Maybe ignored/neglected pain does http://tiny.cc/Noqpj

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Nonsense. The woman presented with severe symptoms as well as reported severe pain and was slandered as a drug-seeker rather than given a proper medical assessment and treatment.

The medical error studies were discredited long ago. Obviously it’s not zero, but it’s not the astronomical number in the studies.

They were criticized, not “discredited.” Stop making stuff up. There is every reason to believe they are underestimates as they did not include all medical errors and they did not report on errors outside of hospitals.

And pain, whether you like it or not, is a symptom. It is not a vital sign.

Pain behavior is not a symptom, it is an observable sign. Other vital signs may also be elevated where severe pain is present. That pain is a symptom and not a sign may seem logical at first glance, but a little thought quickly dispells that notion. If pain has no objetive signs, how do doctors assess pain in infants or people with dementia? How do anesthesiologists assess pain in people who are under anesthesia? How do veterinarians assess pain in animals?

It is interesting how fast the “pain isn’t a vital sign” people are to jump on a lack of pain behavior or elevated vital signs as evidence that a person reporting severe pain is either faking or exaggerating their pain. Patients may or may not show physiological or behavioral markers of pain and people with chronic pain often have learned to suppress pain behaviors and do not show eleveated vital signs as they have gotten used to being in pain. Other people may have their blood pressure go through the roof while they scream in agony. So pain may be purely subjective, partly objective/subjective, or objective, depending on the observer and patient in question. To dismiss such a potent defense mechanism like pain as a “symptom” is shortsighted.

But if it makes you feel better to call it “Pain: the Fifth Vital Symptom” then go for it. The real problem is you just don’t want to be forced to assess and treat pain.

One gets tired of arguing with people who have absolutely no knowledge of the subject.

One also gets tired of arguing with people who lack the critical thinking skills or intellectual honesty to question the rice-bowl protection propaganda and absurdist medical folklore they swear by even when human life and human suffering are at stake.

I admit I didn’t read the whole study, but I have previously read parts of it and I just re-read the Executive Summary. I didn’t see where it said anything like this and perhaps you are listing a critic’s assessment of the report rather than something that was in the report itself? Could you show me the part you are referring to? The report is available in full for free at:

http://www.nap.edu/catalog.php?record_id=9728#toc

There are many good reasons for believing the report may be an underestimate:

1. It is based on physician self-reports of medical errors that were entered in the charts. Numerous studies have demonstrated the obvious: that physicians and nurses are loathe to indict themselves by reporting medical errors in the chart thus the actual number of medical errors is likely far greater than this report cited.

2. It fails to take into account people who were injured in a medical setting but later died of those injuries outside the medical setting.

3. Fails to account for all types of medical errors leading to death. For example, the CDC estimated in 2007 that there are over 98,000 deaths a year from hospital infections alone, yet according to a Consumers Union report the IOM report scarcely mentions hospital infections.

http://www.consumersunion.org/pub/core_health_care/011324.html

The simple fact is serious medical errors (not just adverse events such as a mild/moderate drug reaction) are required to be reported. I am not saying everyone is, I am saying that is the professional expectation, and those that don’t are playing with fire.

Some 24 states as of now do not have medical error reporting requirements, and of those that do, they are hardly enforced aggressively and hospitals do have a very strong incentive to fudge the numbers. It may be a “professional expectation” just like taking chronic pain seriously is supposed to be, but the reality is far from what’s expected.

I know you have an axe to grind payne, but as you expect MD’s not to paint chronic pain patients with one brush (which I totally agree with) maybe you should try the same thing with us.

Since you “know” that I have an axe to grind, you can no doubt explain what that my particular agenda is as well as point to examples of my making overgeneralizations about your profession.

I’ve seen Dr. Berwick use the figure one million frequently. I’ve never seen the figure 15 million; do you have a reference?

Thanks

Never felt I had to defend anything to the likes of you, definitely not to payne.

We don’t have facts in this case, doesn’t stop people from opening their mouths.

The medical error studies were discredited long ago. Obviously it’s not zero, but it’s not the astronomical number in the studies.

And pain, whether you like it or not, is a symptom. It is not a vital sign. One gets tired of arguing with people who have absolutely no knowledge of the subject.