Susan Kubicka-Welander, a short-order cook, went to her pain checkup appointment straight from the lunch-rush shift. “We were really busy,” she told Dr. Robert L. Wergin, trying to smile through deeply etched lines of exhaustion. “Thursdays, it’s Philly cheesesteaks.”
Her back ached from a compression fracture; a shattered elbow was still mending; her left-hip sciatica was screaming louder than usual. She takes a lot of medication for chronic pain, but today it was just not enough.
Yet rather than increasing her dose, Dr. Wergin was tapering her down. “Susan, we’ve got to get you to five pills a day,” he said gently.
She winced.
The problem is at some point the pain killers become ineffective in combating the pain and the user becomes addicted. So when our initial response is “where is this doctor’s compassion”, the truth is he/she is being more compassionate in denying the drugs. In my job, I see what opiates do to people everyday. And sadly, it is compounded by HHS which now takes patients’ satisfaction ratings in to account for Medicare/Medicaid reimbursements. An addicted patient will give a bad rating to any doc who denies opiates, this incentivising bad practice.
David Keller,
I’d really like to know how you propose to deal with the very real and severe pain I experience every day from diagnosed disc problems (multiple MRI’s show the detailed damage) at L3-L4, L4-L5, and L5-S1.
I now have to go in to the doctor’s office once a month to obtain my very much needed prescription; each office visit costs me nearly $200, and medication is, of course, over and above that. The pharmacy treats me like a drug dealer, making it a major hassle to get my prescription filled, and embarrassing me for having the temerity to want to try and live with a reduced level of pain.
You say that denying me medication is compassionate. What alternative do you offer? Are you saying that my back pain is actually a figment of my imagination, which can be dealt with by placebos? Would you suggest that the same approach be taken with diabetics – hold back that insulin, they’ll be better for it?
Why not just sign me up for euthanasia; it would be so much easier to kill me off than trying to make my life bearable…