Critics call for changes in Joint Commission pain standards and hospital patient surveys

To help stop a nationwide opioid epidemic, critics today called for changes to The Joint Commission's pain management standards and to the federal government's patient surveys used in hospitals.

Both foster dangerous prescribing practices by physicians, according to dozens of healthcare organizations, medical experts and consumer advocacy groups. The groups sent letters to The Joint Commission and to the Centers for Medicare & Medicaid Services (CMS) on Wednesday calling for those changes, according to the Associated Press.

Given the opioid crisis, the groups say it's time to revisit the accreditor's pain management standards and change the surveys that ask patients to rate hospitals based in part on questions about how their pain was treated.

"The over-prescription of opioid painkillers is one of the root causes of the epidemic that is killing 30,000 of our fellow Americans every year," said Gary Mendell, founder and CEO of Shatterproof, a national organization fighting addiction, in a statement emailed to press. In the last 15 years, the number of opioids prescribed has quadrupled, while at the same time the number of overdose deaths has quintupled, according to Mendell, who signed the letters, along with senior health officials from several states and leaders of professional organizations that include the American Society of Addiction Medicine.

The critics say the current system encourages physicians to overprescribe addictive drugs to treat patients' pain. The Joint Commission standards require healthcare organizations to routinely ask all patients to assess their pain and have led to aggressive pain management, critics say. The letter to CMS calls for removal of pain questions from the agency's patient satisfaction survey, known as Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS, which is used to determine hospital reimbursement rates. A bipartisan group of senators has also introduced legislation to eliminate the connection between the survey questions and Medicare reimbursement.

Physicians are bearing much of the blame for fueling the opioid epidemic with one poll finding that one-third of Americans say doctors are mainly responsible the abuse of prescription painkillers. However, many physicians say it is unfair to blame them when for years they were encouraged to treat patients so that they were pain free.

Physicians are caught in the middle when it comes to treating patients' pain and now complying with new Centers for Disease Control and Prevention guidelines issued last month advising them to prescribe treatments other than opioids for chronic pain outside of active cancer treatment, palliative care and end-of-life care.

To learn more:

To learn more:
- read an Associated Press article
- find a copy of the letter to CMS (,pdf)
- check out a copy of the letter to The Joint Commisson (.pdf)
- read the proposed legislation