“We (Patients and Doctors) have a vested interest in talking to each other, not around or about each other.”
That was the message Terri Lewis Ph.D told an audience at the International Conference on Pain Medicine in Chicago.
Lewis said there is a “care crisis for persons with chronic pain” that must be addressed. She talked about the need for a “working alliance” that emphasized an agreement between physicians and patients on the goals and tasks of treating the chronic pain.
Lewis, who has written extensively on what she believes is a broken health care system, has a special and lifelong interest in chronic pain given that her father and her son both had to endure it. The former Southern Illinois University professor has been on assignment in Taiwan where she is working to help implement community health care systems into the Taiwanese health care model.
Recently, she has been using social media to gather information from chronic pain patients about their experiences in the health care system. Some 500 persons have answered her survey – and what she’s finding is that things are not in a good place.
“27% of respondents report that their working relationships with their physician has deteriorated, and 21% report having to change pharmacies,” she said.
The survey, she thinks, revealed several data points that are hurting patients.
- The DEA now directs pain treatment in America
- Persons with chronic pain are treated as addicts
- In rural American, patients have to travel more than 50 miles to see their physician because treating providers have relocated
- The pharmacists will no longer fill the prescription
- Once the regulations change, my provider dumped me
“We should all worry that physicians are afraid to treat patients who are victims of pain,” she told them. “More and more, doctors are refusing to treat their patients who have chronic pain because the DEA has instilled fear in them.”
While chronic pain does not favor one income or education group to the exclusion of other, the majority of approved filings for disability are persons in the prime work age of 45-to-59 years old, leaving households vulnerable to economic insufficiency and care partner burnout.
“This is no way to run a railroad,” she said. “or a health care system.”
Lewis, who is a patient advocate, reminded her audience of the high rate of burnout among pain specialists that may be a wakeup call to the specialty. She showed an article in Anesthesiology News in October 2014, that reported the burnout needed to be addressed since it places the physicians at risk for substance abuse, interpersonal difficulties and suicidal tendencies.
And important, it also increases the risk for medical errors.
“Patients need to know and believe they can speak to their doctors as equals,” she told the National Pain Report. “That’s a big change in how most doctors view patients and vice versa.”
Lewis said she expected her talk would rankle her audience.
She was pleasantly surprised.
“After the talk, there was quite a bit of positive reaction. I’m thinking that we may be getting to a place where a serious conversation and some accompanying change might occur in how chronic pain is treated,” she said. “It is certainly is time to do something different.”
Physicians and researchers are very interested in elevating this conversation and getting it back on track toward the service of patients. There was pretty widespread agreement among folks in the hallway conversation that nobody benefits from the current state of affairs, least of all patients.