Archive for the ‘pain management’ Category

Walgreens and their Secret Checklist

Recently, we opened up our doors and invited the local pharmacists to come and visit our practice. We had three pharmacies take us up on our offer and stopped by. I would like to thank Cortez Drugs, Seven Hills Pharmacy, and Pinebrook Pharmacy for taking the time out of their day and coming to visit our office. We did this mostly because of patients that have complained that Walgreens had refused to fill their prescription(s) and inferred that it had something to do with Dr. Gorrell.

We came across and interesting article that reveals the selective process Walgreens has been using to choose whom they will fill and whom they will not fill for.

http://www.wthr.com/story/23469086/2013/09/18/walgreens-secret-checklist-reveals-controversial-new-policy-on-pain-pills

We want to encourage patients that have been denied their medications by Walgreens to file a complaint.

https://www.research.net/s/WalgreensGFDPolicy

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Pharmacy Relationships

Dr. Gorrell is taking an innovative approach to the difficult and complex dynamic between pain management clinics/physicians and pharmacies/pharmacists. He has issued the invitation to pharmacies and their staff to come and visit his clinic open door style.

Dr. Gorrell is board certified in both anesthesia as well as pain management and exempt from the state requirement to register and be inspected, however he chooses to for quality assurance standards. He is now taking it one step further and opening his doors to local pharmacies. He will have an open door for pharmacists and their staff all day to tour the office and review his documents.

Since his move to Spring Hill in 2012, he has been working to develop rapport with local pharmacies because it is difficult for patients to find pain medication due to the pain medication shortage as well as the evolving rules and regulations that individual pharmacies have imposed. Dr. Gorrell will make available his forms and documents, his quality assurance manual, prior inspection reports, his curriculum vitae, criminal background report as well as a redacted patient record.

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JULY 1st Education Requirement For Pain Physicians

Springhill, FL June 14, 2012- Kelvin W Gorrell MD successfully passed his board certification in Pain Management with The American Board of Pain Medicine.  Dr. Gorrell already holds board certification in anesthesiology and completed his ten year renewal in July of 2011 with The American Board of Anesthesiology.  In addition to his board certifications, Dr. Gorrell has recently trained  to begin offering patients Suboxone therapy to patients with opiate addiction.  After July 1st , 2012  rule 64B8-9.0131 goes into effect for pain clinics in Florida.  Many pain clinics cannot meet this standard of education requirements for their physicians and will close.  Make sure that your physician is qualified and will continue to practice past July 1st.

 

64B8-9.0131 Training Requirements for Physicians Practicing in Pain Management Clinics.

Effective July 1, 2012, physicians who have not met the qualifications set forth in subsections (1) through (6), below, shall have successfully completed a pain medicine fellowship that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) or a pain medicine residency that is accredited by ACGME. Prior to July 1, 2012, physicians prescribing or dispensing controlled substance medications in pain-management clinics registered pursuant to Section 458.3265, F.S., must meet one of the following qualifications:

(1) Board certification by a specialty board recognized by the American Board of Medical Specialties (ABMS) and holds a sub-specialty certification in pain medicine;

(2) Board certification in pain medicine by the American Board of Pain Medicine (ABPM);

(3) Successful completion of a pain medicine fellowship that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) or a pain medicine residency that is accredited by the ACGME;

(4)(a) Successful completion of a residency program in physical medicine and rehabilitation, anesthesiology, neurology, neurosurgery, family practice, internal medicine, orthopedics or psychiatry approved by the ACGME; or

(b) Sub-specialty certification in hospice and palliative medicine or geriatric medicine recognized by ABMS;

(5) Current staff privileges at a Florida-licensed hospital to practice pain medicine or perform pain medicine procedures;

(6) Three (3) years of documented full-time practice, which is defined as an average of 20 hours per week each year, in pain-management and, attendance and successful completion of 40 hours of in-person, live-participatory AMA Category I CME courses in pain management that address all the following subject areas:

(a) The goals of treating both short term and ongoing pain treatment;

(b) Controlled substance prescribing rules, including controlled substances agreements;

(c) Drug screening or testing, including usefulness and limitations;

(d) The use of controlled substances in treating short-term and ongoing pain syndromes, including usefulness and limitations;

(e) Evidenced-based non-controlled pharmacological pain treatments;

(f) Evidenced-based non-pharmacological pain treatments;

(g) A complete pain medicine history and a physical examination;

(h) Appropriate progress note keeping;

(i) Co-morbidities with pain disorders, including psychiatric and addictive disorders;

(j) Drug abuse and diversion, and prevention of same;

(k) Risk management; and

(l) Medical ethics.

In addition to the CME set forth in subsection (6) above, physicians must be able to document hospital privileges at a Florida-licensed hospital; practice under the direct supervision of a physician who is qualified in subsections (1) through (4) above; or have the practice reviewed by a Florida-licensed risk manager and document compliance with all recommendations of the risk management review.

