotional stress on genuine patients who feel they are being treated like drug seekers.
For those who are drug seeking there are other potential consequences to keep an eye out for:
- Potential for increased incidences of “doctor shopping” in neighboring states
- Potential increased theft of medications and break-ins,
- Increase in use of heroin and alternative drugs as opioids become more difficult to obtain.
The three-day rule is certainly a conversation to be had, but perhaps equally as relevant is exploring alternative pain treatments.
Are we taking the right approach?
Many people do not realize that pain management is a specialty itself and is offered as a separate board-certification.
Unfortunately, most people seek specialist pain management care after having suffered with chronic pain for a long time and seeing physicians whose therapies are limited to pain medications.
Chronic pain along with prolonged use of narcotics causes multiple changes in the body such as changes in normal levels of circulating hormones and sleep cycles. These chronic physiologic changes can cause mood changes along with changes to how our bodies perceive pain.
The good news is that there are many alternative pain treatments available. In most cases successful pain management utilizes an integrated approach that encompasses a combination of treatments.
As physicians we recognize that the opioid epidemic is a very real and serious situation. As board-certified interventional pain specialists we also recognize there is a need to treat genuine pain responsibly.
We therefore recommend;
- Using non-surgical, interventional procedures to immediately and effectively reduce pain levels.
- In cases where medication management is necessary; reduce reliance on pharmacologic substances, maintain low doses and do not limit “pain medicine” to strong opioids & narcotics,
- Outline a detailed and carefully designed treatment plan that takes a multi-modal approach to include: weight-loss, chiropractic, physical therapy and/or counselling.
Interventional pain management procedures often enable patients to participate in and get the most out of other alternative treatments such as exercise, physical therapy or chiropractic manipulation.
These therapeutic interventions (procedures) work extremely well at the onset of pain when other physiologic changes have not yet occurred in the body and there is less damage to reverse.
Therefore, the earlier a patient seeks specialist care for their pain the less likely that patient is to be placed on a long-term medication schedule.
The Surgeon General, Vivek H. Murthy, M.D., M.B.A. recently sent out a letter to all American physicians urging us to do everything in our power to address the opioid epidemic.
The opioid epidemic is a very real and serious situation, so too is the need to treat pain responsibly.
Newbridge Spine & Pain Center is one of the Greater Washington area’s premier interventional pain management facilities dedicated to treating pain. Our physicians are Anesthesiologists with sub-specialty training in pain management.
There are many misconceptions about the ‘pain management’ specialty resulting from the mismanagement and over-prescribing of addictive painkillers. However, our specialization, interventional pain management, addresses both the rising opioid epidemic and the need to treat pain.
Treating pain in a conservative, responsible manner is our daily commitment.
We do this by:
- Utilizing non-surgical, interventional pain procedures to quickly and effectively reduce pain levels.
- In cases where medication management is unavoidable, we aim to reduce reliance on pharmacologic substances, opioids & narcotics by maintaining low doses and outlining treatment plans that take a multidisciplinary approach to include; weight-loss, physical therapy and/or counseling for example.
The Newbridge team spends a significant amount of energy encouraging our fellow healthcare providers to refer to interventional pain management before prescribing or laying out a treatment plan. This is because our therapeutic procedures work at the onset of pain as well as for chronic pain conditions.
We firmly believe that the sooner a patient can be treated by a pain specialist using interventional methods the less likely that patient is to be prescribed a long-term medication schedule.
Most pain complaints relate to pain originating throughout the spine, however, an interventional pain doctor can treat acute and chronic pain all throughout the body to include the limbs and joints in the peripheral body.
Statistics show that chronic pain affects more Americans than diabetes, heart disease and cancer combined (Source:http://www.painmed.org/patientcenter/facts_on_pain.aspx).
These statistics indicate that treating pain responsibly is a major health concern and demonstrate the need for ethical, qualified and specialized practitioners in the field.
The term “pain management” is likely to conjure thoughts of dangerous medications and drug addiction. The mismanagement and over prescribing of addictive pain killers has certainly become a major problem in today’s society making it no longer appropriate or appealing for your family practitioner to treat pain.
A relatively misunderstood and underutilized specialty called interventional pain management has emerged from the well-publicized opioid epidemic and the genuine need to responsibly and effectively treat pain.
