Chronic pain management has been in the healthcare industry spotlight in the midst of the ongoing opioid crisis, and one expert argues that the best solution may not include treating patients' pain at all.
Providers need to take a patient-centered approach to pain care, Mark D. Sullivan, M.D., Ph.D., co-director of behavioral health services at the University of Washington Center for Pain Relief, writes in a blog post for NEJM Catalyst. And to make chronic pain management more patient-centered, clinicians must let go of the idea that patient-centered care caters solely to the whims of the patient.
Patient requests and expectations may not necessarily conform with what’s best for them, Sullivan writes. This can be a difficult balance for physicians to strike with patients who are in pain and who may want more painkillers despite the risks.
“Simply because a patient prefers an increase in his opioid dose to reduce his pain level does not make this the right treatment choice,” Sullivan writes. “It is surely a good thing to reduce pain, but it is neither the only good thing nor the most important thing, even if patients desire it.”
Instead, Sullivan writes, providers should learn more about patients’ lifestyles and encourage patients to take more of an active role in maintaining their own health. When a doctor knows what the patient’s personal goals are, then he or she can do a better job of determining what care options fit best, even if that means the pain goes untreated.
Pain management approaches have been under the microscope in the wake of the opioid addiction crisis, with some calling for a new look at the “culture of pain management.” Sullivan’s proposal may be a tough sell for some providers, as patient satisfaction scores can take a major hit if docs start to ease off on pain management.
A multidisciplinary approach to pain has also been touted, as FierceHealthcare has previously reported. Some providers are also calling on payers to cover alternative pain management approaches as they’re increasingly pressured to try them.