(7) Upon completion of the 40 hours of CME set forth above, physicians qualifying under (6) above, must also document the completion of 15 hours of live lecture format, Category I CME in pain management for every year the physician is practicing pain management.

Rulemaking Authority 458.3265(4)(b) FS. Law Implemented 458.3265(4)(b) FS. History–New 5-17-11, Amended 5-28-12.

Dr. Gorrell has successfully met several of the qualifications and will continue to serve the Hernando County community by practicing interventional pain and wellness medicine using nutraceuticas and bio-equivalent hormone therapy at this office located at 5119 Commercial Way Spring Hill, FL  34606.  For more information, you can reach his office at 352-224-3139 or visit his website www.doctorgorrell.com ###

 

 

 

CVS Blacklists High Prescribing Pain Management Doctors

Unlike other Pain management clinics that are known to be “pill mills”, our office has not experienced difficulties from pharmacies  filling our patient’s medications. Recently there was an article that I came across in Tampa Bay Business Journal that touched the tip of the iceburg of challenges facing pain management physicians and their patients.  Click

Many Florida Pharmacists Deny Pain Patients Properly Prescribed Meds

 to see the original article.

The article states that the Florida Society of Pain Management Providers (www.Flspmp.org) are aware and concerned about this growing issue. While I am not denying that pharmacists have a tough job and need to be vigilent, I agree with the article when it stated that some pharmacists are acting as vigilantes. I have had  heard of pharmacies  refusing to fill prescriptions that  were verified by phone.  I have had patients LIED TO and told that they couldn’t accept  valid prescriptions  or they were told they were out of the medication. I have been asked to supply patients MRI reports without any type of written release. In response to these requests I have asked them to send me a valid written request for the information on a HIPAA compliant release form which I am happy to supply since a pharmacist is not supposed to maintain a medical record on a patient! My concern is that these reports  May fall into the wrong hands. Not a single pharmacy has complied with MY request for a release. I get asked daily for  the diagnosis on patients. I have asked what for and have been told they will then determine if they feel that the patient needs the medication based off that information. I challenged them and asked them, isn’t this the job of the physician? Some patients have numerous diagnosis’ so is my office staff is supposed to randomly pick? or should they disturb me from the exam room where I am seeing another patient to ask me? If we state “osteoarthritis” are they supposed to just know the severity without any physical exam, prior medical record, history, or diagnostic tests that I utilize to determine if they “feel” the patient needs the medication? When I asked one pharmacist this and challenged him that some patients can be treated for this with exercise and tylenol while other patients are suffering with disabling pain due to the same illness he simply stated, “that’s a good point. Is that what this patient’s diagnosis is?” So you can see,  It is impossible for them to function beyond the scope of  their practice  as a pharmacist and now act as the physician overseer as well. I find it positively frightening to think that the power of the physician as a diagnostician and healer is being challenged at all levels. When I need treatment, I go to the doctor; not the pharmacist for a reason!

Patients are denied their valid prescription medication from these pharmacies that will sell the same patient alcohol or tobacco on their way out the door! Both Walgreens and CVS have made public positions against pain medication prescribers, especially medications like Oxycodone. I would like all patients that have been denied their medication or been harassed by a pharmacist to visit www.flpainnews.com on how to sign the petition and report your grievance and file a DOH (Department of Health) complaint.

In my practice, I have implemented all the new rules and regulations and it is a struggle as the rules and regulations are changing so quickly and in a perfect world, I would love to only have to keep up with the challenge of medicine as treatments and medications change just as quickly. I will do my part to practice in the specialty I chose. I think law enforcement and lawyers should be the only ones practicing law and I believe the only people that should prescribe/monitor/change medications are physicians.

Florida PDMP Prescription Drug Monitoring

October marks and important time for implementation of the Prescription Drug Monitoring system for providers.  We have been approved for access which will help speed up the verification process for patients.

The Goals of the Prescription Drug Monitoring  Program (PDMP)

  1. Support access to legitimate medical use of controlled substances
  2. Help identify and deter or prevent drug abuse and diversion
  3. Facilitate and encourage the identification, intervention with and treatment of persons addicted to prescription drugs by health care practitioners
  4. Help inform public health and safety initiatives through the outlining of use and abuse trends of controlled prescription drugs
  5. Help educate individuals about PDMPs and the use, abuse and diversion of and addiction to controlled prescription drugs

you can find more info at:  http://drugcontrol.flgov.com/pdmp/about.html

Pain management is a unique and misunderstood specialty.  We struggle to make sure that our patients are educated to the process so that they do not get the wrong impression when they go thru the intake process.  Due to regulatory processes and Dr. Gorrell’s demand for high standards of care, we are required to do a thorough examination of ALL new patient documentation and collection of information includes sending out HIPPA compliant release of information (ROI) request to all sources of information unless we receive the information faxed direct from the source to us.  Examples include the most recent MRI or CT report from the radiology company & the most recent 2 months of medical records from the prior pain management Dr. This process can sometimes be time consuming because we are at the mercy of the other entity to get this information back to us in a timely manner.  It helps save time when patients come in a day or so prior to their appointment to sign any releases we may need.  When a patient comes for their initial appointment, our intake process involves a thorough history and physical.  Our staff and Dr. Gorrell want to make sure that you get the care and attention that you deserve, so access to the drug monitoring database and being provided documentation direct from the source will allow us more efficient use of your time as well as ours.

