Several members of the Department of Anesthesiology participated in the visit United States Surgeon General Jerome Adams, MD, MPH paid to VUMC on Friday, May 18, 2018. His visit consisted of a Health Policy Grand Rounds titled “Combatting America’s Opioid Crisis” as well as several meetings to discuss key programs at VUMC and the School of Medicine.
Jesse Ehrenfeld, MD, MPH, served as Special Advisor to the Surgeon General as well as the site lead for the visit. To prepare, Ehrenfeld said he worked with his team to arrange opportunities for Adams to learn about VUMC and “included our strategies around population health, advancing health equity, and responding to the nation’s opioid crisis. I also worked closely with the Department of Health Policy to coordinate his public talk on combatting the opioid crisis.”
David Edwards, MD, PhD, and Leslie Fowler, MEd, attended a meeting titled “Opioid Abuse Research, Public Policy, and Provider Education,” which discussed the ongoing efforts, projects, and initiatives VUMC is working on surrounding the opioid crisis in Middle Tennessee and the United States. Edwards said he shared some of VUMC’s strategies for treating perioperative pain and addictions and how patients are screened for risk of poor outcomes related to opioid addiction.
Fowler discussed a project called “Function First, Opioids Last” using the QuizTime application. This program delivers Continuing Medical Education credit to physicians for interacting with questions and content surrounding important clinical topics like opioid prescribing. One important outcome is that retention of the content may result in clinician’s behavior changes and better prescribing practices.
Fowler explained the project targeted opioid prescribing practices specifically Obstetric/Gynecologists and Hospitalists. “If we have enough interest and resources, it could be scaled to larger physician groups in Middle Tennessee. One result of our pilot showed an increase in the prescribing of non-opioids for our learner group from 17 percent pre intervention to 34 percent post intervention,” she said.
Ehrenfeld said working with a highly visible senior official is both an incredible privilege and learning experience. He said he received tremendous feedback on how positive the visit with Adams and his team went. “It was a terrific opportunity to showcase some of the extraordinary work happening on campus, and continue to develop partnerships with the federal government to advance the health of the nation.”
One of the things Fowler learned during the visit is that Adams is committed to battling the opioid crisis and has advised the public to be trained and have access to naloxone, an opioid overdose reversal drug. “Not only is he extremely knowledgeable about the facts and statistics concerning opioid abuse, misuse and addiction, he genuinely seems to care about the effects this epidemic has had on the people in the United States,” she elaborated.
The passion Adams has for turning off the tap of excess opioids while at the same time expanding treatment options was something Edwards said he learned about Adams during the visit. “He would like to enable primary care doctors to more easily treat addiction by expanding the number of providers getting their DEAx license. I feel that is a great idea,” he said.
Edwards said the Surgeon General’s visit was helpful. “It informed us of the vision and strategy that is occurring at the national level and this will help us locally align and support this strategy,” Edwards said. “VUMC will benefit from a cohesive treatment strategy for addiction.”
Chair of the department Warren Sandberg, MD, PhD, said the opportunity for members of the department to present to Adams was a great opportunity to highlight what not only the department is going to contribute to the opioid crisis strategy but VUMC as a whole. “It is not every day your institution and department get the chance to have a discussion with the United States Surgeon General.”