Medical & Legal Aspects of PAIN MANAGEMENT
PROGRAM MORNING SESSION I
7:45 - 8:00 a.m. Welcome & Introductions
S. Sandy Sanbar, MD, PhD, JD, Program Chairman , ABLM Past Chairman
Educating Practitioners, Patients & Public about Controlled Substances
Moderators: Carl Hook, MD, President & CEO, PLICO, and Christopher S. Candler, MD, EdD, Associate Dean of Academic Affairs, Associate Professor of Medicine, OUHSC
8:00 - 8:30 a.m. – Pain Management Education and Competence
Christopher S. Candler, MD, EdD
8:30 - 9:00 a.m. – Pain Evaluation, Assessment and Documentation Guidelines
Gretchen M. Wienecke, M.D., Clinical Associate Professor,
Department of Anesthesiology, OU Physicians Pain Management Center, OUHSC
o Clinic Pain Management Policy and Guidelines
o Comprehensive Pain History Guidelines
Types of Pain; Pain Processing; Assessing Pain
Assessing Risk for Opioid Abuse
Assessing Pain in Special Populations and in ICU
Assessing Risks and Benefits
o Comprehensive Physical Examination Guidelines
o Documentation Guidelines
9:00 - 9:30 a.m. – Initiation of Treatment Plan & Pharmacology of Pain Medications
C. Scott Anthony, D.O., Pain Management of Tulsa, OK
o Components of an Effective Treatment Plan
o Applying Evidence-Based Guidelines to Common Pain Conditions
o Pain Management Guidelines & Standards
o Patient and Public Education and Instructions
9:30 -10:00 a.m. – Periodic Review (Follow-up) of Pain Treatment
Layne E. Subera, D.O., Skiatook, Oklahoma
o How to Monitor Patient Progress
o Components of an Effective Periodic Review/Follow-up
o Review of Functional Goals
o Monitoring Adherence to Medication Regimens
o How to Manage Non-Adherent Pain Patients
o How to Distinguish Addiction vs. Pseudo-addiction
10:00 – 10:15 a.m. – BREAK
PROGRAM MORNING SESSION II
Prescription Monitoring, Drug Testing & Discharging Patients
Moderators: Lyle Kelsey, MBA, CAE, Executive Director, OMB, and Deborah Bruce, JD, Executive Director, OOB
10:15 – 10:45 a.m. – Prescription Monitoring, Drug Testing, Discontinuing Rx
C. Scott Anthony, D.O., Pain Management of Tulsa, OK
o Establishing a Drug Testing Platform;
o Documenting Medical Necessity for Drug Testing; and
o Role of Urine Drug Testing (UDT) in Monitoring Treatment Adherence.
10:45 – 11:15 a.m. – Medical-Legal Considerations of Pain Management
S. Sandy Sanbar, MD, PhD, JD
o Establishing a Physician-Patient Relationship
o Obtaining Informed Consent (or Informed Refusal) to Pain Management
o Physician/Patient Pain Management Agreement (Contract)
o Duty to Document in Medical Record
Elements of Effective & Specific Documentation
Accurate Coding for Pain Diagnosis, Testing and Treatment
o DEA Standard
o HIPAA Privacy Standard
o FDA REMS (Risk Evaluation and Mitigation Strategy)
o Duty to Refer or Consult
How to Facilitate the Referral Process
When to Refer for Patient Behavioral Issues
How to manage a Difficult Physician-Patient Relationship
o Terminating a Physician-Patient Relationship
o How to Discharge a Non-Compliant Patient.
11:15 – 12:00 p.m. – Presentation of Cases and Questions & Answers
12:00 – 1:00 p.m. - LUNCH BREAK
PROGRAM AFTERNOON SESSION
Pain Medications: Federal and State Law Enforcement
Moderators: D. Wade Christensen, B.S., J.D., First Gentleman of Oklahoma
Christensen & Associates, Oklahoma City, OK
Kenneth King, CEO and Executive Director, OSMA
1:00 – 1:30 p.m. – Controlled Drugs: State Laws & Regulations
Robert Hudson, JD, First Assistant Attorney General, Oklahoma
o Abuse of Pain Medications
o Fraud Involving Controlled Drugs
o Crimes/Murder Involving Pain Medications
1:30 – 2:00 p.m. – Compliance with Oklahoma Medical Board Rules
Lyle Kelsey, MBA, CAE, Executive Director, Oklahoma Medical Board
o Pain Management Rules – Oklahoma Medical Board
o CME Pain Management Education Requirements;
o Investigations of Prescribers; and Disciplinary Proceedings
2:00 – 2:30 p.m. – Pain Management Rules - Oklahoma Osteopathic Board of Examiners
Deborah Bruce, JD, Executive Director, OOB
o Pain Management Rules – Oklahoma Osteopathic Board of Examiners
o CME Pain Management Education Requirements;
o Investigations of Prescribers; and Disciplinary Proceedings
2:30 – 3:15 p.m. Pain Medications: Compliance with Narcotics State Laws
Director Darrell Weaver, BA, MBA, OBNDD
o Prevention of Injury and Death.
o State Prescription Monitoring Program (PMP)
o Proper Disposal of Drugs
o Organized Diversion Rings;
o Pill Mills; Predators; and Doctor Shoppers.
3:15 – 4:00 p.m. – PANEL ALL Speakers – Pain Malpractice, Qs & As, AND Comment on the Drug Court Program by The Honorable Judge Martha Oakes, Special Judge of the District Court of Oklahoma County
4:00 p.m. – ADJOURN
