{"id":1183,"date":"2020-02-19T00:24:51","date_gmt":"2020-02-19T07:24:51","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=1183"},"modified":"2020-02-19T00:24:51","modified_gmt":"2020-02-19T07:24:51","slug":"chronic-pain","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=1183","title":{"rendered":"Chronic Pain"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

Most of us live with chronic pain. For some, it can be\ncrippling. <\/p>\n\n\n\n

As a young doctor, I quickly came to realize it was a\ndifficult condition to manage. Whether it was headaches, back pain,\nfibromyalgia, pelvic pain or joints, the suffering could disrupt people\u2019s\nlives, lay them low. It could be depressing, isolating, ruining.<\/p>\n\n\n\n

When the pharmaceutical industry started claiming to doctors\nin the 1990\u2019s such pain could be \u201ccured\u201d with their new formulation of\ntimed-release narcotics, I understood the temptation to treat these conditions\nwith such. But our past twenty years of opioid over-prescribing and subsequent\nsky rocketing accidental overdose deaths should have taught us that easy cures,\nthough tempting, can be fatal. That didn\u2019t satisfy my oath to do no harm.<\/p>\n\n\n\n

I did my best to study the research. I attended conferences\nand listened to experts. But more, I listened to the patients. <\/p>\n\n\n\n

I went into medicine thinking my job was to fix what ails\nthe patient, when possible. I remember in residency; our patient interactions\nwould be viewed by a behavioral health specialist who would give us feedback.\nToni, the specialist watched me once and commented, \u201cYou need to be careful.\nYou want to fix patients.\u201d<\/p>\n\n\n\n

I was struck dumb. \u201cThat\u2019s my job!\u201d I countered.<\/p>\n\n\n\n

\u201cNo, it isn\u2019t.\u201d She replied firmly. I pondered that one for\na long time.<\/p>\n\n\n\n

 It was a hard lesson\nfor me to learn that many ailments aren\u2019t fixed, but managed. When a cure isn\u2019t\navailable, the focus has to move to maximizing function. That adjustment can be\nhard to accept. It often was for me.<\/p>\n\n\n\n

But I worked at learning. I thought that was my job, as a\nprimary care physician, to care for the patient. So, I am troubled now when I\nsee so many patients with chronic pain sent away from their primary care\nproviders to pain specialists. I think some of this is a reaction by my\ncolleagues to our years of excessive prescribing. Doctors got on the opioid\nbandwagon too easily. So now some won\u2019t even take a short ride. I see signs up\nat the receptionist: \u201cWe do not treat chronic pain\u201d. This too, is I believe, a\nmistake. Patients need our care.<\/p>\n\n\n\n

Don\u2019t get me wrong, pain management specialists are\nvaluable. I have made such referrals. They have much greater depth of\nexperience than I do in their fields. But most primary care providers can\nmanage most chronic pain patients. <\/p>\n\n\n\n

In rural Idaho, chronic pain is common and specialists are\nfar apart. We need to help our primary care providers serve their communities.\nAnd we are.<\/p>\n\n\n\n

I get a quarterly report from the Board of Pharmacy on my patterns\nof prescribing controlled substances. It lists the number of prescriptions, the\ndaily dose and comparisons to my colleagues. This is helpful.<\/p>\n\n\n\n

If I have concerns that a patient might be \u201cdoctor shopping\u201d\nfor controlled substances I can access a data base that lists all\nprescriptions, sorted by prescriber and patient. It even links to most\nsurrounding states. This is a great resource.<\/p>\n\n\n\n

But one of the best tools has been developed by the Idaho\nWWAMI program, the medical school affiliated with the University of Washington\nSchool of Medicine. It is Project ECHO. Twice a month any provider can log in\nto an hour-long conference with specialists. Colleagues from around the state\nwill be on the screen. After a short presentation there is time for questions,\ncase presentations and discussion. Management of these challenging conditions\nis supported. <\/p>\n\n\n\n

Currently, the Idaho legislature is considering whether it\nshould support this program with taxpayer dollars. It would be a worthwhile\ninvestment. I wish it had been available when I was starting out. <\/p>\n","protected":false},"excerpt":{"rendered":"

Most of us live with chronic pain. For some, it can be crippling. As a young doctor, I quickly came to realize it was a difficult condition to manage. Whether it was headaches, back pain, fibromyalgia, pelvic pain or joints, … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1183"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1183"}],"version-history":[{"count":1,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1183\/revisions"}],"predecessor-version":[{"id":1185,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1183\/revisions\/1185"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}