The Mindscape Medical News website recently published a fascinating piece on the topic of helping primary care physicians treat chronic pain more effectively. The article identifies weaknesses in the system, including a lack of training among doctors. It then goes on to explain how the system could be improved. Here is my question: should primary care doctors be better trained to treat chronic pain?
The easy answer is ‘yes’. But there is more to it than a simple matter of training. I can actually see both sides of the argument. There are valid reasons to help primary care doctors be better at treating chronic pain. But there are also valid reasons for leaving chronic pain to pain management doctors, doctors who have received additional training to specialize in pain.
Arguments in Support
Providing better training that allows primary care physicians to treat chronic pain more effectively seems to make sense. Primary care doctors are the first line of defense in medicine, so to speak. The more they can manage in their office, the less need there is to send patients to specialists. This saves time and money. At least that is the theory.
Given that pain is one of the most common complaints heard in doctor’s offices, primary care physicians not being familiar with pain treatment seems odd. But we can be pretty confident in saying that primary care physicians are not adequately prepared for chronic pain merely by the fact that the most common solution they offer is prescription medication.
This is not necessarily a problem except for the fact that there are other approaches to chronic pain. Writing a prescription is not the only option. Pain management doctors know this. Take the doctors at Lone Star Pain Medicine in Weatherford, TX. They write prescriptions when necessary, but they also encourage patients to consider injection therapies, spinal cord stimulation, regenerative medicine, physical therapy, and other options.
Arguments Against
Let us say that primary care physicians received adequate training in chronic pain while in medical school. They would be equipped to care for patients who would no longer have a need to see specialists. It sounds attractive at first glance. But imagine the implications.
Primary care physicians are already pushed to the limit. They are internists with a broad body of knowledge covering hundreds of conditions, illnesses, and injuries. They are medicine’s jack of all trades. Is it wise to make them responsible for treating chronic pain?
Pain medicine is an additional fellowship doctors undergo in order to become pain management specialists. Pain management doctors learn about the mechanisms of pain, its many causes, how patients respond to it, and a whole variety of treatments that go above and beyond prescription medications. Quite frankly, it is a lot of knowledge to absorb.
Primary care physicians could undergo the same training in medical school. But then they would be adding a specialty to primary care. That would increase patient load and physician responsibility. Primary care physicians who already feel overworked and underpaid would have yet another burden to bear.
Pain Medicine Should Remain a Specialty
I am not a medical professional by any means. But as a patient, it is my opinion that pain management should remain the specialty it is. Primary care physicians are already dealing with a full plate. They don’t need something else to deal with.
Pain management is a complex area of medicine that requires additional knowledge and skill. I believe it is something best left to specialists who have undergone the extra training. Let primary care physicians refer chronic pain patients to those specialists.
