Pain Management: First, Do No Harm


We are so excited about our upcoming event that we are giving you a sneak peek of the first talk of the day by Rebecca Ferrini, MD, CMD entitled “Pain Management: First, Do No Harm”.  Dr. Ferrini has prepared a comprehensive handout to complement her presentation and with her permission, we are sharing it with our readers.  Some of Dr. Ferrini’s pearls of wisdom are provided below, and the complete handout is available for download.

Dr. Ferrini’s Pearls:

  • You must do something, but you will likely NEVER alleviate all pain.  The best treatment: “I believe you”—compassion and empathy, be present and trying, hope/optimism and explanations –far exceeds the prescription.  Get the conversation off asking for opioids and back to treating pain.

Wi-Fi calling in your Facility?

by Tim Gieseke MD, CMD

I have been the Medical Director of a large CCRC since 1986, which was before we had cell phones.  Over the years, this technology has dramatically improved, but at this particular facility, I barely receive text messages and still can’t receive cell phone calls.  The big issue is the 1000-foot elevation Annadel State Park immediately next door, which blocks much of the signal of my carrier.  There is another carrier with a better signal, but even that signal is weak.  Some years ago, I tried a signal amplifier unit, but that proved ineffectual.

My new associate, Dr. David Greene, has the other carrier, but found it inadequate and did activate a better option.  Newer phones available over the past 3+ years have an option to make and receive calls by tying into the facility w-ifi system.  I went to my carrier and they set up this wifi option without charge.  I am pleased to report that I now call and receive calls with an excellent landline-like clarity.

CALTCM Support AMDA Futures Program

by Tim Gieseke MD, CMD

For many years, the AMDA Foundation has sponsored the Futures program designed to expose geriatric fellows, residents (FP, IM), and advanced practice nurses to a career in Postacute and Long Term Care in a focused program at our annual meeting.  Next year, the 2018 AMDA meeting is in Grapevine, Texas from March 21-25.  The time is now to apply for a scholarship to this strategic meeting.  

Dr. David Greene MD, CMD and I are so supportive of this meeting that we have arranged through our main employer, sponsorship for 2 geriatric fellows from California to receive this award.  Hopefully, there will be other sponsors within California.

David and I have been attending the AMDA annual meeting for over 20 years.  It has been an extremely valuable asset to the career we are so passionate about.

Now is the time to apply for this superb career development opportunity.   For more information visit:  

Donations can be made directly through CALTCM and designated for California AMDA Futures Program Fellows, click here to donate.

2017 INTERACT Null Findings

by Albert Lam, MD

A new study from the Interventions to Reduce Acute Care Transfers (INTERACT) team at Florida Atlantic University appears to cast doubt on the ability of INTERACT to reduce readmission rates.  The study, published in the Journal of the American Medical Association Internal Medicine, showed no significant reduction in overall hospital admissions (per 1000 resident-days) in the intervention group that received INTERACT training and no difference in 30-day readmissions or ED visits compared to facilities that did not receive INTERACT training.

These findings are striking, and bring into question the effectiveness of INTERACT in reducing nursing facility to hospital readmissions.  Yet, despite all of this, our own experience is that INTERACT makes an incredible difference in nursing facilities.

So what does this really mean?

Planning for Success

by Tim Gieseke MD, CMD

As a person on the front line assisting facilities caring for patients of increasing medical complexity and disability, I’ve often seen facilities react to patient care problems that develop rather than developing care processes proactively that may prevent or minimize them. It’s challenging to take the latter approach given our limited resources, staff turnover, and high volume of care with shorter lengths of stay of our post-acute patients.

<< first < Prev 1 2 3 4 5 6 7 8 9 10 Next > last >>

Page 1 of 61