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BackPage Online, February 2020

doi: 10.1097/01.BACK.0000653864.12973.bb
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Is Pain Just an Opinion—a Subjective Response to a Perceived Threat?

A recent article in the New York Times by Austin Frakt, PhD, addressed a key topic in pain medicine. Does pain represent a discrete, fixable abnormality? This is a key question in spinal medicine—where most forms of low back pain have no obvious cause. Frakt correctly points out that most pain is “in the brain.” He cited famed neuroscientist V.S. Ramachandran, PhD, who offered the famous quote that “Pain is an Opinion,” a response to a variety of stimulating and modulating influences. And he discusses various influences which may relieve pain—without ever addressing the tissue sources of pain.

Here is a link to the NYT version of the article:

https://www.nytimes.com/2019/12/02/upshot/pain-and-the-mind.html

and a link to the version at the Incidental Economist:

https://www.nytimes.com/2019/12/02/upshot/pain-and-the-mind.html

The Electronic Health Record: Is It More Reliable Than a Microwave Oven?

Developing the electronic record has been a major priority in the US medical system over the past two decades. It was supposed to allow seamless access to important patient information across medical systems. However, many doctors now regard the EHR as a time-consuming boondoggle that hasn't simplified anything. A recent study in Mayo Clinic Proceedings looked at the usability of the EHR with a cross-sectional study of physicians from all disciplines. They graded the usability of the EHR compared with other digital and electronic tools. It received a grade of 45 out of 100—which translated to an “F” according to the study results. By way of comparison, a cheap microwave oven received a score of 87, which translated to a “B” grade. And the authors found a strong association between the EHR and physician burnout.

Here is a link to an article on EHR at the Lown Institute website:

https://lowninstitute.org/news/ehrs-get-a-failing-grade-for-usability/

And here is a link to the study in Mayo Clinic Proceedings:

https://www.mayoclinicproceedings.org/article/S0025-6196(19)30836-5/pdf

Spending Less Would Improve Back Care—and Much of Medical Care

The past quarter century has seen a huge explosion in the costs of back care in the United States—and a steady increase in overall medical spending. In back care, it is apparent that the US medical system is wasting much of its $85 plus billion-dollar investment in spine care—and should do less and spend less. Here is a fascinating essay at the Health Affairs blog on reducing spending on health care by Bruce Pyenson and Marjorie Schulman—and how it might improve overall health and increase prosperity.

Here is a link to the article entitled “There's Nothing Wrong with US Health Care That Less Money Couldn't Fix”:

https://www.healthaffairs.org/do/10.1377/hblog20191205.766250/full/

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