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A group of primary care clinics in West Virginia has an anesthesiologist on staff to treat patients with chronic pain, in an attempt to reduce prescription opioid addiction.
Community Care of West Virginia hired the anesthesiologist four years ago, to allow primary care doctors and nurse practitioners to concentrate on other medical conditions they feel more comfortable treating, The New York Times reports.
Many of the clinics’ patients have physically demanding jobs, such as mining, waitressing and tree cutting, and come to the clinic to ask for opioids such as Vicodin and Percocet.
“We needed to talk about congestive heart failure or diabetes or out-of-control hypertension,” said Dr. Sarah Chouinard, Chief Medical Officer at Community Care of West Virginia. “But we struggled over the course of a visit to get patients to focus on any of those.”
Some of the clinics’ doctors were prescribing too many painkillers. In many cases, the doctors had grown up with the patients in the small towns where they practiced and were reluctant to deny their requests for opioids.
In the past four years, more than 3,000 of the clinics’ 35,000 patients have seen the anesthesiologist, Dr. Denzil Hawkinberry, for pain management. They continue to see their primary care providers for other health conditions.
“I’m part F.B.I. investigator, part C.I.A. interrogator, part drill sergeant, part cheerleader,” said Dr. Hawkinberry, who is in recovery from an opioid addiction. He says he has not used drugs for almost nine years.
About 70 percent of the 1,200 patients in Community Care’s pain management program are prescribed opioids. Their treatment may also include non-opioid drugs, physical therapy, injections and sessions with a psychologist. Dr. Hawkinberry said many patients have been taking opioids for years. He tries to lower the dose, and to have patients try other pain management techniques.