Oakes and Oakes
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Oakes and Oakes Consulting |
Medication Management Counseling and PATIENT GROUPS MEDICATION MANAGEMENT COUNSELING OUTLINE Group One: What your physician expects and why. Avoiding wrongdoing: Handling medications really, really responsibly. Avoiding the appearance of wrongdoing: The bad guys and how NOT to get mistaken for them. Governmental alphabet soup: DEA, FDA, GBI, and other factors affecting the patient-physician relationship that might surprise you. Group Two Dependence or addiction? How to tell the difference. Types of medications used to treat pain: Surprising results from drugs you may never have considered pain treatments. All pain medications are not created equally: Medications that work most effectively for chronic use. Drugs are not enough: Non-opioid (non-narcotic) treatment plans that help opioid medications work more effectively. Your best treatment plan is YOU: The crucial importance of self-care. Good Days and Bad Days: Warning signs of serious depression and anxiety. FREQUENTLY-ASKED QUESTIONS Q. What is the purpose of Medication Management patient counseling groups? A. Medication Management Counseling is a brief, two-hour group for prescription opioid users. Chronic pain patients learn best ways to use and manage opioid medications, including an introduction to non-opioid (non-narcotic) cognitive-behavioral pain management. Medication Management is research-based and presents the most current treatment strategies that help opioid medications work most effectively. Just as pain affects one’s whole life, all of life affects pain. Medication Management counseling reduces stress by acquainting patients with the physicians’ expectations and ground rules for chronic opioid therapy, so that everyone communicates more effectively. Q. Is this patient group optional? A. Generally speaking, no, but that depends on the referring physician’s requirements, so you should consult with your physician. Physicians often require assigned patients to appear for assessment and Medication Management counseling within 30 days or they receive no refills until they complete this part of the treatment plan. Literally, no appearance, no refills. This underscores the value of the group and the seriousness of following the whole person treatment plan. Q. Why is this patient group so important? A. Several reasons, all important. First, patients who are informed about their medications tend to feel better through being more treatment-compliant. They usually require fewer rescue doses and crisis visits, which lowers healthcare costs. Second, the federal Drug Enforcement Agency strongly recommends comprehensive pain management, not just prescriptions. Comprehensive pain management includes behavioral and lifestyle patient counseling to encourage the changes necessary to live well despite chronic pain. Behavioral counseling may include random pill counts, to discourage illegal redirection of medications. Third, we teach valuable information to help good patients do better pain management. Fourth, we encourage good behavior by limiting access. People who divert drugs exhibit different behavioral patterns than real pain patients and usually avoid responsible behavior, such as attending Medication Management counseling. Q. Random pill counts? What is that? A. Patients must come to the clinic office within 24 hours of the phone call, and bring their medication. We count their pills during the counseling session. DEA strongly recommends this approach to encourage accountability. Human nature being what it is, even good patients do better when held accountable. Q. Is my doctor requiring this class because he thinks I am a drug abuser? A. No. This patient group is to help good patients do a better job with pain management. If anyone thought you were a drug abuser, then they would just stop your opioids, and certainly would not offer Medication Management patient groups. Q. Is this patient counseling group new? A. No. Patients from several local pain clinics have participated in Medication Management patient counseling groups. Q. Is this counseling group to help me quit my medications? A. No. One result of failing to treat the whole person is that the pain medications do not work or do not work as well. Some patients find, to their great surprise, that other treatments or other medications may work more effectively than the opioid and voluntarily reduce their doses. We will discuss specific real-life examples. Q. What difference does it make if I take one pill or five pills, so long as I do not exceed my monthly allotment? A. Research from the neurosciences shows that keeping pain down is easier than knocking pain down. Literally, patients require fewer pills when they take medications every day as prescribed, whether they feel bad or not. When pain neurons fire, they do not fire in a straight line, but more like a Roman candle or star burst, so keeping pain under control requires fewer drugs long term. Q. Will insurance cover Medication Management patient counseling and groups? A. Yes, if you have behavioral or mental health services in your contract, CPT codes 90853 or 90857, group therapy, are covered. Please call 404.627.2004 for pre-certification and fee schedule. Q. What about length of treatment and costs? A. Medication Management = two hours of group therapy, CPT Code 90853 or 90857. When done individually, two units of 90806. Random pill count occurs during brief individual behavioral therapy, CPT Code 90804, 20 - 30 minutes. Q. If insurance will not pay, do you have special rates and terms for self-pay? A. Yes. Please call 404.627.2004. A. Any physician, case manager, or claims adjuster responsible for a patient taking opioid medications. Patients wanting more information about opioids may refer themselves. Prescribed opioids are the only patient requirement. MARILYN T. OAKES is a rehabilitation counselor in Atlanta, Georgia. She attended the University of Kentucky and graduated from Peabody College at Vanderbilt University and the University of Alabama-Birmingham. She has worked with pain patients more than 25 years and served on Pain Teams at the University of Alabama - Birmingham Pain Center and the Center for Spine Care at Shepherd; she is presently a member of the Northside Hospital Multidisciplinary Pain Management Team. In 1998, she became a pain patient, and now uses her experiences to help patients. She is a Licensed Professional Counselor and nationally board-certified in counseling, rehabilitation counseling, rational hypnotherapy and pain management. She is presently the only Certified Rehabilitation Counselor and Licensed Professional Counselor in Georgia with dual certification in pain management. |
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