Pain Management

Why patient-centered care transforms chronic pain management

Physician

March 20, 2026

The real magic in chronic pain care isn’t just the pills or the procedures, but it’s the connection between doctor and patient. When a physician shows genuine empathy and truly listens, patients feel seen, trust deepens, and outcomes improve in ways that often outshine standard treatments. Take this striking study: Among more than 1,400 people with chronic low back pain, those cared for by highly empathic doctors ended up with …

Politics and fear have replaced science in U.S. pain management [PODCAST]

The Podcast by KevinMD

Podcast

March 18, 2026

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Patient advocate Richard A. Lawhern discusses the article “U.S. opioid policy history: How politics replaced science in pain care.” Richard argues that for decades, public policy on pain treatment has been driven …

How punitive board tactics are harming pain management physicians

Kayvan Haddadan, MD

Physician

March 18, 2026

A systematic review was conducted following PRISMA 2020 guidelines. Databases (PubMed, Embase, Scopus, Westlaw, LexisNexis) and gray literature were searched from January 2010 to November 2025 using terms related to medical board discipline, pain management, and overreach. Eligibility included studies, legal cases, and reports on disciplinary actions, due process violations, or consequences for physicians/patients.

Findings of 1,847 records, 42 were included (28 journal articles, eight legal cases, six reports). Key abusive …

Chronic pain management: Balancing relief and regulation

Kayvan Haddadan, MD

Physician

March 17, 2026

As a pain physician with over 20 years of experience treating patients with chronic pain, I hear the same plea almost every day: “Doctor, it hurts, please help.”

As an author and patient advocate, I wanted to verbalize the daily reality of chronic pain.

Chronic pain affects an estimated 24.3 percent of U.S. adults (approximately 60 million people) as of 2023, with 8.5 percent (about 21 million) experiencing high-impact chronic pain that …

Why false accusations against doctors destroy careers

Olumuyiwa Bamgbade, MD

Physician

March 15, 2026

A false accusation or unfair allegation can destroy a doctor long before any court delivers a verdict. That is the part the public rarely sees. A charge alone can shatter a medical career. It can trigger suspension, isolation, gossip, media exposure, loss of referrals, financial collapse, and permanent reputational injury. In many cases, the accusation becomes the punishment. The acquittal verdict arrives later. By then, the damage is already carved …

AI in pain assessment: Balancing innovation with patient safety

Kayvan Haddadan, MD

Physician

March 5, 2026

In Northern California and beyond, health care systems are rapidly integrating artificial intelligence (AI) and digital tools to transform how pain is recognized, measured, and managed. From algorithm-guided assessments to wearable sensors and predictive analytics, these tools promise to augment clinical decision-making and improve patient outcomes. Yet significant controversies remain, including concerns over algorithmic accuracy, bias, data privacy, and the extent to which technology should complement or potentially displace human …

Why buprenorphine prescribing still lags after the X-waiver repeal

S. Hillary Kim-Vences, MD, MPH

Conditions

March 2, 2026

The repeal of the “X-waiver” in the Consolidated Appropriations Act of 2023 was widely celebrated as a long-overdue step toward expanding access to buprenorphine for opioid use disorder (OUD). By removing the requirement for supplemental training and a special DEA designation, policymakers hoped to normalize treatment and reduce barriers for clinicians.

Yet nearly two years after, buprenorphine prescribing remains inconsistent across the country. Only one in four Americans …

Why doctors struggle with health care system delays

Kayvan Haddadan, MD

Physician

February 27, 2026

As a pain physician, I spend my career advocating for patients who struggle to access appropriate pain management. I write often on hurdles like restrictive opioid policy, excessive regulatory scrutiny, prior authorization, and administrative burdens that detract from patient care. Yet nothing prepared me for the visceral reality of being the patient on the other side of the system.

From physician advocate to patient in the system

My recent experience, unrelated to …

Understanding Moore’s Law and the exponential growth of technology

Richard A. Lawhern, PhD

Conditions

February 25, 2026

When I was a teenager, practical computers did not yet exist. In 1966, my first exposure to a computer in engineering school was a room-sized mainframe whose fast memory consisted of a foot-tall rotating magnetic disc that could store 8,000 “bytes” (each byte containing eight “bits,” which allow for 256 possible values representing alphabetic letters or numbers).

At the time, we could forget about storing the full text of the King …

The hidden cost of medical board regulation and prosecutorial overreach

Kayvan Haddadan, MD

Physician

February 22, 2026

Close your eyes and imagine a health care system that truly prioritizes patients above all else, one that is free from political interference, financial incentives, or secondary gains that distort decision-making. In this ideal framework, regulatory bodies such as the Medical Board, Centers for Disease Control and Prevention (CDC), and Drug Enforcement Administration (DEA) would enforce guidelines uniformly and based on evidence, without inadvertently inflating costs or compromising care quality …

Peptides for chronic pain: Navigating safety and regulations

Stephanie Phillips, DO

Meds

February 21, 2026

I have so many patients struggling with horrible arthritis pain! All the treatments we have either really don’t work well or have side effects, and many times cause more harm than good. I found myself having a risk-benefit discussion with every single patient with chronic pain, and at times, feeling like I was doing more harm than good when trying to help treat the pain.

