Michelle Ocelnik focuses on some of the challenges and cost associated with traditional pain therapy and discusses the use of adjunctive noninvasive neuromodulation therapy that may help reduce both medication and costs. Michelle concludes that noninvasive neuromodulation can reduce pain, decrease pain medications, and improve function, without the negative side effects of narcotics and without the expense of invasiveness of implantable spinal cord simulators, and that it can be an important tool to use in the rehabilitation of the injured worker.

Viki Solomon Freinberg shares with the readers her perspective of how it feels to be a case manager. In summary, Viki reminds the reader that

* we are case managers;

* we are special and have heavenly attributes; andwe add to the world with our knowledge and special skills.

Marcy Tigerman presents the reader with the question: "How can an effective case manager take a step back from being a lifelong 'do-er' and refocus on becoming a 'cue-er' for enhanced success?" She directs the reader to realize that getting the job may not be enough. Take it to the next level, empowering our client to actually become more independent in complex healthcare situations. We should be guided daily by advocacy and autonomy, which are underlying case management values. Marcy asks the question: "Have I stopped, focused, and truly explained what options my patients have in these situations?" Read this article and see how you measure-up to Marcy's time-tested convictions.

Kathryn Bennett alerts us to the increased number of patients who are using the emergency department as their primary care provider. The pressure rises to treat and discharge or transition patients to the inpatient unit as timely as possible, which may not be the best care for the patients. The focus of this article is on setting the stage for successful implementation of key initiatives that will help guarantee success and "Put the right patient in the right bed with the right caregiver." Kathryn concludes her article on the success note that patient bed time has been reduced from 150 min in August 2007 to 95.5 min in December 2008.

Frances Snowden, BS, RN, CRRN, CCM

Contributing Editor