Become Your Own Advocate

By | March 2, 2011

It is as bad to be “Chicken Little” as to be “Pollyanna”. You and your doctor must honestly appraise what is known and what is unknown or uncertain. Then you must become your own best advocate. There is always something else that can be done. It may be experimental. It may be dangerous. But someplace in the world somebody is working on your problem and if you never go for the consultation you will never be able to decide whether alternative or experimental therapy is for you!

While the current issue of TIME magazine contains a wealth of useful information, there are a few points I disagree with. One such point is a quote from an interview with Dr. Michel Dubois of NYU that appears at the bottom of page 74. He states, “We don’t know much more about pain than we did 200 years ago.” This is obviously hyperbole to emphasize the tremendous amount, which remains unknown or uncertain. It does, however, unfairly minimize the tremendous amount we have learned.

You may think I am splitting hairs, but I have always felt that it is as bad to be “Chicken Little” as to be “Pollyanna”. I would agree with Dr. Dubois in the sentiment that the average physician does not know much more about pain than he did 200 years ago, but this is more of a problem with medical education than medical research. In general, workers in the field of pain have had a difficult time translating basic research into clinical therapies. Furthermore, it is difficult to disseminate information about modern pain therapies past the realm of specialists into the offices of primary care physicians. The reasons for this are legion and include the subjective nature of pain, the relative rarity of many of the individual conditions and the lack of qualified specialists who are capable of delivering some of the more complex therapies.

What needs to change is the perception of chronic pain as a symptom. Once the general medical community recognizes chronic pain as a separate disease entity or a group of related disease, chronic pain will begin to be treated in the same way as heart disease or neurological illnesses. The simple cases will be treated by primary care physicians and patients with complex problems or who have failed standard therapy will be referred to specialists. Again, following the model of other diseases, patients need to become advocates for their own care. Do not accept statements such as “Nothing can be done.” Ask for a referral to a specialist and if necessary get a second opinion.


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