Dr Gorrell Renews His 10 Year Anesthesia Board Certification

Dr. Gorrell renewed his Anesthesia Board Certification in July of 2011 with The American Board of Anesthesiology (www.theaba.org).  MOCA, or Maintenance of Certification, originated with the American Board of Medical Specialties in 1999.  The ongoing Lifelong Learning and Self-Assessment, continual assessment of Professional Standing (medical licensure), periodic assessments of Practice Performance and decennial assessment of Cognitive Expertise allow physicians the opportunity to improve their skills in six general competencies – Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Interpersonal and Communication Skills; and Systems-Based Practice.  By implementing these activities, Dr. Gorrell has demonstrated his commitment to quality clinical outcomes and patient safety.

Dr. Gorrell offers anesthesia services (as locum tenens), pain management (including interventional pain management), and wellness/functional medicine.

Dr Gorrell to be speaker for AAPC St Petersburg Chapter October 18, 2011

Dr. Gorrell will present his talk, Biggest Mistakes In Pain Management for AAPC (American Academy of Professional Coders) on October 18th at 6:00 pm at All Children’s Education and Conference Center located at 701 4th Street South St. Petersburg, FL  33701 (between 7th Ave S and 8th Ave S and parking is in the back of the building.  You can visit www.allkids.org or a map.  Please RSVP to Dolores Morris at dmorris@fountainheadonline.net or call 727-456-3291 and leave a message.  There will be 1.5 AAPC CEU’s offered for this talk.  AAPC is a wonderful organization for billers, coders, practice managers and physicians www.aapc.com.  There is no fee for meeting, can attend as a guest if not a member of AAPC.

All pain MD’s & concerned citizens must attend the 9 AM Public Hearing to Consider Ordinance Regulating Pain Management Clinics by Hernando COUNTY ATTORNEY GARTH COLLER

9:00 AM, Board of County Commissioners, 20 N. Main St., Room 400,
Brooksville, FL 34601, Regular Meeting, ~ Agenda~, Tuesday, June 14, 2011,
Hernando County

There is no discrimination between good pain management or bad pain management physicians. It says specifically that all existing pain clinics will be targeted by this law and all clinics must pay a $3000 application fee. It includes a complete moratorium on any and all new management clinics and no existing pain management clinics can expand. It says that within 90 days of applying, all existing pain management clinics will be notified if they are approved to remain! There are no criteria that are described to explain how they will decide whether you are still a “good fit” for the neighborhood and location you currently occupy. As you know, with the new state law, if one’s location was not approved you would then be put out of business and be at square one trying to apply for a new state license and simultaneously waiting for Hernando County to approve your new county license. This is additional unnecessary bureaucracy and all pain management physicians must be concerned that any of us despite all our efforts to be compliant, could be arbitrarily determined by Hernando County to not fit in according to the new pain management clinic zoning ordinance. Two weeks ago, the governor just past under an additional 98 pages of legislation to control and regulate our specialty. There is no need for an additional 18 page County ordinance and we should all be united in preventing it!

The Gorrell Institute Exhibits at First Unity Church of St Pete Goddess Spa Day Saturday, May 7 from 9:30 am to 2 pm

Stardate 5/6/11. As we attend the Chick Fil A Leadercast at PHCC in Spring Hill, FL, we are planning to see you Sat 5/6/11 at the First Unity Church in St Petersburg’s Goddess Spa Day from 10AM to 2PM.  Doctor Gorrell will personally be there to answer any and all of your health questions. He is a diplomate of the American Academy of Anti-Aging Medicine and an Anesthesiologist. If you have any questions about pain management, health, wellness, beauty, or how to roll-back the aging process by 10 years, then come to see Dr Gorrell.  If you have chronic diseases or chronic pain that has stumped your doctors thus far, come see us. Dr Gorrell will help you to get to the root cause of  you and your family’s diseases with proper diagnosis and advanced Nutraceutical therapies so you can be happy, healthy and well again!  What is your health and life worth? Is it priceless? Then invest time in learning how to be healthy.

Event location: First Unity of St Petersburg at Unity Campus | Phone – (727) 527-2222 | Fax – (727) 526-1277 | Address – 460 46th Ave North, St Petersburg, FL 33703.  Click link to their site for more information: Goddess Spa Day Saturday, May 7 from 9:30 am  to 2 pm.

Call now 352-224-3139 to leave a message. We will be back in the office on Monday by 10 AM & we will return your call then.

Scheduling 352-224-3139

1648 S Ohio St #217,
Salina, KS 67401

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