The role of a good interventional pain management physician is to provide improved quality of life and enable patients to participate in activities such as; pick up their child, walk the dog and participate in physical therapy sessions for example.
An interventional pain management specialist could be a physical medicine and rehabilitation (PM&R) physician or, as is the case at Newbridge Spine & Pain Center, a highly skilled, board certified anesthesiologist sub-specialized in pain management procedures and techniques.
There are many misconceptions about what an interventional pain management physician actually does and few people know the full scope of procedures available to responsibly and effectively treat pain.
Firstly, an interventional pain specialist does not just write prescriptions, in fact, this is at the bottom of their toolkit. The interventional pain doctor performs procedures either in an office or ambulatory surgical center (ASC) setting.
These procedures range from a simple trigger point injection, epidural steroid injection, or a nerve block to radiofrequency ablation or spinal cord stimulation for example. Many of these procedures can help patients avoid an opioid or narcotic medication schedule altogether.
Learn more about interventional pain management at newbridgespine.com
View Doctor bios at http://newbridgespine.com/our-providers
Southern Maryland’s premier medical facility exclusively dedicated to pain management, has added a new Nurse Practitioner to their team, Ms. Felicia DePina.
Ms. DePina is a native of Chicago’s south side. She is a military vet who served her country in both peace time and war as a combat medic; achieving the prestigious Army Accommodation Medal for military service.
During her military tenure she saw first-hand the benefit of and need for responsible short and long-term pain treatment.
Following an honorable discharge from the US Army Ms. DePina attended the University of Alaska Anchorage where she received a baccalaureate of science in nursing.
Ms. DePina enjoyed a full and satisfying nursing career of more than 15 years, before deciding to take her nursing experience and education to the next level. She pursued an advanced master of science in nursing degree, ultimately becoming a Nurse Practitioner.
Ms. DePina is board certified nationally as a Family Nurse Practitioner, through the American Academy of Nurse Practitioners. She is a Certified Registered Nurse Practitioner in the state of Maryland, currently holding states licenses as a registered nurse in Georgia, Maryland, North Carolina, and Texas.
As the newest member of the Newbridge Spine & Pain Center team in Southern Maryland she will see patients suffering from chronic pain primarily at the practice’s Waldorf location. There she will join a well-established team including; Physician Assistant, Singh Bhurji and CRNP, Celia Gramsky all assisting board-certified interventional pain management physicians, Dr. Madhavi Chada and Dr. Majid H. Ghauri.
Chirag Sanghvi M.D. now seeing patients in Leesburg, Virginia
Leesburg, Virginia – July 26, 2016 – Newbridge Spine & Pain Center, Loudoun County’s specialist pain management facility added physician Chirag Sanghvi, M.D. to head their Virginia team.
Dr. Chirag Sanghvi is board certified in both Anesthesiology and Pain Management and completed his fellowship in Pain Management at the Cleveland Clinic in Cleveland, Ohio.
Dr. Sanghvi was the lead physician at the Prince Frederick, MD branch of Newbridge Spine & Pain for over 4 years until his recent move to Northern Virginia. After several months in Loudoun County patient feedback for this physician has been outstanding;
“[He is] very knowledgeable and professional. He listens and explains the causation and treatment plan for my condition thoroughly. I have the utmost trust in his decision making.” states current patient Kevin K.
The complexity of treating pain has never been more evident than it is today.
Due to this Dr. Chirag Sanghvi urges patients to come to pain management as early as possible, “to prevent pain from progressing into a debilitating hindrance it needs to be treated appropriately. Patients come to me after years of improperly dealing with pain and perhaps having seen many physicians. I cannot emphasize enough that the earlier I can treat a patient with interventional procedures the less likely they are to have long-term pain and the need for long-term treatment”
Pain is one of America’s largest health challenges and can have a devastating impact on a person’s ability to do every-day-things. As a firm believer in the multidisciplinary approach most of Dr. Sanghvi’s treatment plans incorporate other modalities such as physical therapy.
This fact makes Dr. Sanghvi’s goal all the more promising as he takes the Leesburg practice under his wing, “my goal is not only to help reduce pain but to optimize my patient’s ability to perform their daily tasks, pursue their hobbies and live a happy, active lifestyle.”
