At Mon, 22 Apr 2002, Hchalm@aol.com wrote:
>
>Are these laws on the books to help us or not or are they just complete
>hogwash? Seems as if these are in effect they should be able to be used
>against the doctors that are not providing adequate pain relief, but doctors
>are still denying us the medication that we need and are letting so many
>suffer needlessly. Seems as though something should be done or could be
>done. But it seems that the DEA and FBI are winning the battle as they are
>trying to take away the licenses of doctors that are willing to treat the
>chronic pain patient, therefore, doctors are afraid to prescribe adequate
>medication for fear of indictment by the DEA. Believe me, 8 doctors in VA
>were raided and are being indicted by the DEA and FBI because of their
>prescribing narcotic pain medication.
>
>Helen Chalmers
>
>Well I'm feeling kind of cynical so maybe that colors this question for
>me, but I think that this is one of those "feel good" initiatives that
>is not taken at all seriously by the people who would have to take it
>seriously. I saw this on a nice poster on the wall in the exam room at
>my doctor's. It was printed up by a drug company, given out as a nice
>"freebie" to the doc. On the opposite wall was another nice little
>poster, also a drug company freebie. It said, "Your doctor cares about
>you too much to prescribe an antibiotic you don't need." One time I was
>80% sure I had a viral sore throat, but felt sick enough that I decided
>a throat culture was a good idea. So I went in to the doctor. She did
>NOT do a throat culture. She said, "Oooo, that looks nasty. Our policy
>is to treat all sore throats." And she sat there RIGHT UNDER THE POSTER
>(the no-unnecessary-antibiotic poster) and wrote out a prescription for
>amoxicillin... (And yes she's still my doctor -- she believes that
>adhesions cause pain!)
>
>The problem is that the people writing up these manifestos about how
>pain patients have a right to treatment are ignoring the 2-ton elephant
>at the party. In law-enforcement circles (as in the DEA, FBI, etc.) it
>is simply assumed as an unquestioned fact that there is no such thing as
>chronic pain. John Jones or Suzy Smith have a gallbladder removed, or
>open heart surgery, or a hammer-toe repaired. They are sick, in pain,
>they have surgery, the surgery causes pain, they get pain killers, the
>surgery cures their problems, they don't need any more painkillers after
>a couple of days or weeks. The law-enforcement types start out with the
>assumption that treatments never fail, nothing is ever untreatable, and
>that treatments could never make pain worse except temporarily. So
>anyone who claims to be still in pain 3 weeks after the treatment MUST
>be a druggie looking for a fix.
>
>I've heard this from an ER doctor: "Yeah, right, they come in saying
>they are in terrible pain, and they know the 14-syllable name of exactly
>the narcotics they want, and the exact dosage." (rolls eyes.) As if
>someone who was in chronic pain for years would NOT know the names and
>dosages of the drugs that help? Anyone with an IQ larger than a box of
>rice-a-roni would figure that out after a few years! But you see they
>don't believe that anyone could be in pain for years and years.
>
>I've read stories where the DEA or FBI will take the fact that a doctor
>has lots of patients on narcotics and use this as prima fascia evidence
>that the doctor is a drug dealer. As if there were no other
>explanation! Obviously if in a community most doctors are afraid to
>prescribe long-term narcotics, then the few doctors who ARE willing are
>going to collect all of the chronic pain patients in the community. I
>mean nobody thinks it especially ominous that a huge fraction of an OB's
>patients are pregnant, or that a huge fraction of a cardiologist's
>patients take nitroglycerin, right?
>
>The 2-ton elephant at this party is that it is completely reasonable for
>a doctor to want OTHER DOCTORS to give adequate pain relief to the OTHER
>DOCTORS' patients, and is ready and willing to right all sorts of florid
>manifestos to that effect. But of course when it comes to giving his
>OWN patients adequate pain meds, he knows that every chronic pain
>patient that he treats adds a little to the very real risk that he will
>end up in jail, financially ruined, etc.
>
>When that doctor treats you like a druggie, realize first off that he is
>LYING. And the person that he lies to first and foremost is HIMSELF! He
>is pretending that you are not really in pain because if he admitted
>that you were in pain then he would have to do something about it. And
>if he did something about it, he would be taking big risks. So he lies
>to himself to cover the fact that he is a coward.
>
>Those conventions and summit meetings can prattle on about "patient's
>rights" until the cows come home, but nothing is ever going to change
>unless we can get the DEA and FBI et al to stop throwing doctors in jail
>for treating people who are in pain for more than a few weeks.
>
>At Fri, 19 Apr 2002, Tish wrote:
>>
>>Is this pain patients bill of rights..a rule or a law or something.
>>Can we take these to our Dr?
>>Im so sick of having Drs look at me like i am a DOPE ADDICT!
>>Because i need pain medicine.
>>Thanx Tish
>JOINT COMMISSION ON ACCREDIDATION OF HEALTH
>
>> "Unrelieved pain has profound physiological and psychological consequences
>> that result in significant costs to patients and families, to the health
>> care system, and to society as a whole," according to Yank D. Coble, Jr.,
>> M.D., president-elect, AMA. "Unfortunately, a variety of barriers impede
>> the use of appropriate treatments, causing many patients to suffer
>> needlessly. We have an important opportunity here to provide relief for
>> patients by promoting consistency and quality in the management of pain."
>>
>> "Pain is the most common reason that patients seek medical care, yet we
>> don't always know whether the treatments provided are effectively meeting
>> patient needs. This must change," says Dennis S. O'Leary, M.D., president,
>> JCAHO. "Working together, I am confident that we can make significant
>> strides in addressing this serious public health issue."
>>
>> "One of the major precepts of caring for patients is to always strive to
>> relieve pain and suffering" said Greg Pawlson, M.D., executive vice
>> president, NCQA. "These measures will help us quantify how we're doing in
>> that area, while at the same time driving improvement in the care delivered
>> to a large, diverse patient population."
>>
>> The AMA, JCAHO and NCQA have worked together to coordinate performance
>> measurement development activities since 1998 and earlier this year
>> unveiled Coordinated Performance Measurement for the Management of Adult
>> Diabetes -- a new approach to measuring performance in the delivery of care
>> to diabetes patients.
>>
>> Purdue Pharma, L.P., is providing unrestricted funds to support development
>> of the pain management measure set. Control and responsibility for the
>> design and content of the measure set rest solely with the AMA, JCAHO and
>> NCQA. JCAHO will function as the administrative center for the project.
>>
>> For additional information, please contact:
>>
>> AMA - Robert J. Mills (312-464-5970)
>> JCAHO - Charlene D. Hill (630-792-5175)
>> NCQA - Brian Schilling (202-955-5104)
>>
-- cathy :-)