NEWSLETTER FEBRUARY 2023

PRACTICE STATEMENTS

  • Urine Testing MAX COST $99
  • All Medical Care – Done at Office Visits 2023
  • Please REVIEW / KEEP you prescription PRINTOUT 2023
  • (for Staff) PEER-to-PEER *** Very Important !!!
  • (for Staff) “NEW INFORMATION” top of the page on all APPEALS
  • We are doing SEMINARS again this year !!!
  • Please HELP US — Stay Ontime ——- with our daily schedule.
  • If the California Medical Board calls you, one of my patients, requesting you allow them to subpoenae your medical chart — PLEASE SAY NO.

PAIN PSYCHOLOGY EVALUATIONS

Pain management is a very challenging field with patients that have chronic disease and often multiple, severe comorbidities (i.e. depression, insomnia, deconditioning, etc.), along with medical board & DEA surveillance, and with the usual medical insurance challenges such as denial of treatment. Now in 2022 we saw a new challenge – pharmacies running out of medicine!! Several pharmacies in the Antioch area ran short of Norco just before the Christmas holiday – not a very welcomed gift for many. Ugh!!!  God will provide.

So the stresses of “life on earth” are not getting any less – and their does not appear to be any relief in site.  Patients, staff, and Dr. Cluff alike – we need to protect our mental health.  The first sentence of this section emphasized (in a concise manner) the immense challenges that pain management patients face everyday.  My life is stressful enough, I cannot imagine trying to do it all with 8/10 chronic pain everyday.  Multidisciplinary Pain Management refers to a “TEAM APPROACH” to helping patients with their chronic pain.  The “core” to this approach most commonly includes a (i) Pain Trained MD (fellowship training) and a (ii) Pain Trained Psychologist.  Other practitioners on the team may include (a) Physical Therapist (b) Addiction Specialist (c) Social Security etc. specialist (d) other specialists (i.e. Rheumatologist, Dermatologist, Surgeon etc.) and (e) Primary Care doctors.

Using the Multidisciplinary Pain Management approach helps ensure the patient is getting comprehensive evaluation / treatment.  As stated above, the world is getting more and more unpredictable and full of stress.  Even without that increased stress, the life of a person with chronic pain is not easy.  Depression is very common as well as insomnia, weight gain, deconditioning, physical disability, suicidality, and drug toxicity, including overdose.  The multidisciplinary approach helps us to identify these various issues, sort them out, and get the patient the help that they need.

CALIFORNIA MEDICAL BOARD

If the California Medical Board calls you, one of my patients, requesting you allow them to subpoenae your medical chart — PLEASE SAY NO. They need permission either from you (the patient) or the judge. Please make them get permission from the judge. That may help extend the “life” of this medical practice.  As I have told my patients before — we are on a five year probation (ending June 2025) for primarily two reasons (a) poor documentation (b) high opioid prescribing.  Our documentation is improving (a monitor reviews 50 charts a month), and we are tapering our patients with chronic pain.  It is in God’s hands.  We are following His lead.  PRAYERS.

TIME MANAGEMENT — OFFICE VISITS

Please help us stay on time.

Right now we are seeing patients every fifteen minutes. Four patients every hour. At some point we would love to have 20 minutes per patient – we can PRAY for that. 

The 15 minute visits includes the following:

(1) “small talk” Small is not worthless as it can help us document details of the patient’s life >> i.e. patient hobbies, stressors, family well-being

(2) Patient’s medical update: pain control   pain treatment, including medicines   comorbidities like insomnia

(3) Dr. Cluff >>> write and send prescription

(4) Dr. Cluff >>> do physical examination

(5) Dr. Cluff >>> document the subjective history and objective physical exam in the medical report

(6) Not a lot of time to spare

EVERYTHING DONE AT OFFICE VISITS

Please work with Dr. Cluff to get everything that you need for the month done at your office visit.  Our most frustrating issue of 2022 is patients that call the day after their visit and need to talk about something they need done.  Of course the next day when they are calling in, we have a full clinic of patients seeing Dr. Cluff – one of these patients will have their monthly office visit interrupted because of the forgetfulness of the first patient.  If a patient needs additional items discussed after their visit, they can wait till their next visit, or we can schedule an additional visit.  We are looking forward to a “new approach 2023” where we can see patients in a clinic that is uninterrupted by unscheduled calls/texts/visits – thank you for your help in this matter.

PLEASE HELP US BY 

(a) Knowing the date your medicine is due to be filled

(b) Alerting staff (Becki or Virginia) about work that the patient wants done at the office visit (i.e. paperwork filled out; labs/MRI reviewed; etc)

(c) PLEASE learn the importance of the “checkout prescription sheet” Dr Cluff gives you. Please don’t lose it (put it on the refrigerator)