As the Baha Men so nicely phrased it in their 2000 hit single, I can’t help but wonder Who let the dogs out?
Look out Upton Sinclair – muckrakers like you have nothing on the likes of John Fauber of the Milwaukee Wisconsin Journal Sentinel in his “Watchdog” article entitled Chronic pain statistic called exaggerated, misleading. He and his media colleagues, those watchdogs of the public good, have already brought down multiple notorious underminers of the American way of life – scum of the earth – pain professionals and patient advocacy groups. But for journalists like John Fauber, recall that even Upton Sinclair knew that “It is difficult to get a man to understand something when his job depends on not understanding it”.
How is it that we have come to take for granted that destroying people’s reputations is honorable work these days but working as a consultant with the pharmaceutical industry is tantamount to selling one’s soul to the devil? Now, the pharmaceutical industry doesn’t do itself any favors with the constant commercial barrage, and especially direct to consumer adds, that makes them look like snake oil salesmen for indications and diseases that sometimes are made up to fit a treatment. But I am sure that given that everyone gets 8 minutes with their doctors that some priming of the pump has, in their view, become a necessary evil to facilitate dialogue between patient and provider. But by and large, the American pharmaceutical industry should be something Americans take pride in. They innovate, and through research discover new and effective, often life-saving therapies for all sorts of medical disorders. They put newer and better tools in the hands of doctors that save lives. It is our health care system that makes them function as a (sometimes slimy appearing and aggressive) business. But are they really a lower form of life because they don’t act like charities? And they need consultants to share their clinical and scientific knowledge, experience, and expertise with them, and for this they sometimes pay handsomely. Of course the pain leadership was needed and of course these guys commanded large consulting fees – they are the best of the best. Do I detect a note of jealousy in all these reports?
If so, what these rabid watchdogs should be jealous of is that not one of the pain leadership ever said anything they didn’t believe for an honorarium. I guarantee it. There are actually complex human beings in the world who can maintain their ethics and their common decency even when they are being fairly compensated for their service. But I digress; this is big news, you have uncovered the big lie: the pharmaceutical industry made up the problem of chronic pain!
Allow me one more comment media watchdogs: I know when you or someone you love needs pain services the practitioners you persecute won’t withhold their services and sit in judgment of you as harshly as you have them.
You smell a rat. Guys like you, thank God we have you to save us from the pain doctors, oh and those degenerates at the Institute of Medicine. This time you’re really onto something. This one is big, almost as big as Weapons of Mass Destruction.
OK here it is…there might not be exactly 100 million people with chronic pain in the United States. You know what members of the media? I don’t care if there is one person and one person alone in this country with severe chronic pain if it is you or your mother or sister or wife, then you too would have wanted the Institute of Medicine (IOM, Relieving Pain in America 2011 report here) to come along and try to reverse the millennia of poorly treated pain, the lack of empathy and the complete academic and clinical disregard for pain and the people who suffer with it that characterized the field since time in memoriam. This figure was a projection, admittedly on the high end.
The watchdog implication would have the world believe that the projection of “100 million Americans suffering from pain” is related to the desire of those at the forefront of pain management/treatment to unleash a drug abuse epidemic on the American public to keep those honoraria flowing in. Was it used to sell narcs? Does everything lead back to people trying to line the pockets of the big bad makers of PAINKILLERS? Try this figure on for size…pain is the most common reason people go to the doctor. And not everyone is hoping to score some opioid as a result of the encounter.
People are suffering. The IOM was trying to get research and science and clinical interest in the topic jump-started. In so doing, the pain field made many mistakes. The term undertreatment was a mistake. It implied that pain would be eradicated if we simply did more of something…we did, and it didn’t work, because pain is poorly treated…inexpertly treated, incompetently treated…not under treated. The increasing of any one intervention, be it opioids, meditation, group therapy, epidural steroid injections, antidepressants, anticonvulsants, surgery or standing on your head isn’t going to help even the majority of sufferers. We need peace between warring factions, we need education and advocacy and we need more – not less – freedom for pain practitioners to practice artfully. The environment of fear makes for conservative treatment that stifles practitioners’ creativity and doesn’t help people as well as they otherwise might. And if the Milwaukee press doesn’t believe it, perhaps you should spend a day in a legitimate pain clinic and spend time with the suffering patients that are turned away from multiple primary care providers and even pain interventionalists that are scared to death to write for a controlled substance. Once again, shame on the journalistic sensationalism.
Congratulations on writing another attention grabber – after all, that is your job, which “depends on [your readers] not understanding” the whole truth. My job is treating pain and ensuring that both patients and referring providers learn and understand the therapeutic nuances and risks for each individual patient – this education often times extends to third party payers to mitigate risk with appropriate monitoring and perhaps treatment with less common therapies than the norm. There within lies the nemesis between true clinicians and the media.
As always, comments are welcome, especially from canines!