Senators Seek to Silence Pain Patients
http://www.painnewsnetwork.org/stories/2016/2/10/by6zy0jfl3gd41mp6zxh2aiex41lh5
By Pat Anson, Editor
We’ve run several columns recently about the poor quality of pain care in hospitals and how many pain sufferers are treated as drug seeking addicts. Emily Ulrich’s column about her mistreatment in hospitals (“The Danger of Treating ER Patients as Drug Seekers”) really hit a nerve, generating hundreds of comments on our website and Facebook page from readers who shared their own hospital horror stories.
This makes a recent letter from over half the U.S. Senate all the more striking, because it seeks to silence hospital patients who are unhappy about their pain care.
In the letter to Health and Human Services Secretary Sylvia Mathews Burwell, Sen. Susan Collins (R-Maine) and 25 of her colleagues claim that many pain sufferers get opioid pain relievers far too easily in hospitals. To see the letter and the list of senators who signed it, click here.
“For millions of patients who are suffering from illness or injury, prompt delivery of pain control which may or may not include opioid pain relievers is proper and humane,” the letter states. “Yet inappropriate use of opioid pain relievers does not provide any clinical benefit and may actually pose a risk of harm. The evidence suggests that physicians may feel compelled to prescribe opioid pain relievers in order to improve hospital performance on quality measures.”
At issue is a Medicare funding formula that requires hospitals to prove they provide quality care through patient satisfaction surveys. The formula rewards hospitals that provide good care and are rated highly by patients, while penalizing those who do not.
Collins and her colleagues asked Burwell for a “robust examination” of the patient surveys – and strongly suggested that questions about pain management be eliminated. The Medicare survey has 32 questions for patients about their hospital experience, including two that ask if a patient’s pain was “well-controlled” during their hospital stay and if hospital staff did “everything they could” to help a patient with pain.
“Currently, there is no objective diagnostic method that can validate or quantify pain. Development of such a measure would surely be a worthwhile endeavor,” the letter says. “In the meantime, however, we are concerned that the current evaluation system may inappropriately penalize hospitals and pressure physicians who, in the exercise of medical judgment, opt to limit opioid pain relievers to certain patients and instead reward those who prescribe opioids more frequently.”
Some doctors agree with that sentiment.
“I’ve just had conversations with several physicians in the last week and they were saying they felt pressured by patient satisfaction surveys,” Andrew MacLean, deputy executive vice president and general counsel of the Maine Medical Association, told the Portland Press Herald. “This type of inquiry would be helpful and we applaud the senator’s efforts.”
More people suffer from chronic pain than heart disease, diabetes and cancer combined, and pain is a major reason why people even seek admission to a hospital; so the senators are proposing that the opinions of a large segment of hospital patients be ignored, not that it isn’t happening already. Pain patients frequently tell us they go without appropriate pain treatment in hospitals because they are quickly labeled as drug seekers. Some have horrific stories of mistreatment.
“My sister had Complex Regional Pain Syndrome (CRPS/RSD), went to 3 different hospitals was treated the same way. Finally she got a doctor that did his job, only to find out she had stage 4 cancer. She died less than 2 months from the time she got diagnosed,” wrote Melissa.
“My 13 year old daughter went in with chest pain and they told me she was having an anxiety attack. They did nothing. Two days later we found out from the children’s hospital that she had a hole in her heart and could have died. ER doctors are the absolute dumbest, cruelest people I have ever met,” said Shannon.
“I used to work in an ER. Patient came in with tremors, talked of pain. She was quickly diagnosed as a pregnant drug addict who received no care and was sent home,” wrote another reader anonymously. “Two days later her husband brought her back demanding treatment. Doctor wanted to put her into rehab when she went into labor along with seizures. It wasn’t drugs it was meningitis. She and the baby BOTH died.”
“I take Norco for chronic back pain. I go to the ER for a different medical issue and I get the looks and nothing to relieve my pain. I recently herniated a second disk in my back and was given nothing in the ER. I refuse to go to another one. If I am bleeding out or literally dying I don’t know if I would go into another ER. All they do is judge because they can’t feel my pain,” wrote Mistye Staten.
