What impact do the many interprofessional healthcare providers beyond the physician play in structural iatrogenesis and/or patient advocacy? This case ends with the medical assistant playing a crucial role. Much of the discussion has been focused on the patient-physician relationship because of the emphasis on prescribing behaviors...and how can we include other providers who interact with patients with chronic pain to create healing teams and to help 'check' our implicit biases? What happens when varied providers on the team present different biases?
I work with RNs, for example, who are patients' greatest advocates when they miss refill appointments, drop into clinic, need a prior authorization, etc. I also served on an institution's opioid review committee and found that some members who were physical therapists, pharmacists strongly believed that zero patients should be on chronic opioids, were interacting with my patients with chronic pain more frequently than I would, and yet were often left out of conversations like this one.
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