Friday, August 1, 2014

Plan of Care

Why a “plan of care”
FIRST DO NO HARM                                    

After an appropriate evaluation, diagnostic studies and assessment, providers present their patients with a plan of care. Plans of care should be based on the patient’s “needs” not “wants”. The current scientific knowledge, training and experience of the provider will govern the best plan for that particular patient. Some plans are very clear cut and based exclusively on science and findings such as surgically removing the appendix on a patient with appendicitis. Others are more complex and hard to be universally accepted and subject to many opinions by the patient, the provider, the family and even sometimes the insurance companies.

Unfortunately pain management plans of care are more like the latter. Subject to controversy and debate by many.

Those who are trained and boarded as subspecialists in pain management, try very hard to deliver a plan of care that is within the current science and acceptable pain practice. Experience and training play a very important role in the development of a scientific good treatment plan. However we constantly face challenges because of the different “opinions” that some patients and some providers have. They go from one extreme to another, nothing more controversial than pain drugs. 

A good, scientific plan of care must
a)     establish medical necessity.
b)     prescribe appropriate medications for the medical condition.
c)      obtain diagnostic tests that are needed
d)     prescribe any procedure or intervention needed
e)     refer in consultation for other services that might benefit the patient.
f)       provide follow up care and future support.


Most of all we must follow the accepted reasoning of FIRST DO NO HARM when we develop a scientific plan of care.

Cesar A. Euribe, M.D.

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