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Patient Pain Gets More Attention.


WebMD Health News

Jan. 12, 2001 (Washington) -- Pain. It is one of the most common reasons patients seek medical care, yet studies show it is widely undertreated in this country.

The reasons vary. There are, for example, negative connotations associated with strong painkillers: Both patients and doctors may mistakenly fear that taking painkillers, like morphine and other opiates, to control pain will result in addiction.

But as of Jan. 1, the Joint Commission on the Accreditation of Healthcare Organizations is scoring hospitals and other healthcare entities on how well they assess and treat pain in all patients. An independent, not-for-profit organization, the Joint Commission sets healthcare standards for about 80% of the nation's hospitals and accredits the hospitals based on how well they follow those standards.

"The [new pain] standards are necessary because pain is a major public health issue in this country," Janet McIntyre, spokeswoman for the commission, tells WebMD.

For some patients, the new standards don't come a minute too soon. Susan Wolf, 42, a North Carolina resident who suffers from rheumatoid arthritis, tells WebMD that the standards "show how far we've come in the last five years."

Wolf recalls a 1996 knee replacement operation: "I woke up from surgery in agony. The doctors refused to help. I'll never forget -- there were men in white coats with their arms crossed looking down at me saying, 'We cannot do anything else. We're not allowed to give you more than x amount of drugs per hour.' I was lying there crying and in horrible pain. I ended up staying in the hospital longer than the doctor had initially said I would. And my recovery took a lot longer and was more difficult."

The medical world is, indeed, realizing the value of pain care. According to Leeann Rhodes, MD, medical director of pain management at Washington Hospital Center, "If you have a patient's pain under control, they are going to get up and [recover] better, they're going to be able to eat better, and their whole quality of life is better. If they have physical therapy, they will be more compliant."

How do the standards work? The commission is giving hospitals flexibility on the specifics, but according to McIntyre, pain has to be treated as a co-existing condition. "If you have breast cancer, you not only have to be treated for your breast cancer, but for any pain that might be associated with that cancer," she says. "The whole idea is recognizing that pain management is a crucial component of quality care."

Paul Schyve, MD, the Joint Commission's senior vice president, tells WebMD, "All patients should be asked if they have pain. If they do have pain, then there should be some sort of an instrument used to judge the severity of the pain, which can be used over time to see if the pain changes."

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