Relieving Pain: It Isn't Always About the Meds
Date: November 30, 2009
Pain is the number one reason why a patient visits a doctor. Yet many studies show that doctors often underestimate the severity of their patients’ pain and as a result fail to provide adequate treatment. Now, neurologist Beth Murinson is on a mission to change that.
The Department of Neurology’s director of pain education, Murinson is starting with the pain curriculum at the Johns Hopkins School of Medicine, where, beginning this spring, first-year students will take an intensive, three-and-a-half-day course on pain.
Murinson, who has received funding from the Mayday Fund and the Milbank Foundation for Rehabilitation for her work in pain education, says most medical schools include on average only five hours of pain education in their curricula—not nearly enough. Being able to assess how much a patient is hurting does not come naturally, Murinson explains, and in her own studies, she’s found that many students aren’t able to translate empathy into good clinical decisions when it comes to patients with pain.
The new medical school course will be taught by faculty from Neurology, Physical Medicine and Rehabilitation, Psychiatry and Physical Therapy. It will include sessions on the science of pain, diseases that cause pain and techniques for evaluating pain. Medications and non-pharmaceutical methods of pain relief, such as physical therapy and motivational counseling are also part of the mix.
But knowing the science of pain is only one aspect of managing it, says Murinson. Great doctors also need to have compassion for their patients and provide support to those who are suffering. So, in addition, students will practice patient interviews and examinations that focus on assessing both physical and emotional aspects of a patient’s pain. And because Murinson has found that studying the humanities encourages students to connect with pain’s emotional and cultural aspects, they will also be asked to gauge its impact by reflecting on physical suffering as depicted in art, literature, drama and philosophy.
Murinson isn’t stopping with students. As co-chair of The Johns Hopkins Hospital Pain Task Force, she is also developing a pain education program for nurses, doctors and pharmacists throughout Hopkins Hospital. The program will be introduced in the next few months.
“Pain has often been perceived as something that must be endured,” comments Murinson. But research shows the consequences: Patients whose pain is inadequately treated take longer to recover from an illness. They lose more days from work and have higher rates of work-related disability. “Everyone pays the price for inadequately treated pain,” she says, “so getting a person pain-free has tremendous benefit to society.”
But beyond such practical reasons for improving pain education, says Murinson, are the loftier goals of medicine. “Pain is a major cause of human suffering. Educating doctors to treat pain effectively is a deeply humane thing to do.”