Published by Family Practice News
Discomfort treating chronic pain, inadequate empathy for pain complaints, and failure to set appropriate boundaries for scheduled pain medications are among the key obstacles to effective chronic pain management by primary care physicians, according to two experts.
For those with doubts about their abilities or the validity of pain complaints, “how you feel about treating chronic pain is going to be perceived by the patient,” cautioned Louis Kuritzky, MD, clinical assistant professor, University of Florida, Gainesville. “The mindset of the clinician is important.”
When clinicians consider chronic pain patients difficult or burdensome, patients can develop a sense of stigmatization without anything explicit being expressed by the treating physician, Dr. Kuritzky said. This can be self-defeating. The clinician-patient relationship and the chance of successful therapy are in trouble before either gets started.
Primary care physicians – not chronic pain specialists – provide most of the care for chronic pain, according to several experts at the meeting, held by the American Pain Society and Global Medical Academy. Yet, chronic pain management receives limited attention in family medicine or internal medicine training. According to one survey cited at the meeting, the majority of primary care physicians report that they are uncomfortable treating these complaints.