Want to be sick ? Take a close look into how we treat patients who live with chronic pain. But beware if you do this you will be nauseated by the treatment that is allowed under this branch of medicine. The normal practice of medicine is to help the patient. The doctors treat the patients symptoms with known treatments and the patient gets better in most cases. In some cases to the patient does not recover. That is a really dumbed down description of our health care system.
That is not how pain management works. Before any treatment. Before a patient even sees a doctor the patient is assumed to be an addict who wants to get high. Wait what was that ? Let me say it again. Before a patient even sees a doctor they are assumed to be an addict looking to get high. The patient is forced to prove they are not an addict. They are forced to fill out an insulting questionnaire. They are forced to piss into a cup to be tested to see if they are taking their medications and to make sure they are not using any other illegal narcotics. They put up with random pill counts and other humiliations in the name of proving they are not addicts just to get treatment. This isn't a one off either. It is ongoing. It is repeated time and time again to keep proving they are not selling their pills, to keep proving they are not taking illegal drugs. What a freaking crock of bull excrement.
Nowhere else is this the "Normal" treatment of patients. this is in desperate need of change. We need a complete revamp of pain management regulations and practices. We need a Pain Patients Bill of Rights We need a single national governing body for pain doctors that can certify them as having the additional education and are up on the best practices for treating pain patients and can certify them every five years. Currently there are multiple different organizations that will certify a doctor as being able to treat pain patients but most states do not even require a doctor to have this certification. There is no national requirement to be certified to practice pain medicine. A doctor with no more than the 9 to 10 hours of education on pain that is part of medical school can set up a pain management clinic. This is a field that needs more than just the normal med school education. The sources of chronic pain are so diverse and multifaceted that it is a joke to expect a doctor with no additional education to be able to effectively treat it.
For more on this jump below the orange snow doodle.
Besides a new national governing body there is much more needed. The whole view of pain patients needs to change. Yes addiction is a possibility. A small possibility. Most patients in chronic pain will never become addicts. This is because opioids work differently on people in pain. We do not get high from the medication. There is no cloud nine or euphoric high for us. Instead the medication lowers our pain level. Doctors have to walk a line between turning the patient into a zombie and controlling their pain. However there is no one set of guidelines that will guide a doctor on dosages. The dose that leaves Jane flat on her back and unable to function may not even bring down Jack's pain to a livable level. So treating every single patient as if they are an addict and forcing them to repeatedly prove they are not needs to change. If the doctor has a reasonable suspicion of addiction then they may institute further measures to ascertain their belief. However if a patient is found to have become an addict they should be referred to an addiction treatment and counseling center. Not just tossed out into the cold. That is just about malpractice. Allowing a patient to become an addict and then not helping them try to recover is insanity and inhumane treatment.
Another fun aspect of PM clinics is the tendency to push certain treatments such as shots. When a patient says "No" they are coerced into saying yes by the threat of dismissing the patient from the clinic. Now Not all of them do this but a large portion f them do. This is because these shots bring in much more money than just a regular office visit does from the insurance company. This needs to end immediately. If a patient says "No"to a treatment they should not be dismissed from the clinic. Forcing unwanted and often unneeded medical procedures upon patients is the definition of malpractice.
I mentioned a Pain Patients Bill of Rights. above. There are many online from different sources. Some are okay and some are just garbage. A fellow Kossac has written a pretty detailed and comprehensive one. Neuroptimalian has done a very good job on this. This is a pretty comprehensive effort to change the outlook of PM clinics. I will include it below but what we need is help. I know there is a lot of different people here on DK and some may be able or willing to lend their expertise to our efforts. We need a hand to get this off the ground and try and get it started. If you are willing and can help let us know. Every movement starts small and I am hoping we can grow and find the help we need to get this out and start trying to change our lives. Please either leave your willingness to help in the comments or if you wish to help anonymously send me a Kosmail. I understand sometimes you can't take a public stand but we can use help behind the scenes as well. So this is a plea for help. If you can let us know in the comments or by Kosmail. If you can't spread the message as far as you can. It s time we took a stand and fought back. Share and rec as much as possible please. This is for a great cause that is trying to get off the ground.
These rights are not in final order. Nor are they written in stone Nor are they the only ones we will want. We welcome all suggestions as to their doability wording etc.
I have numbered them in the order presented so as to help when commenting you can just use the number.
