I want to address the issue of the lack of education about pain and its treatment among medical professionals. I have encountered that problem in my studies and practice. I believe it to be crucial in combating several issues the healthcare system is facing.
The modern approach to pain treatment developed in the mid-1980s was based on very limited research based on mere 38 cases (Portenoy & Foley, 1986). Since then opioid analgesics became the basis of pain treatment for the majority of patients. That led to the oversimplification of pain treatment which in turn led to misuse of opioids, increase in the number of addicts, and proliferation of infamous “pill mills”. In recent years, the consequences of that oversimplification were addressed, but some of the core issues remain. According to the research by the Bloomberg School of Public Health, the legislation in Florida addressing the issue of analgesics misuse led not only to the decrease in the number of mills but even to the decline in the number of heroin deaths (Bernstein, 2015). This demonstrates the dire consequences of the neglect shown in regards to pain treatment. At the same time, there has been very little discussion concerning the effectiveness of different pain treatment methods and how they may be improved. The medical schools also refuse to acknowledge the importance of pain treatment.
A large number of medical professionals are ignorant about the various aspects and approaches to pain treatment. At the same time, all physicians are faced with chronic pain during their work. This leads to unintentional misuse of opioids since they are still perceived by many as the best treatment for chronic pain. That leads to the possible emergence of addicts and all of the problems mentioned above, plus ineffective treatment for some patients which might be the worst problem of all from the professional perspective. The roots of this issue lie in the educational system. Curricula in most the medical schools do not include any sort of pain treatment course since it is considered less important than other aspects of the education. All of the problems caused by the inadequate pain treatment, however, prove that approach to be wrong.
As a chairman of the Committee on Education and the Workforce, you have the power to resolve this issue. I request you to look into the issue and support making pain treatment courses an obligatory part of the medical school curricula across the country. Currently, several schools successfully run such courses. The method used by Johns Hopkins School of Medicine is recapped in the publication “A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development” (Murinson et al., 2011). That paper can be used as a basis for the implementation of similar courses into curricula of other medical schools.
The issue of underestimating the importance of pain treatment has caused a fair share of problems over the last 30 years. Continuing to do so is sure to cause even more.
References
Bernstein, L. (2015). Florida pill mill crackdown also may have curbed heroin deaths, researchers find. Washington Post. Web.
Murinson, B. B., Nenortas, E., Mayer, R. S., Mezei L, Kozachik, S., Nesbit, S., Haythornthwaite, J. A., Campbell, J. N. (2011). A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development. Pain Medicine 12(2), 186-195.
Portenoy, R. K. & Foley, K. M. (1986). Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain: Clinical Updates 25,171-186.