stance abuse;
6. Establish a “WORKING DIAGNOSIS;”
7. Tailor a plan with MEANINGFUL and FUNCTIONAL goals
(to be reviewed “from time to time”);
8. WHERE MEDICALLY APPROPRIATE use non-opioid options
instead of or IN ADDITION TO prescribing opioids.
The requirements of Section Four lend themselves to creation of
a checklist.
At the INITIAL EVALUATION a Hoosier physician must be DRAMATIC
Note: The initial physical exam must be done by the prescribing
D iagnosis made (“working diagnosis”)
R
ecords obtained (a diligent effort made to obtain &
review)
A ssessment of pain
M ental health (and substance abuse) screen
A ctivity goals established
T ests ordered if indicated
I nstead of opioids, use non-opioid options
C onduct a focused history and physical
physician and cannot be delegated.
Note: Pain specialists contend that a truly “objective pain assessment
tool” does not exist, as pain is personal and subjective. Nevertheless, at minimum, I recommend a visual analog scale (i.e., 0 to 10)
or similar documentation aid be employed in order to satisfy the
regulatory requirement.
SECTION FIVE (Agreements and Informed Consent)
Although the term “Informed Consent” (IC) is not mentioned,
Section Five clearly deals with elements of informed consent in
discussing the requirement for a treatment agreement (TA). Both
the PATIENT and the PHYSICIAN must sign the