DETROIT (WWJ) – An Oakland County doctor is examining ways to impact the opioid crisis in Michigan.

Giancarlo Zuliani of Zuliani Facial Aesthetics in Bloomfield Hills has a published article in the Journal of American Medical Association which examines the abuse of pain killers and focuses on the relationship between doctor and patient. He believes that relationship is ground zero in the battle against addiction.

“When people would be coming into the hospital they would be judged on how much pain control they have — and because pain was looked on as a fifth vital sign and what we saw it was a linear increase with the amount of pain medicines prescribed along with us measuring pain in the hospital and it’s gone, sort of, out of control from there,” says Dr. Zuliani.

He says it began in 2001 with the increase of physician and hospital reimbursements tied to patient satisfaction scores.

“Providers are actually worried about patient satisfaction surveys and one of the main ways we have tied satisfaction is decreasing pain.”

As an example of what happens with better communication between patient and doctor, he has reduced the amount of pills he prescribes post-rhinoplasty from 30 to 12.

“Approximately 75 percent of the people which we studied required less than 15 pills,” he said. “We uphold values and the Hippocratic oath … ‘first to do no harm,’ so if the patient necessarily doesn’t always correct in this setting despite the fact that they can be giving us negative scores.”

At that point he transitions his patients to a non-steroidal anti-inflammatory medicine like Tylenol.

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