When NASCAR racing legend Dick Trickle killed himself last month because of his debilitating chronic pain, it focused considered attention on how pain is diagnosed and treated.
At the National Pain Report, we’ve been talking with pain specialists around the country and found many think that medical schools need to do a better job of preparing physicians to diagnose and treat pain.
“Historically medical schools average only six hours dedicated to pain management, and the bulk of that time is on prescriptions,” said Beth Darnall, PhD, clinical associate professor in Stanford University’s School of Medicine.
Darnall is concerned that patients will rely solely on opiods for chronic pain if they are not given alternative resources, and that those alternative resources aren’t being taught.
UCLA’s Dr. Andrew Charles agrees, calling the diagnosis and treatment of chronic pain “a huge public health problem” because of lost work productivity, the costs to the health care system, and the social costs to pain sufferers and their families.
“Medical schools should do a better of preparing physicians to identify and treat chronic pain,” said Charles who runs the Headache Research and Treatment Programs at UCLA’s David Geffen School of Medicine.
Charles also says patients need to be better educated about pain as well, calling the lack of training a “global problem.”
The hard truth is that pain is the number one reason for a person in the United States to seek medical attention. And a Denver, Colorado pain physician joins Dr. Charles and Dr. Darnall in the call for medical schools to pay more attention to how we train physicians.
“The academic system in the U.S. has never formed a residency which would produce a physicians who is skilled in the diagnosis and treatment of pain,” said Daniel Bennett, MD, DABPM, a Denver pain physician who is chief medical officer for National Pain Report. “This boils down to money and politics, which is sad.”
Since some current doctors are not up to date on how to diagnose and treat pain, it can be a challenge for chronic pain sufferers to find the right doctor. Arlene Grau of Lakewood, California recently wrote a column for the National Pain Report that likened finding the right doctor to finding a life partner.
“We go through great lengths to confirm that he/she is the one, and, if you’re like me, you have a list of qualities you look for in the person,” Grau said. “If you are a chronic pain sufferer, then finding the right doctor to care for you should be the same way.”
Grau went to several different physicians before she met one that she feels understands and listens to her.
Dr. Darnall points out that some states are doing better. In Washington state, 27 hours of pain education in the medical curriculum is required, but she emphasized “this is by no means a national practice.”
Experts we’ve talked to think that more physicians need to be able to communicate better with their patients.
This means a better understanding of the physiological mechanisms of pain, the psychological factors that influence pain, the benefits of multidisciplinary pain care, and an emphasis on patient empowerment — connecting patients with resources and information to best manage their pain.