The impact of the "business" of pain medicine on patient care.

Objective: The objective of this article was to examine the impact on patient care of the growing economic forces in pain medicine.

Discussion: Chronic pain is a growing problem in the United States, as more people seek treatment than ever before. The practice of pain medicine is influenced by many market forces, including industry relationships with pain providers, lawmakers and insurance companies, direct-to-consumer advertising, insurance reimbursement patterns, and competition among health care systems and pain management providers.

Colorectal cancer screening: physician attitudes and practices.

Purpose: The American Cancer Society (ACS) set a nationwide goal to increase to 75% by 2015 the proportion of people aged 50 and older who have colorectal cancer (CRC) screening consistent with ACS guidelines. Little is known about current physician screening practices and attitudes. The purpose of this study was to document current physician attitudes and practices regarding CRC screening, and to formulate appropriate interventions to meet the ACS screening goal.

Epidural opiates and local anesthetics for the management of cancer pain.

The role of epidural morphine in chronic cancer pain treatment is unresolved. In a population of 1205 cancer patients, the aggressive use of systemic opiates limited the trial of epidural analgesia to 16 cases. Successful analgesia was achieved with epidural morphine alone in 6 of these 16 cases following systemic opiate failure.