Patients flood ERs nationwide
Posted on Sunday, July 30, 2006
The problem of chronic pain — one of the biggest financial and time drains on emergency rooms — is worsening as fewer people have health insurance to treat the problems before they become extreme.
Chronic pain affects three times as many people as heart disease and costs the nation as much as obesity, yet some emergency rooms often fail to effectively treat chronic pain.
More than 50 million Americans suffer from chronic pain, costing more than $ 120 billion in reduced productivity, sick time and medical costs, the American Chronic Pain Association and the National Institutes of Health estimate.
As Americans live longer, they’re more likely to suffer from painful, chronic conditions such as arthritis and diabetes.
In some cases, drugs aren’t the best remedy for pain. And in other cases, addiction is the motivation for seeking medication.
At issue, many doctors and patients say, is personal biases in the treatment of patients who complain of severe pain. Those issues become more serious when patients make the emergency room their first resort for managing pain that is best treated in pain clinics and by primary care physicians who have a history and relationship with the patient.
No medical test exists to measure pain levels. While some doctors look for physical cues such as restlessness or an elevated pulse, experts say people with chronic pain often adapt and don’t show symptoms. So doctors are left with nothing but a patient’s word to measure pain.
“ Pain is the No. 1 reason people visit their physicians, yet many physicians don’t receive much training in how to handle pain, ” said Dr. Carmen Green, director of pain research at the University of Michigan.
A number of factors exacerbate the problem in the emergency room: Lack of training on how to handle pain is a major contributor.
Patients who go to the ER for the first line of treatment are often poor and uninsured and not getting regular care.
Many are women and minorities, two groups that many studies indicate often receive less adequate treatment for pain.
In an online survey by the American Chronic Pain Association, 64 percent of patients who visited an emergency room in severe pain were not seen within an hour. About 47 percent of the people who responded defined their visit to the ER as “ poor, ” “ terrible” or “ the worst experience of my life. ”
In another study, in which clinicians at 20 hospitals in the United States and Canada interviewed 842 ER patients after being discharged, about 40 percent of the people who arrived seeking help for pain left in pain.
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