How the pain scale and patient satisfaction leads to death

Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse.  The epicenter of much of this has been my beloved Appalachia.  My home-town, Huntington, WV, might as well be re-named “Oxycontin,” or maybe “Heroinville.”  It’s ugly. Enormous amounts of ink have been spilled on this topic, and I don’t intend to explain the genesis of it in detail.  In short, however, about 20 years ago some doctors thought we weren’t being kind enough in our treatment of pain.  Some articles were published to draw attention to this theory.  We started using the pain scale.  0 = no pain, 10 = the worst pain ever. Around the same time, administrators discovered the customer/patient satisfaction score.  Taken together, physicians and nurses were pressured by 1) academic peers and medical directors as well as 2) administrators, to give more pain medication. So, to recap mathematically: Pain scale x Satisfaction score = Better reimbursement + Death Recently, smart people have discovered that a lot of what we were told to do in clinical practice was probably (to put it delicately) utterly stupid and ultimately deadly.  Having said that, not all of the drug abuse in the country is because doctors gave out too many pills (although pill-mills are obviously a problem). Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Emergency Medicine Hospital-Based Medicine Primary Care Source Type: blogs