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  • About
    • Why We Matter
    • Our Team
    • Contact Us
  • Learning Center
    • The AD Archives
    • The AD Core Toolkit >
      • Opioid Safety Toolkit
      • HIV Prevention Toolkit
    • MATERIALS LIBRARY
  • News & Media
    • Blog
    • Podcast Series
    • E-Newsletter
  • Detailing Directory
    • Partners by Location
  • EVENTS SERIES
    • Training Series
    • CONFERENCE SERIES
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The DETAILS BLOG

Capturing Stories from the Field: Reflections, Challenges, & Best Practices

Clinicians as Champions: Understanding Barriers & Enablers to Detailing Success

4/2/2019

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An Interview with Johnathan Goree, MD
Director of Chronic Pain and Opioid Stewardship
University of Arkansas for Medical Sciences

NaRCAD Training Alumnus


​by Kristina Stefanini, Program Coordinator at NaRCAD

​
​NaRCAD: Thanks for talking with me today! Can you tell me a little bit about yourself and how you ended up in pain management?

​​Johnathan Goree: I’m from Arkansas originally. After completing college at Washington University in St. Louis, medical school and residency at Cornell, and a pain medicine fellowship at Emory, I was recruited to start the chronic pain division at the University of Arkansas for Medical Sciences – 2 miles away from where I went to high school. I’m proud to work in Arkansas; Arkansas is such a poor and rural state, so we don’t often have the resources that other states have. 

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I went into anesthesiology because I wanted to be the best prepared doctor for an emergency, but I moved into pain medicine because I missed the 1-on-1 patient contact and longitudinal patient care. Here are some other things that lead me into pain medicine. After getting my wisdom teeth removed, I was given too much fentanyl during the procedure resulting in being given Narcan to wake up. 

​That was the first time in my life I experienced 10/10 pain.  It allowed me to understand how pain can completely dominate someone’s consciousness. I am also passionate about pain management in minority communities. Many in those communities feel that their pain is undertreated, and evidence backs that up. 

NaRCAD: As a physician, what are some of the barriers that detailers may have talking to clinicians about pain management? How can these be navigated?​

Johnathan Goree: Every physician will say the number one barrier is time. While most physicians are excited to learn about anything that will improve patient care, unfortunately, physicians are usually not in control of their schedule.

One of the challenges we anticipate with our project is that people aren’t volunteering for the initial detailing visit.  As a result, physicians may feel a little targeted.  But again, I emphasize that most physicians strive to be better doctors every single day.  I believe that with high quality, non-confrontational educational materials, this challenge will be overcome.

​To my fellow detailers, don’t be discouraged if you have a bad visit with a physician. There are so many factors that can contribute.  That physician could be having a bad day for a number of reasons. I can say from experience, sometimes those little nuggets of knowledge can make a huge impact days, weeks, or months later.  ​​​

TIPS FOR DETAILERS:

1. Be mindful of the time allotted.

2. Frame everything as patient-centered or patient-focused

3. 
Learn how to navigate the office staff. (Winning the front desk is most of the battle!)  
​NaRCAD: How can clinicians act as champions in an academic detailing campaign?
 
Johnathan Goree: One way physicians can help is with the crafting of educational materials. Physicians know how physicians think and can help by crafting a message that may better catch attention.   
 
Another is by dedicating time to answer follow-up questions from detailers and other clinicians.  In my field of chronic pain management, detailers that don't have a clinical background may not know how to answer questions on specific off-label situations or treatment of specific pains. A follow-up visit or call with a clinician can help with that. 
 
NaRCAD: Anything else you’d like to add for our readers?
 
Johnathan Goree: More praise for you guys – your course is excellent! Really understanding the science and method behind academic detailing made me excited to be a part of it. I hope more physicians engage both as detailers and as champions. I think it’s really important. 
Biography. 
Johnathan Goree, MD, Director of Chronic Pain and Opioid Stewardship
​University of Arkansas for Medical Sciences
​
​Board certified in anesthesiology and pain medicine, Dr. Johnathan Goree received his Bachelor of Arts in biology from Washington University in St. Louis.  He then moved to New York City where he completed both his medical degree and a residency in anesthesiology at the Weill College of Medicine at Cornell University.  Following his time in Manhattan, he completed a fellowship in chronic pain medicine at Emory University Hospital in Atlanta, Georgia.  In 2014, Dr. Goree returned home to Little Rock, Arkansas to join the faculty at University of Arkansas for Medical Sciences where he serves as the Director of the Chronic Pain Division and an Assistant Professor in the Department of Anesthesiology. He primarily focuses on the treatment of chronic pain conditions using opiate sparing, minimally invasive techniques.  His specific research interests include complex regional pain syndrome, neuromodulation, and the effects of opioid education initiatives on patient outcomes.    
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Creating Change Together: Partnering with NaRCAD

7/18/2017

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Director's Letter: Summer 2017 | Mike Fischer, MD, MS, NaRCAD Director
Academic detailing is naturally versatile, growing from the initial studies focused on prescribing decisions to include interventions to improve childhood screening, assessment of cardiovascular risk, smoking cessation treatment, and many other important clinical topics. 
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Whenever medical care and patient outcomes can be improved by outreach education to frontline clinicians, there’s an opportunity for AD to make a crucial difference. We’ve seen our partner organizations use AD in novel and exciting ways, making adaptations to fit their specific interventions and to combat diverse challenges.

Healthcare is in a period of ongoing, rapid change—and continued innovation in clinical outreach education is critical in improving the quality of patient care. But for new ideas to have an impact, they need to be evaluated and communicated to the larger community. Tell us more about what you’re working on—we’ll connect you with others addressing the same clinical topic, or working with a similar geography or population, and we’ll share your experiences and results via our best practices blog, website, newsletter, and social media platform. 
Along with trainings and networking opportunities, NaRCAD provides targeted consultation and technical assistance to improve your successes in the field. We also participate in collaborations with programs as part of multifactorial interventions and research studies.  

  • ​Are there specific initiatives on which we can partner together to launch a new intervention?
  • ​Do you have an idea for a research study to assess a novel adaptation of AD?

If so, drop us an e-mail, give us a call, or write a note in the comments section below--we’ll be in touch to figure out next steps, whether that involves submitting a proposal together, figuring out a customized training, or connecting you with experts that can support your project.

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​Whether you’re looking to strengthen your team, meet thought leaders in the field, or tell us more about your work in person, we hope you’ll join us at our Fall Training in September, and our annual International Conference on AD this November--registration is open for both, and we look forward to seeing you soon!
-Mike

Biography. Michael Fischer, MD, MS, NaRCAD Director
Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more.
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​NaRCAD is a program of the Division of Pharmacoepidemiology & Pharmacoeconomics [DoPE], Department of Medicine at Brigham & Women's Hospital.
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