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.

  • Document that you care and that you are trying, and the challenges in treating pain in this individual and the rationale for your decision.

  • In my experience, much chronic pain is opioid-resistant (pain 10/10 even with opioids) and this fact alone makes me wary to prescribe for the majority of my patients with chronic pain.  Worth a try, but if they won’t keep a journal and if pain doesn’t drop with dose escalation, likely this will not be effective.  Use an opioid use agreement.

  • Much chronic pain will never resolve—goal to learn to live with it. Monitor living, not pain.

  • Justify your choices to use or avoid opioids: “I swore an oath not to do harm. I know from my experience and from guidelines that opioids are likely to do you more harm than good. Your pain is real and I am not giving up, but I care about you too much to prescribe something that will hurt you.”

  • Every RX you write is your license—stand up to pressure from patients, families, ombudsman, licensing, administrators. You are not a pusher!  Assure in your heart you are doing what is right and could stand up to justify it (with well-written notes following guidelines) if pressed.

We hope you will join us for this half-day conference, which offers CME and CE credits to conference participants, please see accreditation page for details. Registration Rates: CALTCM Member $75 / Non-Member $100.  Hope to see you in Sacramento!

“Propel” into the Future: Updates for the Busy Professional

Saturday, October 28, 2017

8:00am – 1:00 pm


Accreditation Statement

Event Webpage


Date & Location:

UC Davis, Betty Irene Moore Hall

2570 48th Street, Sacramento, CA 95817

Room BIMH 1800