Comments on: http://www.kevinmd.com/blog/2005/03/doctors-are-much-more-likely-these.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2005/03/doctors-are-much-more-likely-these.html/comment-page-1#comment-52235 Anonymous Mon, 07 Mar 2005 04:59:00 +0000 http://clients.emmense.com/kevinmd/2005/03/17969.html#comment-52235 Suits like this are a terrible idea, plain and simple. Not that that will prevent the most ghoulish of tort lawyers from trying their luck. Pain 7 out of 10. I have seen complaints like this in patients with wide ranges of disorders, which is to say, "numerical" pain scales are highly subjective. Not everyone rates pain well; some rate all pain at 9-10, however improbable; others are incredibly stoical. So circled numbers on a pain assessment chart are now to be considered "data". What do the smiley-face or cranky-face get?<br /><br />Not to trivialize pain, especially the compassionate use of analgesics in end-of-life care, but there are<br />limits to what can be done with opioids without suppressing respiration and hastening death (assuming that pain relief without hastening death is the purpose). Sometimes the safe limits of analgesics fall short of pain relief. I have seen this, and it is distressing all-around, including for the physician. How will suing doctors who try but fail to reach some idealized, and perhaps impossible<br />plane of pain management help patients in the future? Will this suit make doctors want to treat these patients all the more? (Remember, the DEA and watchful state regulators aren't laying down for this). I think it will do the opposite; suits like this will only spur even more defensive practices at times when patients need their doctors most. Suits like this are a terrible idea, plain and simple. Not that that will prevent the most ghoulish of tort lawyers from trying their luck. Pain 7 out of 10. I have seen complaints like this in patients with wide ranges of disorders, which is to say, “numerical” pain scales are highly subjective. Not everyone rates pain well; some rate all pain at 9-10, however improbable; others are incredibly stoical. So circled numbers on a pain assessment chart are now to be considered “data”. What do the smiley-face or cranky-face get?

Not to trivialize pain, especially the compassionate use of analgesics in end-of-life care, but there are
limits to what can be done with opioids without suppressing respiration and hastening death (assuming that pain relief without hastening death is the purpose). Sometimes the safe limits of analgesics fall short of pain relief. I have seen this, and it is distressing all-around, including for the physician. How will suing doctors who try but fail to reach some idealized, and perhaps impossible
plane of pain management help patients in the future? Will this suit make doctors want to treat these patients all the more? (Remember, the DEA and watchful state regulators aren’t laying down for this). I think it will do the opposite; suits like this will only spur even more defensive practices at times when patients need their doctors most.

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