Let’s improve the response to pain, not place blame
Thursday, January 04, 2018
When observing conflict, I've often pointed out that it takes "two to tango," meaning each party has a role in managing conflict. To point the finger at one group/individual or another is simply assigning blame.
And, as we know well in the world of safety, improvement doesn't occur unless we address the entire multifaceted system.
In 2017, I gained greater personal insight into the world of pain and the patient. I also learned from those I met on Facebook support groups and two new resources, which have helped me better understand my own pain and that of those around me. As an administrator and educator, I can now better see the opportunities for improvement.
In September, I reviewed a new book titled, "Why It Hurts: A Physician's Insights on the Purpose of Pain" by Dr. Aneesh Singla. This week, I came across a short Ted Talk on Twitter (see video below), titled, "What We Lose When We Undertreat Pain."
My years of experience combined with my new insight helps me recognize what I think are the most important aspects of the opioid and pain management issue that need to be addressed in 2018.
1. Drive decisions with data, not just the emotion of stories.
In the video, Kate Nicholson presents federal statistics of 100 million people in the U.S. being affected by chronic pain, including 50 million in persistent/severe pain. She adds that only 2.5 million abuse opioids.
Opioids appropriately treat pain and heal people. Attacking doctors and excessive limitations on access to opioids will most likely impact those who need the medications the most and lead to unintended consequences of increased risk (and costs) elsewhere.
2. Educate current and future physicians on the proper management of pain.
Nicholson points to the top reason for an emergency room visit being pain, but pain management is underaddressed by medical education. We need to close the gap between the prevalence of pain in society and the time dedicated to training.
As a start, medical and continuing education needs to include components for screening of emotional pain and addictive patterns, identifying those who are at risk of abuse and monitoring their behavior. Singla goes a bit further to describe the multidimensional model, or perception of pain. It includes sensory, affective and cognitive.
3. Educate society and hold them accountable for their role in pain management.
Singla carefully explains the vitally important role of pain, which is to carry a message to the brain. Some pains can be elevated by addressing the underlying condition, but others can't be "fixed."
We all need to find the point where we can live with less pain, or listen to our body and know when it is time to stop and rest — preventing further injury. Family and friends in caregiver roles also need to recognize their responsibilities. Healthcare professionals need to be equipped to help patients on this journey.
In 2018, I hope to hear the conversation shift to properly medicating pain and away from blaming physicians and opioids for the abuse and deaths.
Perhaps we will see the next generation of pain medication: nonaddictive drugs. Until then, public policy will best serve society by ensuring that each individual patient can be properly medicated.
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