Newbridge Spine & Pain Center is open 5 days a week and is located at 161 Fort Evans Rd NE, Suite 340, Leesburg VA 20176. View Dr. Sanghvi’s bio at http://newbridgespine.com/doctor/sanghvi/
New Medical Building in Prince Frederick Officially Opens Doors
Ceremonial Ribbon Cutting and Open House Held
Prince Frederick, Maryland – June 14, 2016 – Newbridge Spine & Pain Center, a Southern Maryland medical practice exclusively dedicated to pain management, held its grand opening ceremony last Tuesday, June 7th 2016.
The opening ceremony revealed the name of the new Prince Frederick medical building, “Rudy Medical Center”. The building honors longtime employee and Nurse Anesthetist, Rudy Ocampo, CRNA.
Mr. Ocampo, CRNA is one of a team of anesthetists and anesthesiologists providing patients with the option for monitored anesthesia (sedation) during pain management procedures such as; epidural steroid injections, nerve blocks and radiofrequency ablations.
Rudy Medical Center is a state-of-the-art facility located at 80 Sherry Lane, Prince Frederick. The building, which is home to Newbridge Spine & Pain Center and Newbridge Surgery Center of Prince Frederick, was designed to beautifully complement the style and charm of the city of Prince Frederick.
Dr. Greesh John, M.D., one of the clinic’s physicians, states, “Patients have already commented that the new building has enhanced their visit experience. Not only do we offer the most sophisticated pain treatments available anywhere but we now do so in a spacious, modern and comfortable atmosphere.”
The new building solidifies the company’s commitment to serving Southern Maryland pain patients by hosting both the pain management office, where patients are seen for consults, and the procedure suite, where patients are treated with out-patient procedures for a full range of pain conditions.
About Newbridge Spine & Pain Center
Newbridge Spine & Pain Center has helped thousands of patients experience effective, long-lasting relief from
acute and chronic pain. By incorporating powerful, sophisticated pain-relieving treatments into customized plans of care, our pain management experts provide patients with the ability to return to living an active and healthy lifestyle.
Some of the many conditions we successfully treat include back and neck pain, spinal cord disorders, cancer pain, auto & work injuries, fibromyalgia, arthritic pain and many other painful conditions. Additional information is available at www.NewbridgeSpine.com.
Prince Frederick, Maryland – March 3rd, 2015 – Newbridge Spine & Pain Center, Prince Frederick’s premier specialist pain management facility has moved.
After 5 years at 70 Sherry Lane, Newbridge Spine & Pain Center founder Jay Gonchigar M.D., decided it was time to plant permanent roots in the community where he and fellow physicians, Chirag Sanghvi M.D. and Greesh John M.D. have successfully treated over 2,500 local pain patients.
The business has constructed a brand new facility at 80 Sherry Lane boasting modern décor with 6 exam rooms, 2 procedure rooms and a state-of-the-art recovery area.
The building will be home to both the pain management office, where patients are seen for consults, and the Procedure suite, where patients are treated with interventional, out-patient, procedures for a full range of pain conditions.
With an administrative and clinical team comprised of over 15 local residents, the new premises is open 5 days a week and marks a serious commitment to providing specialist pain relief to the Prince Frederick community.
“Over the past 5 years we have been honored to provide Prince Frederick and the surrounding community with the highest-quality interventional pain treatments available anywhere. Our new premises demonstrate our commitment to do so for many years to come” states founder Jay Gonchigar, M.D.
The new facility opened 1 March 2016 and is now accepting new patients.
Newbridge Physicians awarded Washingtonian “Top Docs 2015”
Congrats to our founder Dr. Jay Gonchigar and senior physician Dr. Majid H. Ghauri for being selected among the Washingtonian magazine’s Top Doctors of 2015.
Dr. Gonchigar has been practicing pain management since 1996 and is one of the DMV areas longest standing specialist pain providers.
Dr Majid H. Ghauri has over 13 years of experience practicing pain medicine. We sat down with Dr. Ghauri between procedures to ask a few questions about his passion for pain management.
Since 2002 Dr. Ghauri has developed his specialist interventional pain management techniques therefore you’d expect him to have a favorite procedure, “I enjoy performing all interventional procedures. Whenever a procedure helps a patient feel better I’m happy. Whatever procedure will most effectively achieve pain relief for that patient is my favorite at that time.”