Below is the Pain Patients Bill of Rights as written by Neuroptimalian:
PAIN PATIENTS' BILL OF RIGHTS
In order to provide suitable care to all pain patients and avoid incurring significant fines or penalties, all pain prescription providers:
1) Absent clear, documented evidence to the contrary, must work from the assumption that new patients are not addicts or drug-seeking individuals and treat them accordingly (innocent until proven guilty or showing clear, articulable signs of being problematic);
2) Must provide every patient who asks with a copy of the actual applicable laws and guidelines (federal, state & local) which concern pain prescriptions;
3) Must not subject patients to more strict office/practice policies than those required by the actual applicable laws;
4) Must provide 100% pain relief, substituting another treatment if claiming a patient's current treatment is detrimental; such treatment must continue to be provided in perpetuity unless another provider is willing to assume treatment and patient agrees to the change in provider; patient shall not be obligated to identify the new provider, the responsibility for finding a new provider shall be the onus of the original provider;
5) Must, upon request, provide all departing patients with a referral to another provider situated nearby that is willing to take the patient and that the patient is willing to transfer to;
6) Must, upon request, provide patients and new providers with patients' complete medical records within 15 days;
7) Must let patient determine the form of treatment they desire; i.e., if patient rejects injections or surgery, patients must be provided with prescriptions for pain pills or pain patches, they cannot be compelled to experiment with other procedures if they don't want them;
8) After a patient's honesty and trustworthiness is established, an entry confirming same must be prominently posted in their file and, without new, documented cause, their treatment may not be reduced;
9) Patients experiencing pain must be treated with the highest priority of all presenting patients, second only to patients facing imminent death;
10) Patients under suspicion for being abusers shall be evaluated, using tools which include a written questionnaire, blood tests, hair analysis and psychological evaluation; patients passing blood tests shall not be denied pain relief medicine in the short term;
11) Patients deemed to be addicts yet who have proven medical conditions that are known to cause pain shall be referred to a reasonably priced treatment facility;
12) Medical providers who refuse to provide relief to pain patients shall lose their licenses to practice medicine;
13) Doctors must provide free services for one unemployed/destitute pain patient for every ten insured/self-pay patients;
14) Doctors must individually document the length of time a patient reports that a pain medication is effective, as well as the length of time it takes for relief to begin after a dose is taken. In the event an average of patient reports differs from pharmaceutical manufacturers' representations, the patient average shall be taken to be the actual truth and the patient shall be prescribed sufficient medication accordingly.
15) Doctors shall provide waivers to patients upon request which relieves doctors and their practices from all liability as to the consequences of any particular course of treatment which a patient desires which differs from a doctor's recommendation.
16) After their first year of treatment, patients shall not be subjected to drug analysis tests, pill counting or other attempts to expose abuse without significant cause. Further, patients shall not be tested for marijuana usage, and if the same is detected anyway, the usage of marijuana shall not be used to determine a patient's fitness to begin or continue taking a prescription pain medication.
17) Doctors will provide patients with an additional prescription for a 30-day reserve supply of pain medication for usage during the inevitable occasions when medicine is unavailable, i.e., when pharmacies are out of stock, when mailed prescriptions are late, when patients are between doctors, etc. If a patient is required to use medications from the reserve supply, a prescription to replace the used doses will be provided upon request and presentation of documentation of need.
18) Patients shall not be prevented from, nor punished for, obtaining prescription refills from any legal provider anywhere in the world, either personally or via Internet sales. All Internet pharmacies will be assumed to be "legal" unless their entities' names appear in a database to be compiled by the federal government and made available for public inspection and usage via an Internet website.
19) All federal and state laws which specifically govern doctors' treatment of pain patients shall be provided via an Internet website which patients may access. Said laws shall be provided in summary form with links to the full underlying laws, shall be succinctly written in plain, layman's English;
20) Each state shall provide a service consisting of pain patient advocates who shall operate on behalf of pain patients. Advocates shall be free of all conflicts of interest with respect to medical facilities, pharmaceutical manufacturers and state and federal legislatures;
21) No patient shall be released from a practice's patient roster unless abuse can be shown that is severe enough to warrant mandatory rehabilitation services or criminal prosecution;
22) A doctor's failure to adhere to the above shall result in the following fines and/or other consequences. All fines shall be paid within 30 days and evenly split between patient and governmental authority. Fines/consequences are to be counted against each doctor/practice, not each individual patient:
On the first offense, a fine of $500;
On the second offense, a fine of $1,000;
On the third offense, a fine of $10,000 and a term of at least one year in jail;
9:10 AM PT: I realize this is not a final document. This is the birth process. The baby has a ton of room for growth. Please feel free to tell us exactly what you like ( if you like any of it) What you hate and why.
Tell us what you would change and how. Feel free to rewrite any of these you do not like. in the comments or by Kosmail to me. You will not hurt our feelings. We want your help.