Table 2.

Questions submitted to allied health specialties

SpecialtyExample questiona
Addiction assessment/treatment services‘Patient is addicted to benzodiazepines but is motivated to taper off and is seeking support from community resources. Previous efforts at withdrawal have resulted in binging and relapse. Family has offered support. Please provide advice on how to manage reduction of drug intake.’
Clinical pharmacist‘What is the risk of adverse effects (for example, serotonin syndrome, seizures) when combining tramadol with an SSRI? Many of my patients with chronic pain are also on SSRIs or tricyclics, and I would prefer to keep them off more potent opiates. Are adverse effects seen quite quickly after initiation, or could a delayed effect take place? Advice on how long and aggressively to monitor would be appreciated.’
Diabetes education‘Patient is in his fifties with type 2 diabetes. His A1C levels are better than they have been previously [PCP lists A1C percentage]. He is taking multiple oral medications for diabetes, high blood pressure, and anxiety [lists medications and dosages], but requires further treatment. He refuses to take anything via injection. Are there any other oral options for his diabetes?’
Musculoskeletal rehabilitation‘Patient is in late fifties and has been experiencing pain in her tailbone for approximately 1 month due to a fall. Current treatment consists of a donut cushion for sitting and over-the-counter pain medication. An X-ray revealed dislocation [gives details]. Given these findings, would surgical intervention be recommended?’
  • a Question specifics have been altered to ensure patient and provider confidentiality. PCP = primary care provider. SSRI = selective serotonin reuptake inhibitor.