Challenges in prescribing

The treatment of pain with medication is one of the most challenging tasks our physicians must perform. It requires knowledge of pharmacology, experience, patience and courage! Courage, because medicines routinely cause side effects, have toxicities, and may fail at their intended purpose. There are risks of interfering with medication plans or philosophies of referring physicians. In addition, prescribing pain medication is apt to be judged and second guessed by family, colleagues, insurers, regulators and attorneys. Strong opinions abound! At times medications are inappropriate and the refusal to prescribe under patient pressure can also require courage. Medicines must be chosen for their merits, prescribed with a proper plan, at the proper dose, for the proper amount of time with an eye on consequences. Physicians and patients must also deal with the frustrations of cost, insurance plan coverage restrictions, preauthorizations and other obstacles to the use of many medications. Good medication management requires education, monitoring and modification. Patients and family must be made aware of all these important considerations. With good and careful trials, timely follow up and patience we are often able to establish excellent medication plans to help our patients.

RLM. (3/26/14)