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Dr. Joe Tatta | The Healing Pain Podcast

Chronic pain is a debilitating condition that affects one’s ability to live a full and active life and impacts both physical and emotional health. Whether you are living with chronic pain or a physical therapist or other health professional such as an occupational therapist, psychologist, social worker, nurse, or physician seeking information for treating pain, we invite you to join our global community. Welcome to The Healing Pain Podcast with Dr. Joe Tatta, a podcast that promotes the latest evidence and methods for the safe and effective treatment of chronic pain. Featuring top experts, we bring you the latest research from the fields of pain science, physical therapy, physiotherapy, pain psychology, functional nutrition, integrative and functional medicine, as well as discuss innovation and provide expert opinion every week. More and more patients are seeking integrative and comprehensive pain therapies that care for both their body as well as their mind. A biopsychosocial approach to the care of pain has arrived. Many realize that pain medications and surgery alone are not enough to address the root cause of their problems - such as fibromyalgia, chronic low back pain, osteoarthritis, rheumatoid arthritis, autoimmune disease, CRPS, neuropathy, anxiety, depression, and PTSD. Dr. Joe Tatta is a global leader in integrative pain care and an advocate for the safe and effective treatment of chronic pain. He is the Founder of the Integrative Pain Science Institute, a cutting-edge health company reinventing pain care through evidence-based treatment, research, and professional development. For 25 years he has supported people living with pain and helped practitioners deliver more effective pain management. His research and career achievements include scalable practice models centered on lifestyle medicine, health behavior change, and digital therapeutics. He is a Doctor of Physical Therapy, a Board-Certified Nutrition Specialist, and Acceptance and Commitment Therapy trainer. Dr. Tatta is the author of two bestselling books Radical Relief and Heal Your Pain Now and host of The Healing Pain Podcast. Learn more by visiting www.integrativepainscienceinstitute.com. The Healing Pain Podcast is a great resource for patients suffering from chronic pain as well as for professionals seeking additional professional CEU credits and free continuing education on the most up-to-date information for treating pain based on a biopsychosocial model of pain care. The show covers a wide range of topics that will help you learn all about chronic pain management such us how clinicians can treat pain more effectively, learn how exercise and physical activity alleviates pain, the role nutrition plays in reversing and treating chronic pain, how to use mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy to treat many chronic conditions, and so much more! Chronic pain doesn’t have to be an obstacle in the highway of your life that makes you step on the brakes. Arm yourself with the knowledge on how you can better manage or even eliminate it so you can start living your best – and pain-free – life! Join The Healing Pain Podcast community today.
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Dr. Joe Tatta | The Healing Pain Podcast
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Now displaying: August, 2021
Aug 25, 2021

Thanks for joining us. My guest is Mathew Embry. Mathew has a great story of overcoming adversity and a chronic condition. Mathew was diagnosed with a debilitating form of progressive MS where he was offered no cure and few if any solutions. He and his father, who is a PhD trained researcher, set out on a quest to find answers. They dove into the peer-reviewed medical literature and discovered natural ways to halt and reverse the progression of multiple sclerosis.

His entire journey can be found in the Amazon documentary called Living Proof, where Mathew shares his story of halting the progression of MS. The documentary also explores the relationship between MS charities and the pharmaceutical industry, their lack of transparency with regard to medical funding, as well as their power, influence, and sometimes their ability to avoid opportunities to raise awareness around lifestyle-based treatments such as nutrition and exercise therapy for the treatment of MS. We discussed this story and how potential conflicts of interest affect those in need of chronic disease treatment. Without further ado, let's begin and meet Mathew Embry.

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Aug 18, 2021

In this episode, we are discussing the impact of the health insurance industry on the effective treatment of chronic pain. This is a topic I have been wanting to create some content around for some time. When I look back at the evolution of the show, the episodes typically fall into two buckets. I'm either talking about effective treatments, trying to build, spread awareness around conservative effective treatments for chronic pain or I'm talking about the latest, or some new research that I feel is innovative.

In those two buckets, I'm also always looking for where are the problems and the barriers for us as professionals and for people living with pain to access effective pain care. When I look at the problems, there's one big problem that is like a big flashing red light, the elephant in the room. That's the health insurance industry.

I asked myself, "How has this changed throughout my career?" As a physical therapist, I started practicing or treating patients in 1997. In 1997, I can't think of too many barriers for me treating a patient. When do I say that I'm talking about how much it costs a patient to access conservative pain care and then is that treatment covered? Those are the two big issues, "How much does it cost? Is it covered?" I can tell you back in 1997, I don't remember any patient having a deductible. If there was a copay or something moderate, it's maybe $5 or $10.

I'm not saying as citizens, professionals and people living with pain that we shouldn't be fiscally concerned about the delivery of healthcare because that's important, especially in the United States of America. However, I can tell you in 2021, the average American contributes to their health insurance. Meaning there's typically an employee portion each month as an employee that contributes to your monthly premium. There's also an annual deductible and then there are copays on top of all of that.