When asked what he loves most about pain management he states, “with the advances in pain management procedures and techniques we have been able to establish and maintain an extremely high success rate with injection treatments.” This high success rate means that more patients are able to pursue their daily activities with far less reliance on long-term medications.
The moments he is most proud of in his lengthy career are not achieving his triple board certification, awards or prestige he states, “every time a patient gets better and says ‘thank-you’ I feel proud of what I do and the career path I have chosen.”
His advice for anyone entering the field; “work hard and don’t take any thing lightly.”
These two Newbridge Spine & Pain Center physicians have a long history of treating chronic pain in Maryland and the surrounding area going back to 1997.
With a team of fellowship trained & board-certified pain management specialists, Newbridge Spine & Pain is one of the few pain practices equipped with the expertise and resources to provide patients with monitored anesthesia care (sedation) during pain management procedures.
Pain Specialist Harris Shaikh, M.D.
Now seeing patients in Frederick, Maryland
Frederick, Maryland – September 29, 2014 – Newbridge Spine & Pain Center, a leading Maryland medical pain management practice dedicated to the treatment of chronic pain, has recently added two new physicians to its team of pain management providers in Frederick MD.
Harris Shaikh, MD joins the pain management team at Newbridge Spine & Pain Center in Frederick after completing his fellowship in Pain Management from The Manhattan Center for Pain Management at Mount Sinai St Luke’s-Roosevelt in New York. Dr. Shaikh, like most of the physicians at Newbridge Spine & Pain Center, has multiple board certifications including Anesthesiology and Internal Medicine.
Sana Shaikh, M.D.
Joining him in the move to Frederick is his spouse Dr. Sana Shaikh, also a board certified Anesthesiologist fellowship trained in pain management. Sana Shaikh, M.D. practiced pain management in New York prior to moving to Frederick to join the team at Newbridge Spine & Pain Center.
Harris Shaikh, M.D.
When asked what prompted them to make the move from New York to Frederick the Shaikh’s stated that the move to Frederick was a clear choice, “it was important for us to find a community that is family oriented and has values similar to ours we’re confident we’ve found that here in Frederick” said Dr. Harris Shaikh.
Regarding the choice to join the Newbridge practice he sates,
“I chose Newbridge Spine & Pain because they have a pain management philosophy which is consistent with mine; namely, using a multimodal, multidisciplinary approach that helps chronic pain patients return to the activities they love most.”
While Newbridge Spine & Pain Center brand has been in business for over five years and is conveniently located on Thomas Johnson Drive the physicians of Newbridge Spine & Pain Center, in particular founder and medical director Dr. Jay Gonchigar, have a long history of treating chronic pain in Frederick County and the surrounding area going back to 1997. With a team of fellowship trained pain management specialists Newbridge Spine & Pain is one of the few pain practices equipped with the expertise and resources to provide patients with sedation during pain management procedures, an offer that is especially welcomed by patients experiencing severe pain and anxiety.
Majid Ghauri, M.D., one of Newbridge Spine & Pain’s lead physicians, is enthusiastic about the additional pain providers, “Dr. Shaikh is a wonderful addition to our team his emphasis on and experience in multidisciplinary care is consistent with the Newbridge philosophy and his passion for chronic pain patients is a true asset to us. Additionally, we have the benefit of Dr. Sana Shaikh’s experience as a pain provider and anesthesiologist. Frederick is lucky to have them both.”
Chronic pain is one of America’s largest health challenges and can have a devastating impact on a person’s ability to do every-day-things. This fact makes Dr. Shaikh’s goal all the more promising as he hits-the-ground-running taking the Frederick practice under his wing,
“my goal is not only to help reduce pain but to help optimize our patient’s ability to perform their daily activities, pursue their hobbies and basically live a happy, active lifestyle.”
Newbridge Spine & Pain offices are located in Waldorf, Prince Frederick and Frederick, MD and now in Leesburg VA.
About Newbridge Spine & Pain Center
Newbridge Spine & Pain Center has helped thousands of patients experience effective, long-lasting relief from acute and chronic pain. By incorporating powerful, sophisticated pain-relieving treatments into customized plans of care, our pain management experts provide patients with the ability to return to living an active and healthy lifestyle. Some of the many conditions we successfully treat include back and neck pain, spinal cord disorders, cancer pain, auto & work injuries, fibromyalgia, arthritic pain and many other painful conditions.