NeuroTalk Support Groups - Mayday Report (Urgent Medical School and Health System Reform)

NeuroTalk Support Groups (https://www.neurotalk.org/)

- Reflex Sympathetic Dystrophy (RSD and CRPS) (https://www.neurotalk.org/reflex-sympathetic-dystrophy-rsd-and-crps-/)

- - Mayday Report (Urgent Medical School and Health System Reform) (https://www.neurotalk.org/reflex-sympathetic-dystrophy-rsd-and-crps-/107551-mayday-report-urgent-medical-school-health-system-reform.html)

Mayday Report (Urgent Medical School and Health System Reform)

National Panel Sounds Alarm About Lack of Physician Training to Treat Chronic Pain; Major Health Groups Endorse New Report Which Calls for Urgent Medical School and Health System Reform

“Epidemic” of undertreatment affects more than 70 million Americans

The Mayday Fund Special Committee on Pain and the Practice of Medicine writes that chronic pain should be reframed as a chronic illness since “the burden of chronic pain is greater than that of diabetes, heart disease and cancer combined.” People in chronic pain have longer hospital stays, and many duplicative tests and unproven treatments—all of which drive up the nation’s health care spending, the panel said.

http://www.rsds.org/5/news/2009/Nove...ort_5_199.html

“Doctors, who don’t lack for compassion or medical skills, often offer only limited treatments to patients disabled by chronic pain,” said Lonnie Zeltzer, M.D., co-chair of the panel, and the director of the Pediatric Pain Program at the University of California, Los Angeles. “With little or no specific training in pain management, and working in systems that make it much easier to treat common conditions like high blood pressure than a complex problem like pain, doctors may intend to help but leave most patients under-assessed and under-treated. Minorities, children and women often faced the highest risk of under-treatment.”

Quote:

Originally Posted by Sandel (Post 587307)

Hi Sandel, Thank you for the information about lack of training for chronic pain patients. This is something to be concerned about, not just for us,but for all the future children and adults in the future.
At the annual RSDSA meeting, they said there are 50,000 people a year getting RSD. That's a huge amount of people. I'm grateful for a Dr. who understands chronic pain and RSD.
Thank you again so much for all your research posts. They are always so informative. Hope you are having low pain days. Take care, loretta with soft hugs:grouphug:

I think, it's getting better all the time..
I remember back in '83, when I got injured, NOBODY knew anything about pain, and especially RSD! I had many doctors tell me that I was malingering, (But, when I got to Dr S. he knew, since I was successfully self employed, that it wouldn't make sense!), AND, before he testified for me, he tested me, to make sure it wasn't caused by anything else. (And, I won't tell anyone how). He must do that, because he carries such a big gun. But, it took me 7 years to get to him! Only because my chiro, had a patient who had this, and was seeing him too! I got so tired of driving to different doctors with no result, I started to interview them on the phone, sure they could see my records. I used to get up and walk out of doctors office' as soon as I saw that they had no clue. (Why waste the time, and the Ins. Co money?)

Nowadays, we have an internet, doctors know when you say "RSD".
(They may be frightened, but, they know). Moreover, Ins. Co's Know! Because RSD, is So expensive to treat, and, that's all that can be done!
I read this morning, that chronic pain costs more than High Blood pressure, Diabetes, and Cancer combined! Think about it. Those are well controlled, or, the person doesn't survive.
I'm sorry to say, but, either way, it's not an "Open Drain" to the Ins. Co's Money.
They really freak when they hear RSD.

So, maybe things will start to change. When markets emerge, jobs are created to fill the void. We can only hope and pray.

pete

Hi Sandel,

The field of pain management is an ever evolving specialty, still in it's infancy.

That is why it was so important that our Gov here in BC recognized and designated pain as disease in and of itself. With that recognition in place it is much easier for the Pain Centers to get the badly needed funding to expand and yes that that includes education. Also with this designation it will help to attract bright minds to the specialty. But it's not just the specialist that need to be trained as your posting pointed out “With little or no specific training in pain management," "doctors may intend to help but leave most patients under-assessed and under-treated." This applies to all areas of the world.

Here is an interesting article recently published about a pain study in Switzerland. It speaks to the fact universally accepted guidelines are required for all doctors to be able to effectively treat chronic pain patients.

Quote:

October 30, 2009 - 8:59 AM Pain study finds health system chronically ill

Image caption: Does this Swiss doctor know what he is doing? (Keystone)

Findings from a government-sponsored study into how doctors treat chronic pain are in part a condemnation of Switzerland's exploding health costs.
The authors of the study, "Musculoskeletal Heath – Chronic Pain", said that many treatments including surgery were often carried out unnecessarily.

Lead author Andreas Stuck, a geriatrics specialist at Bern University, told swissinfo.ch that the study revealed, for example, surgery for hip, shoulder or knee problems was scheduled 40 times more often in some regions than in others.

"Orthopaedic measures are used when in fact other treatments would have been preferable and the orthopaedic procedure would not have been required. This would have been less costly and perhaps even more effective," Stuck said.

While the authors have no conclusive evidence as to why there are such large differences between Swiss regions, Stuck says the example does highlight the lack of guidelines for physicians to follow when treating patients with chronic ailments.

The five-year study, funded through the National Research Programme, also found that some types of common treatments are ineffective, including electrical stimulation and injections into joints.

On the other hand, some doctors are reluctant to recommend any treatment at all, preferring instead to prescribe painkillers when physiotherapy would in fact deliver results.

Stuck says he hopes the study will lead to universally accepted guidelines since the conclusions "demonstrate that more clarity is needed on what kind of treatment and diagnostic procedure is offered, and at what point".

The comprehensive chronic pain study includes more than two dozen investigations into various aspects of musculoskeletal ailments, how they are treated and the long term impact. The results of three of the projects were presented at a news conference in Bern on Thursday.

« More clarity is needed on what kind of treatment and diagnostic procedure is offered, and at what point. »

Andreas Stuck, lead author Chronic costs
The confusion that reigns on the chronic pain front has major implications for Switzerland's health care system – one of the most expensive worldwide - and the government's efforts to control costs.

It is estimated that people suffering from musculoskeletal ailments cost Swiss taxpayers up to SFr14 billion ($13.69 billion) a year or 3.2 per cent of Gross Domestic Product.

Almost a third of all consultations with physicians are due to such complaints. And employers lose SFr4.3 billion a year through sick days taken by staff suffering from back pain.

Research into different ways of treating back pain found that patients who received physiotherapy took fewer sick days over a three-year period and cost the system around SFr10,000 less than those who were only prescribed painkillers.

Pro-active therapy
"In the case of back pain, there needs to be a more pro-active, function-centred, early rehabilitation therapy," Stuck says.

"This has been well known for several years, but it has not found its way into doctors' practices. In some cases the primary care physician has recommended that patients should not move too much, and not to return to work too early, when in fact, they should do the opposite."

The main findings of the chronic pain study are sobering. The authors concluded that a health care system spending approximately SFr4,000 a year per capita lacks an effective early diagnosis system and does too little in the area of prevention.

Employers are given their share of the blame for reacting too late to staff members suffering from chronic back pain. And patients need to take more personal responsibility for dealing with their ailments, added the experts.

Dale Bechtel, swissinfo.ch

I often wonder if my orthopedic surgeon had put me in orthotics first instead of operating what my life would be like now. He lied in court documents stating that I had already been using orthotics. NOT! But I digress.

Good interesting topic. Thanks.

MsL