Patients are taking NSAIDs, and I …

Medical bankruptcy: the hidden cost of U.S. health care

Richard A. Lawhern, PhD

Conditions

February 11, 2026

My wife underwent major surgery in December 2025. She remained 10 days in a Charlotte, NC, hospital and was then for several weeks supported at home by visiting nurses, a physical therapist, and a dietician. We just saw the bill: The hospital and participating doctors submitted bills of $120,000 to Medicare and to Tricare (family health insurance for military service veterans like me).

The 21 years that I served as a …

My wife’s story: How DEA and CDC guidelines destroyed our golden years

Monty Goddard & Richard A. Lawhern, PhD

Conditions

February 4, 2026

As health care writers and patient advocates, the authors are engaged in multiple projects intended to encourage major policy changes by highly resistant U.S. and state public health agencies. Misdirected policies and disinformation from these agencies are literally killing patients every day by denying them safe and effective management of agonizing pain, destroying the field of pain medicine, and criminalizing its practitioners.

This is institutionalized madness. It needs to stop. Now, …

U.S. opioid policy history: How politics replaced science in pain care

Richard A. Lawhern, PhD & Stephen E. Nadeau, MD

Meds

January 31, 2026

Based on our combined experience of over 70 years in patient advocacy, pain management, and behavioral neurology, we are convinced that U.S. public perception and public policy on treatment of pain have been driven almost entirely by sociopolitical and legal factors. Seldom in recent years has policy been significantly influenced by science.

The U.S. enjoyed a brief period of scientifically enlightened policy in the late 1990s through 2008. A large number …

The blind men and the elephant: a parable for modern pain management

Richard A. Lawhern, PhD

Conditions

December 22, 2025

Most of us have heard the ancient Indian and Buddhist parable “the blind men and the elephant.” Regardless of source, the parable usually contains these elements:

A ruler assembles several blind men and brings an elephant before them. One feels the head and says the elephant is like a pot; another the ear and says it is like a fan; another the leg and says it is like a pillar; another …

What is shared truth and why does it matter?

Kayvan Haddadan, MD

Physician

December 10, 2025

In our diverse world, where everyone sees things through their own lens, shaped by life experiences, beliefs, and facts, chasing after one absolute “truth” often sparks arguments instead of solutions. But what if we aimed for something better: a “shared truth”? This is about coming together, respecting each other’s opinions, and teaming up to find common ground that works for everyone. It’s like turning a debate into a friendly conversation, …

California’s opioid policy hypocrisy

Kayvan Haddadan, MD

Conditions

December 4, 2025

California’s opioid policies reveal a stark hypocrisy, imposing draconian restrictions on prescriptions for chronic pain patients (leaving wildfire survivors and others in unrelenting agony) while allocating over $100 million annually through initiatives like the California Harm Reduction Initiative (CHRI) and Proposition 36 to provide free needles, pipes, and fentanyl test strips to addicts with minimal oversight. This disparity is compounded by the Medical Board of California’s (MBC) overreach, where physicians …

Read more…

California’s opioid policy hypocrisy

Modified DSM-5 opioid use disorder criteria for pain patients

Richard A. Lawhern, PhD

Conditions

December 1, 2025

Two years ago, I asked, “Doctors diagnosing addiction: Are the blind leading the blind?”

The estimated rates of substance use disorder among clinical patients treated for pain vary greatly, depending on whom one believes. Studies also suffer from a widespread failure to address genetically mediated variability in minimum effective opioid dose between individuals. Thus, I have many times respectfully suggested that the entire body of literature on opioid …

Rethinking opioid prescribing policies

Kayvan Haddadan, MD

Physician

December 1, 2025

As a pain management specialist, my intent is not to promote unchecked opioid prescribing or overlook the serious risks these medications pose. Instead, I advocate for viewing the full picture in patient care. Physicians, trained in medicine and its side effects, must be empowered to use their knowledge and direct observations, including subtle cues like body language and patient interactions during brief visits, to make tailored decisions. Documentation in charts …

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Rethinking opioid prescribing policies

Physician legal rights: What to do when agents knock

Muhamad Aly Rifai, MD

Physician

November 19, 2025

An excerpt from Doctor Not Guilty.

The Fifth Amendment of the United States Constitution exists for a reason. It protects you from self-incrimination. If you remember one rule from this book, hold on to this: Never talk to the police.

By “police,” I mean every investigative agent: FBI, DEA, OIG, HHS, state boards of medicine, and investigators from the attorney general’s office. Not with a lawyer. Not without one. Not ever.

Silence …

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