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BackPage Online, May 2019

doi: 10.1097/01.BACK.0000558078.26399.2f
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Physicians Learning How to Trade Stories With Their Patients. “Narrative Healthcare” Picks Up Steam

Listening to patients—as well as telling them personal stories—builds trust and improves medical care, according to an innovative program at the University of Minnesota. A Minnesota Star Tribune article described an innovative educational program for young physicians. EmmaLee Palai teaches ‘narrative health;’ an approach in which providers become better listeners through the mutual sharing of personal stories, according to an article by Gail Rosenblum. “The thinking is that when providers reveal their own vulnerabilities, be it around mental health struggles, weight issues or just their own uncertainty about treatments, doctor-patient walls as immutable as marble tumble down and patient outcomes improve. This is likely why the approach is gaining national momentum.” It is an intriguing approach for the management of low back pain since healthcare providers have to deal with the same symptoms as their patients. Here is a link to the article:

http://www.startribune.com/future-minnesota-doctors-learning-to-put-down-charts-share-personal-stories-instead/504874242

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Short-Sighted Approaches to Opioid Prescription May Exacerbate the Overdose Crisis

The past few years have seen a reduction in the prescription of opioids. However, some researchers believe that medicine is pushing too many opioid users into increasing use of heroin, fentanyl, and other potentially lethal street drugs. Any viable solution to the opioid crisis has to address multiple epidemics, according to an article in the New York Times by economist Austin Frakt. No single medical or social policy to date appears able to address all the important aspects of this crisis. So all interventions to reduce the use of potentially lethal opioids need to be implemented gradually and studied carefully. Here is a link to the article at the New York Times:

https://www.nytimes.com/2019/03/04/upshot/opioid-overdose-crisis-deaths.html

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The Importance of Being a Medical Conservative

The spine field is notorious for following fad after fad after fad. Most treatments enter the field with a blast of unrealistic publicity, grab market share, and then slowly lose their attraction over several years as providers move on to the “next great thing.” Scientific studies slowly chip away at the claims of treatment success. In the long run, most treatments for low back pain—and this includes many of the popular treatments in the field—end up being marginally effective or worse. And some are downright risky. That is why spine care providers should generally be “medical conservatives.” They shouldn't adopt new interventions and techniques until these go through the fire of repeated, rigorous, scientific testing. Here is an essay on the importance of being a medical conservative from four US physicians:

https://www.amjmed.com/article/S0002-9343(19)30167-6/fulltext

and an essay on that topic from the Lown Institute:

https://lowninstitute.org/news/blog/why-you-should-be-a-medical-conservative/

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