As people in the United States of America, this may be the most important for those of us who live in the United States but I know this impacts all of us around the world, we are paying a lot of money into our health insurance. We have to ask the question, "What are we getting back? What is the benefit that we are receiving?" The average deductible in New York City, the place where I live, is somewhere between $5,000 and $10,000 for a family plan. I have seen family plan deductibles upwards of $20,000. It's clear that premiums have increased.

The second thing for us to consider is copays. When I first started in 1997, copays were maybe $5 or $10. It's not uncommon now. I have seen copays that equal the cost of the PT visits. Copays that run anywhere between $40, $50, $60 and $70 upwards to $100 to receive physical therapy care. We are paying more.

However, at the same time, I have also seen visits decrease. In the United States of America, this varies depending on the diagnosis and where people live, the average length of stay for a PT session is about twelve visits. Consider you have to treat someone who has fibromyalgia and you only have two visits per week for six weeks for a total of twelve visits before the insurance company terminates care.

Effectively, what large insurance companies have done is have contracted or hired third-party medical management companies, which come in. It's what they call they manage health insurance claims, which I would like to call what it is the aggressively deny claims for conservative care. This includes things like physical therapy, occupational therapy, speech, mental health services, as well as addiction treatment.

Not only do they manage that care but oftentimes, insurance companies will not approve a patient seeing multiple providers. For example, insurance companies often regulate if a patient is seeing both a physical therapist and chiropractor or a PT and OT. Any combination of those, they don't like when patients are using their insurance to the fullest extent.

Let's carry that over into what is identified as the gold standard for the treatment of chronic pain, which is multidisciplinary or interdisciplinary care. That's when the patient can access multiple providers. In the United States of America, we have one interdisciplinary chronic pain clinic for every million people that focus on chronic pain management.

Why do we have that? Insurance companies have identified this as expensive care. It's too expensive to pay multiple providers, at the same time, they have severely cut back on those programs probably since the early '80s somewhere. That's when that trend started. That has come back somewhat but we haven't seen a revitalization of interdisciplinary chronic pain treatment programs in the United States of America specifically because insurance companies won't pay for the care.

Lastly, I don't want to just focus on private health insurance companies in the United States. We have things like Medicare and Medicaid, which are government-sponsored plans. Those two have been cut every year it seems. Some emails go out by organizations, such as the American Physical Therapy Association. It's called Stop The Cut. That's where the Medicare fee schedule is reduced.

Each year or every couple of years, the national government tries to reduce payments to outpatient physical therapy services. When payments are reduced, it often has an impact on the number of visits that we can see patients for and the quality of care that we can provide in an outpatient setting. The question is, "How does the health insurance industry perpetuate the chronic pain crisis?"

Joining me is Dr. Michael Schatman. He is a clinical psychologist who spent many years working in multidisciplinary chronic pain management. He is on the teaching faculty of the Department of Public Health and Community Medicine at the Tufts University School of Medicine in Massachusetts and serves as Director of Research and Network Development for Boston PainCare. He has authored more than 100 journal articles and book chapters on chronic pain management and lectures regularly at the international level. He is also the Editor-in-Chief of the Journal of Pain Research.

In this episode, we are going to talk about the health insurance industry and how it impacts the treatment of chronic pain. This is an important episode. Make sure you share this with your friends, families and colleagues all over social media so we can raise awareness on this topic. Let's begin and meet Dr. Michael Schatman.

 

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Aug 11, 2021

We're talking about analgesic medications and how they can have both a positive and a negative impact on how your muscles function. Analgesic medications are simply medicines that are used to alleviate pain. You may have seen them marketed as painkillers or pain relievers. Technically the term analgesic refers to any medication that provides pain relief without putting you to sleep or causing you to lose consciousness. There are many different types of medications that have pain, relieving properties. Some people tend to lump these all together, but they're different groups or types of medications.

 

Some common names you might have heard of are non-steroidal anti-inflammatory medications, such as NSAIDs. These include things like Aleve and Advil. Another group is narcotic opioids, like oxycodone and morphine, and then another common group or non-opioid analgesics typically falls into that category are things like acetaminophen or Tylenol. In many cases, the effect of treatment of chronic pain may include one or more of the analgesic medications I previously mentioned.

 

However, the use of analgesic medications can be potentially challenging for physical therapists because they're faced with a paradox. On the one hand, an analgesic medication may alleviate pain, which you may think makes it easier for people to move and function. Yet, on the other hand, these medications may negatively impact the physiology of your muscles, nervous system and other parts of your body. Here to talk to us about analgesic medication is Dr. Bahar Shahidi.

 

Bahar is a physical therapist and a researcher investigating how analgesics impact muscle physiology, pain as well as physical function. She is an assistant professor in the Department of Orthopedic Surgery at the University of California at San Diego. Her academic background includes a Bachelor's in Chemistry, a Doctorate Degree in Physical Therapy and a PhD in Neurophysiology. Her research focuses on muscle physiology changes in the presence of chronic spinal pain.

 

In this episode, we discuss how analgesic medications impact clinical outcomes in people with chronic low back pain, exercise responsiveness, how to time the use of analgesic medication relative to physical therapy treatment, and balance medication use and exercise for optimizing patient outcomes. Let's begin and meet Dr. Bahar Shahidi and learn about how analgesics impact muscle physiology.

 

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