Henry Ford Health demonstrates its commitment to patients in pain by providing continuing pain management education for physicians and establishing a pain medicine fellowship, as well as its diverse, multi-specialty and personalized treatment of pain.
“Our goal is to educate,” said Dr. Nabil Sibai, an anesthesiologist and pain medicine specialist at Henry Ford Health.
“We did a grand round across the system,” Dr. Sivai told the AMA in an interview, “and we developed a manual for physicians and nonphysician providers on responsible opioid prescribing — how to administer opioids, how to monitor them and how to taper them.”
Doctors also receive feedback on their prescribing and are shown how they compare to their peers.
Henry Ford Health AMA Health Systems Programdelivers enterprise solutions that provide leadership, physicians and care teams with the resources to drive the future of healthcare.
Care teams develop customized plans
Care teams develop customized plans
“Probably the most common reason for pain that we see, and the most common reason for which opioids are prescribed, is typically back pain,” Dr. Sivai said. “We have a number of minimally invasive, non-opioid pharmacological and non-pharmacological options to help manage patients’ pain.”
“In the perioperative period, we use a lot of opioid-sparing techniques, including regional anesthesia and certain infusions and medications, to keep patients as comfortable as possible,” Dr. Sivai said.
Henry Ford Health leaders are also considering how to use buprenorphine to manage chronic pain that requires opioid management.
Buprenorphine “is an opioid in itself that provides excellent pain relief without the risk factors of full mu agonists like morphine and oxycodone,” Dr. Sivai said.
In keeping with Henry Ford Health’s multidisciplinary approach to pain, physician advocates in pain medicine, behavioral medicine and primary care will receive training and education and then serve as ambassadors for their respective service lines and as a resource for physicians embarking on this path, Dr. Sivai explained.
“We have identified physician champions and they have come together in groups and received appropriate training and we will be rolling them out shortly thereafter,” he said.
Henry Ford Health also participates in the Overdose Prevention Engagement Network, an organization dedicated to reducing substance use disorder-related harms and sharing education and resources to enhance person-centered prevention, treatment and recovery. Henry Ford Health has worked with the network to expand access to naloxone in the hospital’s three emergency departments and pharmacies across the system.
The American Medical Association believes science, evidence and compassion should guide patient care and policy changes as the nation’s opioid epidemic evolves into a more dangerous and complex illegal drug overdose epidemic. Learn more AMA Ending the Epidemic Website.
Fellows follow an interdisciplinary path
Fellows follow an interdisciplinary path
Since 2016, Dr. Sivai has served as the program director for the one-year accredited Pain Medicine Fellowship offered to physicians by the Henry Ford Health Department of Anesthesiology, Pain Management and Perioperative Medicine.
“We are a multidisciplinary program, so we accept fellows with backgrounds in physical therapy and neurology in addition to anesthesiology,” Dr. Sivai says, “and recently added emergency medicine, family medicine and radiology to the list of specialty backgrounds that can complete a pain fellowship.”
He added that the program is expected to host its first emergency medicine residents next year.
Fellows will gain experience in the management of acute and chronic cancer pain and will also train in a specialized multidisciplinary clinic focused on the treatment of sickle cell disease and cancer pain.
They will be exposed to the full range of pain treatments: psychological, physical, pharmacological (including IV therapy), complementary therapies (acupuncture, yoga, massage), injections, and other advanced interventions.
According to the Pain Medicine Fellowship webpage, these may include interventional techniques using fluoroscopy and ultrasound guidance, epidural anesthesia, facet joint injections, medial branch blocks, radiofrequency thermocoagulation, sacroiliac joint injections, muscle and joint injections, sympathetic nerve blocks, neuroablation therapy, vertebral augmentation, spinal and dorsal root ganglion neuromodulation, peripheral neuromodulation, percutaneous image-guided lumbar decompression, and intraspinal pump testing and management.
“In pain medicine, there’s a much broader range of training experiences, from one pain fellowship to another,” Dr. Sivai said. “What we try to do is provide our fellows with a well-rounded education that includes both clinical and didactic components so they have a well-rounded knowledge.”
Fellows also provide pain consultation services at Henry Ford Hospital in Detroit and at outpatient satellite clinics in the suburbs.
