| One-Minute Clinician

The Current Healthcare Environment

What scares me is our pendulum of pain management was all the way in one direction, pushing for aggressive pain management, taking that pain score without any kind of other understanding about tolerability or functionality and now we’re a little hysterical. And this pendulum has swung the other way where we have patients who were successfully managed on chronic daily opioids being orphaned, because their docs are too afraid to give them opioids. We have a whole pool of patients who are managed just fine in taking daily opiates, and now get told, “I’m sorry, I can’t give them to you anymore.” And they’re orphaned. They come into the emergency department and they said ‘I’ve been taking this for five years and now my doctor won’t give it to me anymore. I’m actually withdrawing.’ The lack of education and the hysteria that comes sometimes with these crisis is really detrimental to our patients. We’re in this house of medicine really for our patients. The lack of education is a big problem. We do not get reimbursed to sit down and spend 15 minutes talking to a patient about pain or their medication. We get reimbursed really globally as physicians for how many patients we’re seeing. But the quality is more important than the quantity, and our healthcare system reimbursement paradigm right now does not put an emphasis on education. If we could just spend more time educating patients and finding out what they really need from the healthcare provider, we will be able to provide quality care, prevent emergency department visits, prevent potential falls, and prevent chronic diseases. It’s troublesome that we’re not empowered by administration or healthcare nationally. It’s really sit and talk to people, and there’s no focus on prevention. There’s a lot of focus on disease.