Jack M. Berger, MS, MD, PhD and Nalini Vadivelu, MD
Guidelines for the use of controlled substances for the treatment of pain now consider inappropriate treatment, including undertreatment of pain, a departure from an acceptable standard of practice.
Addicts quickly learn the diagnoses that cannot be definitively confirmed or ruled out by examinations or test results but that elicit prescriptions for opioid pain management.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.