Isr Med Assoc J
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Dear unique individual: Really very sorry to hear that you are living with shoulder pain. I'm writing this open letter to you to support decisions you will need to make about how best to manage your symptoms. Shoulder pain never comes at the right time, it always interferes with important work, sports, or social events, and like any pain, we want it gone the moment it starts. ⋯ Remember, it is you, not the health professional, who is the most important person in healthcare. No decision should be made without you being fully and truthfully informed of the anticipated benefits, timeframes, and commitments you will need to address and the possible harm of any intervention. I hope you find this letter helpful.
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Low back pain has been the leading cause for disability worldwide for several decades, and clinical guidelines for its management clearly emphasize a multifactorial approach. Yet, current guidelines are still not well implemented by clinicians. ⋯ Family medicine residents seem to be highly psychologically oriented regarding low back pain; however, they do not necessarily treat their patients accordingly. Their clinical choices seem to follow two different approaches: guideline-consistent and non-guideline-consistent. An ETMI guideline-based workshop may sway their attitudes toward re-activation of patients. Further research is needed to determine whether similar results would arise in larger physician populations.
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Cannabis and cannabinoids have been known for thousands of years for their promising potential as analgesics. Chronic pain is a common complaint among many patients with rheumatic conditions. ⋯ In addition, in recent years, information has mounted about the immunomodulatory effects of cannabis. In this review we discuss findings on the benefits cannabis may have in rheumatic and autoimmune disorders.
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Overuse of healthcare services is a common phenomenon defined as: "a healthcare service that is provided under circumstances in which its potential for harm exceeds the possible benefit." It is expressed in the gap between desired services and available ones and is accompanied by high financial and human life costs. One-fifth to one-third of patients receives unnecessary, ineffective, or potentially harmful treatments or services. ⋯ Government intervention through economic arrangements such as deductibles and pre-authorization of services by the insurer are partially effective in reducing the overuse of health services. Additional solutions include ensuring safety and quality of care as well as shared decision-making.