“Last time I was in the hospital and asked for medicine to control the pain I was told no. I said I at least wanted Ibuprofen and the nurse yelled at me to stop asking for narcotics,” said Amanda Hunt.
A recent study at Temple University Hospital in Philadelphia found that the rate of opioid prescribing dropped by about a third after tougher guidelines were adopted to discourage doctors from prescribing the drugs.
Only 13% of the doctors believed patients with legitimate reasons for opioids were denied appropriate care after the guidelines were implemented. A large majority – 84% of the doctors — disagreed or strongly disagreed that patients were denied appropriate pain relief. Ironically, the researchers did not ask any pain patients what they thought about their hospital care.
Filed under: General Problems
Link to specific congressmen doesn’t work
apparently page has been removed
For some reason that I can’t seem to wrap my mind around, when a CPP has a surgery or trauma, the treating physician seems to think that the chronic pain meds will address the acute pain precipitated by the trauma or surgery. Prior to the insult, e.g., the trauma or surgery, the patient’s Nociceptive System has been equilibrated to the level of analgesic present in a manner that allows the patient’s perception of the pain to be at a level that allows for reasonably normal day-to-day activities…in an ideal situation. Rarely is the pain completely eliminated; rather the pain is ameliorated to the point that a normal life is a possibility, again, in an ideal situation.
Now, on account of the trauma or surgery, that equilibrium is biased to the side of the analgesics not being present in adequate levels that allow for adequate amelioration of the signals being transmitted by the Nociceptive System. It is as if one is highly photosensitive to the point that the levels of indoor lighting considered the usual and customary amounts are too muck. The afflicted individual is given a pair of tinted lens glasses to wear to make the formerly overabundant lighting tolerable. Now this same person is forced to go outdoors on a cloudless, sunny day at high noon. The current tinted lenses are wholly inadequate. The solution is a lens that attenuates a greater quantity of light. Yet this person is told that their present lenses are more than enough. What this situation shows me that most physicians are ignorant to how the Nociceptive System functions and the role that opioids play in managing chronic, intractable pain.
Now, I’m just a lowly pharmacist who is unworthy to even fit the paper surgical booties over the shoes of the High and Holy Healer with Prescriptive Powers (blessings and oblations to their High and Holy Anointing forever). What do I know? Well enough to understand that this is a significant lacking in the education of the prescriber. If I know this and I’m only allowed to count out such medications by fives, then why does not the one who has the keys to the release of such medications continued to be allowed to wallow in such ignorance of the mechanism of action whereby which these medications do their job (note to the reader: I’ve deliberately kept this explanation on a level easily apprehendable by the lay reader…if it appears to be inaccurate/lacking to the educated professional, then this is why).
I’m deliberately being sarcastic, but only to those physicians and mid-levels who metaphorically see themselves as deity-anointed. This lack of education needs to be addressed. There is so much bad information out there that is not motivated by evidence, but rather by the neopuritanical mindset. This information is what leads the prescribers to not become further educated and that which biases the marginalization of the CPP and the continual incarceration of the addict. CPP’s need to be adequately treated and the addict needs to be able to readily access the treatment based rehabilitation program. Both groups require the extended grace of compassion by the health care community Meaningful and accurate education is the only way to win such ideologically-based, societal warfare.
The changes in the way doctors prescribe opiates is 100% due to the CDC guidelines. They’re not even laws, just guidelines that put the fear of God into physicians. I was told by my primary that the changes were coming, but it Tirol awhile to witness the impact. As a Chronic Pain Patient, 12 years compliant, I have been directly affected by these guidelines. I have seen how these guidelines have effected friends as well. It is not good. I had 2 surgeries at one time on my left arm. I was in the O.R. for 3 hours. They did not want to treat my post op, acute pain, because I was a chronic pain patient. This is a problem. When you’ve been a compliant patient for 12 years on a stable dose, it doesn’t change your need to have your acute or post op pain treated. However physicians don’t seem to agree with this. ” Take you chronic pain meds “, they tell me. They don’t want to hear that if I use up my pain meds to treat acute or post op pain I will run short when my pills are counted. That’s your problem, I’m told. I have had to suffer needlessly, and I’m not alone. I’m on a taper dose now and have been taken off meds for anxiety, and, migraines.
