“No Offense, Doctor, But I Want a Referral for My Pain”
SOURCE: Medscape Education Community CME
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Charles P. Vega, MD
Case Presentation
You are seeing a 42-year-old woman whom you diagnosed with fibromyalgia 4 weeks ago. Her main complaint continues to be diffuse, dull body pain, but she also reports occasional numbness in both hands. She says that she has felt fatigue for the past several years, and she blames poor sleep for this. She denies depression but says that she gets tearful when she thinks about her chronic symptoms and how they have limited her from what she has wanted to accomplish.
The patient was treated initially with some education regarding fibromyalgia and its manifestations, followed by several supporting phone calls from your staff. She was given a prescription for an exercise program, which she tried twice but could not continue due to exacerbation of her symptoms. She was also given a prescription for amitriptyline 50 mg at bedtime, which she stopped after 2 days due to dry mouth and increased fatigue.
Two weeks ago, you prescribed duloxetine 20 mg daily. She comes to your clinic today to tell you that this medication has had no effect on her symptoms. She tells you that she likes you as a person, but she requests that she be referred to someone who can treat her illness more effectively.
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Dr. Painter,
Are these CE credits approved for chiropractic licensing boards?
Dr. Lloyd,
I can’t speak for your State Board, but I can hardly imagine WHY they wouldn’t accept credits from one of the foremost medical websites.
Thanks. You never know, right?
Actually, when I was going to Life West 10-15 years ago, I worked in the continuing education department, and I had access to a list of approved providers for California CE. Back then, every CE program had to have the topics listed by the hour in order to be approved by the state. I wonder if that has changed for online credits?
Todd
I tried to look up Utah’s regulations, but I couldn’t find that info on their website.