Managing Pain

By Author: Steven Johnson
Total Articles: 494
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As we emerge from the recession, we find the nation in crisis. Think of the bursting of the housing bubble and the loss of credit as like a wound. Now the nation has to endure the pain of unemployment with more people living in poverty in 2010 than at any other time since we began keeping records. To give you an idea of just how bad the situation is, a recent survey of the hundred most prosperous city areas by the Brookings Institute found only 16 have managed to replace more than half the jobs lost during the recession itself. That means increasing financial pressures to pay unemployment benefits at a time when tax revenues are low. Except, ask yourself whether just paying unemployment benefit is a sufficient treatment. If your body had just received a wound, would you think it sufficient if the only treatment was sewing you back together and leaving you to get better? No! You would expect there to be follow-up treatment through physical therapy to help rebuild muscles and improve mobility. If there was continuing pain, you would expect experts to help you find better ways to live your life with less discomfort. This might ...
... involve redesigning your home, changing the way you work, offering you various drugs to keep the pain under control, and so on.

When you move beyond the original cause but still have consequences flowing from it, you hope and expect there will be an expert in consequences. Just talking to the surgeon who sewed you up is not really the right person to be talking to. That's why we're all frustrated with Washington right now because none of the politicians can agree how to treat the pain. The result? There's no treatment for the pain as they fight among themselves about whether FEMA should have money to deal with emergencies like hurricanes and other minor issues.

Hospitals in America are for profit and whichever doctor sees you first wants to keep you as a patient because you and your health plan represent a source of profit. If one doctor hands you on to another doctor, the profit moves to the second doctor. So the first in time has a direct financial incentive to keep you as a patient even though that first doctor may not be an expert in your later problems. In countries with a socialized healthcare service and everyone on a fixed salary, there's no hesitation in one doctor passing a patient on to a better qualified doctor. Neither wins or loses by the transfer. They get paid the same regardless. But you benefit as a patient because you are always passed on to a person with a better chances of helping solve your problems. In Europe, for example, every major hospital has a department specializing in pain management. In America, only a handful of doctors claim any specialized knowledge in pain management. The average doctor hears your complaint of pain and writes out a prescription for Ultram. If you complain again at the next consult, you get a bigger dosage. If you're still complaining the third time around, the doctor assumes Ultram is not strong enough and writes a prescription for one of the opiates. That increases the risk of addiction.