Adding a Physical Therapist to the Health Care Team in an HIV Clinic Increases Physical Therapy Referrals and Reduces Opioid Prescriptions Provided for Chronic Musculoskeletal Pain in Patients Living With HIV.

BACKGROUND: Musculoskeletal (MSK) pain is common in people living with HIV (PLWH). Health care providers sometimes prescribe opioids to control pain, which may lead to opioid misuse. An interdisciplinary approach that includes physical therapy has been successful in managing MSK pain in various health care settings. Therefore, we sought to find the impact of recruiting a physical therapist (PT) on the number of opioid prescriptions and physical therapy referrals made by physicians in training to manage MSK pain in PLWH. METHODS: We performed a retrospective chart review of patients seen by Internal Medicine physicians in training in an HIV clinic in Detroit before (2017) and after (2018) recruiting a PT to the health care team and collected demographic and clinical data. We also surveyed the trainees to assess how the PT addition influenced their learning. Institutional review board waiver was obtained. RESULTS: Results showed that of all PLWH seen at the clinic, 28/249 (11%) and 37/178 (21%) had chronic MSK pain in the 2017 and 2018 data sets, respectively. In 2017, all 28 patients with MSK pain were prescribed opioids. This decreased in 2018 after the PT addition (10/37 patients; P < .0001). The number of physical therapy referrals significantly increased after the PT addition (2017: 5/28 patients; 2018: 17/37 patients; P = .03). Trainees felt that the PT helped improve their examination skills and develop a treatment plan for patients. CONCLUSIONS: The addition of a PT encouraged physicians in training to utilize nonopioid management of MSK pain in PLWH and enhanced their learning experience, as perceived by the trainees.

Collaboration, Collegiality, and Sharing of Resources: Benefits of a Visiting Professor Exchange Program in Breast Imaging.

The role of a visiting professor (VP) has long been used as a model to share medical knowledge and new advances between different teaching institutions. As with all subspecialties, breast imaging has institution-specific differences in resources and faculty. Sharing of resources between programs can have a profound impact on enriching educational experiences for learners. Our conceptual design of a VP lecture exchange program was between two academic medical centers, Virginia Commonwealth University Health System (VCU) and MedStar Georgetown University Hospital University (MGUH), in the subspecialty of breast imaging. The program was designed to supplement potential areas of weakness in the breast imaging educational curriculum at each respective institution. The program also sought to create opportunities for long-term mentorship and collaboration between institutions. Three faculty members from VCU and three faculty members from MGUH participated for a total of six lectures (three lectures at each site). Participating residents and faculty completed anonymous surveys following each lecture regarding the lecture exchange program experience. The survey responses showed that the VP exchange was well received at both institutions. The VP exchange process was relatively easy to arrange, benefits both institutions, and could even be expanded to the virtual environment.