Compass Opioid Stewardship Clinical Cases

In this episode, Dr. Stader calls Dr. Barnett to reflect on the philosophy of MI and how it has been transformative for his practice.

Additional Learning Resources:

Thomas Gordon's Roadblocks to Communication

Motivational Interviewing Workshops

In this episode, Dr. Stader utilizes the principles of MI when navigating an encounter with Sam, a patient who just had a routine UA test positive for fentanyl, an opioid he is not prescribed. Dr. Barnett and Dr. Stader debrief the details of this case following the encounter including the delicate position a physician occupies when establishing patient boundaries.

In this episode, Dr. Stader implements the breadth of MI tactics discussed thus far in an encounter with Peggy, a pre-diabetic patient with high cholesterol to discuss diet changes.

In this episode, Dr. Stader meets with Rebecca following a trip to the ER for a fall about the potential need to take fall risk reduction measures as she starts to age. Dr. Barnett and Dr. Stader discuss how scaling can be used to gauge where patients' readiness to implement change.

In this episode, Dr. Stader meet with Mark who would like to increase his opioid prescription for his back pain. Dr. Barnett and Dr. Stader discuss the importance of establishing physician-patient boundaries when discussing change behavior.

In this episode, Dr. Stader conducts a new patient encounter with George. Following the encounter, Dr. Barnett and Dr. Stader talk about the four key principles of motivational interviewing: empathy, discrepancy, rolling with resistance and supporting self-efficacy in patients.

In this episode, Dr. Stader meets with Cindy, a fibromyalgia patient on longterm opioid therapy, to discuss decreasing her percocet following a DUI. Following the encounter, Dr. Barnett and Dr. Stader discuss the importance of pushing back against the innate urge to tell a patient the solution to their problem as it can lead to resistance.

In this episode, Dr. Stader introduces the OARS technique in an encounter with Paul who visits clinic regarding his surgeon's wish for him to quit smoking pre-operatively. Following the encounter, Dr. Stader and Dr. Barnett dicuss how open questions, affirming patient sentiments, reflective statements and summarizing an encounter and assisting in moving a patient towards change behavior.

In this episode, Dr. Stader has an appointment with Tom, a chronic pain patient grappling with a new diagnosis of sleep apnea and the need to wear a CPAP machine. Following the encounter, Dr. Stader and Dr. Barnett discuss the stages of change patients traverse.

Dr. Don Stader calls mentor Dr. Peter Barnett to vent about some feelings of burnout he is experiencing with his patients not wanting to follow directions and Dr. Barnett helps him reframe his mentality and offers up motivational interviewing as a potential strategy to employ with his patients resisting change.