I worry if I’m injured in anyway I will not be treated fairly. I don’t know where the middle ground is, but, I wish someone would point it out.
How much longer will Cronlc Pain Patients be grouped with Junkies and labeled as drug seeking because they are in real pain ? As long as Doctors let Politicians /DEA and the media practice medicine and give in to the threats , and let Fear insted of Logic and Compassion guide their decisions , Who Knows ?
Starting to sound like a certain time in German history in the 1930s .
So now what do u think abou these statements. ……ill tell ya u don’t give a dam unless it happens to be you……and yes as u live longer…your time will come…..i hope to hell u suffer as much as all of us ligt chronic pain patients feel…..its like not having anymore gas 4 your car……u going to cry about that….all the while the hot shots in government has gas 4 their cars……Americans are getting dumber by the second…….got an idea…go watch some more Kardashian crap……in the mean time all hell is going to break loose…..cant wait. ….
Senator Collins should be removed from power immediately, by any means necessary. We must teach voters ALWAYS to replace incumbent officeholders, whenever the opportunity affords itself.
I see Sen Mark Kirk’s name on the list…he had a severe stroke at least a couple of years ago…most patients I know who have had strokes of his magnitude have chronic pain and also need pain medication just to do the continued rehab….I find that so ironic that he signed such a letter. My question would be to fire back a letter to each of the signers and ask them if they family members who have diagnoses of chronic pain or they themselves have chronic pain and how would they feel if they were treated if they were an ‘ordinary person’ and not a US Senator with perks at any ER needing pain treatment. I also just find it unusual that not one of them hasn’t had a family member who has experienced the same ‘you’re a drug seeker’ attitude as anyone in the chronic pain community
“The evidence suggests that physicians may feel compelled to prescribe opioid pain relievers in order to improve hospital performance on quality measures.”
When we’re talking about a “suggestion,” then we’re not talking about evidence.
Medicare has recently put a lot of new rules into effect, many of them directly affecting payments to doctors and hospitals. Doctors and hospitals have been complaining about the patient satisfaction surveys long before they went into effect. Up until this point, their complaints have fallen on deaf ears. I’m not surprised they’re using opioids to further their cause. However, I believe studies have been done showing that doctors concerns about the surveys are unfounded.
This just breaks me heart.
This wouldn’t be happening if most of the doctors didn’t prescribe opioids to everyone in the first place. And what’s happening is the people who are really in pain are going to these emergency rooms legitly because they were never turned away from their doctor before and now need real pain relief. So now all of us legit people with pain are being treated like addicts seeking opioid users. I didn’t need to go to the emergency room for relief if my doctor just listened to me. After my very disheartened emergency room visit I was diagnosed with Fibromyalgia, severe Arthritis and nerve damage. My pain is so severe that if I didn’t have pain medication, I wouldn’t be here right now.
I would love to see these doctors and senators walk just one day in our shoes. And let them see what it’s like, because I can tell you none of these senators have experience with pain. Stop acting in humane. There has to be a better system. Adults also need to keep their medication locked so kids can’t get in. Come on, I know your smarter than this. I know it’s easy just to sweep under the rug and not care. But please wake up and see the reality of pain in our bodies. Obviously you have no idea. It’s sickening how these senators turn a blind eye because they know. There are two kinds. Addicts and pain patients. Stop labeling pain patients to this catagory of addicts. We might act like a addict when we go to the ER because we need our pain medicine for our legit diseases that our doctors won’t and are scared now to prescribe.
There will be one day when one or more that are trying to deny us pain relief will experience what I’m talking about and then it will be to late.
Advocate for helping people with real pain