Are tomorrow’s physicians prepared to treat chronic pain?


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5 comments

  1. Gail Sloane

    Hi Kriti
    You are absolutely correct in your assertion and the gaps in training related to chronic pain and chronic disease management in general. As a senior policy analyst in a chronic disease portfolio it was a challenge to have physicians and other HCP integrate non-pharmaceuticals into a treatment plan. This is due to a number of factors-expectations of the patient of a “quick fix”, fee for service payment models and non-coverage for non-pharma treatments or waitlists for programs. Our chronic disease self-management programs -based on the Stanford Model were free and offered across the province. These ought to have been a go to as a recommendation but most didn’t know about them or what the skill building content of the program included. Sadly conversations and coaching are not well renumerated and encouraging patients to set functional goals as the person not provider lives with the illness takes time and a shift in practice.
    Since leaving government, I work with non-pharma organisations to educate health care professionals on a number of issues related to chronic disease. Particularly chronic pain and addiction. The Prescribing Course-Safe Opioid Prescribing is offered across the Atlantic Provinces by the Atlantic Mentorship Network – Pain and Addiction. It is supported by a number of organisations including Doctors Nova Scotia and Workers Compensation Board of NS and NB. The WCB funds all Dalhousie Family Medicine residents in their 2nd year to attend. It is the first initiative of its kind in the country. Further info is available @ http://www.bluesmartieconsulting.com or contact me @ info@bluesmartieconsulting.com

  2. Franklin Warsh

    Kriti,

    First, congrats on being part of the next generation of doctors, and a heartier congrats on demonstrating more thoughtfulness on the subject than a lot of MDs who’ve been in practice for 20 years.

    The truth is, once you’re in practice the guidelines and educational programs are barely worth the paper they’re printed on. Not because a lot of thought research hasn’t gone into them, it has. Rather, all the evidence in the world is meaningless when you’re face to face with an individual patient. You’re going to need to trust your instincts, accept that you’ll make mistakes, and be unafraid to ask for help. Chronic pain patients are the most challenging to deal with in medicine. At both the individual and societal level, pain is so inextricably tied to problems of mental illness, addiction, and drug diversion I don’t know if they’ll ever be solved.

    That said, your awareness that there’s a “hidden curriculum”/cultural bias at play is the most reassuring sign your future patients could ask for.

  3. Tom Closson

    Are today’s physicians prepared to treat chronic pain?

  4. Amanda

    I have chronic pain and am on opioids and it is a nightmare trying to get proper help in Northern Ontario. I don’t have addiction or mental health problems. It takes weeks to get a family doctor appointment, which is unacceptable. I would like to add medical cannabis to my pain treatment plan, but if I do, my physician will stop prescribing opioids. I am very frustrated. Any suggestions? Thank you.

  5. Mary Redmond

    Insightful, intelligent and very articulate! We are in the middle of a very uncomfortable transition in chronic pain management. Physicians and chronic pain patients alike are distressed and anxious. Doctors with experience are having their judgment questioned and doctors without experience are suggesting that the safer path for the patient may be living without pain relief. That suggests to me that your best option may be relying on your apparent good judgment.

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