MedEdPORTAL (Mar 2011)
A Faculty Development Workshop for Primary Care Preceptors: Helping Your Residents Care for Patients Requesting Opioids for Chronic Pain
Abstract
Abstract Introduction The Director of the National Institute on Drug Abuse (NIDA) has described the abuse of prescription medications, particularly opioid analgesics, as a growing public health concern and has called for further research to develop safe and effective pain management strategies and medications with less potential for abuse. This faculty development workshop is designed to address this growing problem by educating faculty preceptors in resident physicians' programs using an unfolding case that represents a typical resident presentation of a patient case in the primary care setting. It provides an overview of diagnosis, treatment, and management of patients who are at risk for prescription drug abuse. In addition, it focuses on effective communication and interpersonal skills and explores physician biases and emotional responses to patients seeking medication for chronic pain. Methods The module consists of a 1.5- to 2-hour session for preceptors of primary care resident physicians that uses discussion, problem-solving, and role-playing. The primary teaching points are embedded in the facilitator's guide. Results Sixteen Harvard Medical School faculty members participated in our pilot faculty development workshop on October 29, 2008 at the Harvard Faculty Club. The workshop received excellent ratings (high or very high) by most participants in all categories of responses. Specific feedback included praise for the case-based, group discussion/role-play format. Discussion Establishing a trusting doctor-patient relationship will help in trying to better diagnose the problem and help the patient, but this relationship is unlikely to develop if the resident perceives this new information as a personal affront rather than the behavior of a patient who may have a serious addiction problem. The resident's anger may interfere with the care of the patient. The resident should come to understand that addiction is a chronic, relapsing brain disease that should be treated as a disease rather than a moral failing; this approach should help reinforce the idea that the resident should not take the patient's behavior personally.
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