How Should We Treat Pain?

By Author: Steven Johnson
Total Articles: 494
Comment this article

The role of doctors in our culture is very important. Because they can be useful in treating injuries and illnesses, they have become a profession. To ensure only the best people enter the profession, there are high educational standards to meet. The training is long and difficult. But, once doctors have qualified, they command respect. This is not just for the knowledge and experience they have collected. The power of the placebo effect also relies on believing the doctors actually know what they are doing. Remember, in all clinical trials, placebos are rated as highly effective by an average one-third of participants. If someone in a white coat gives you a pill in the right circumstances, you are likely to feel better even though the pill is made out of chalk. It's all part of the magic of being a doctor.

The profession has also made big strides in shaping public opinion. The general practitioners used to be the gods. Now, thanks to television shows like House, it's the surgeons in the top hospitals. Not that any of them are like House, you understand. But many do feel they can do what they want. So they develop reputations ...
... for their skills and build empires inside their hospitals. This grows their income and protects them. Why? Because once a patient is allocated to a particular empire, it holds on to that patient. That means the empire gets the credit for all the fee income earned and, if anything goes wrong, no one outside the empire gets to hear about it.

In other countries where they practise socialized medicine, there's a team approach to treatment. Instead of one doctor having a monopoly on controlling treatment, the patient becomes the focus of interest for a group of healthcare professionals representing a range of relevant knowledge and skills. There are regular meetings where groups of people discuss how best to treat the individual. Collective decisions are taken. Why is this better? Well, suppose a patient comes in and reports pain. The first doctor diagnoses the problem and begins treatment. Some time later, the patient is still complaining of pain. In our system, the first doctor might fear loss of reputation if he or she calls for a second opinion, so simply prescribes more painkillers. If the pain persists, the dosage of the painkillers is increased or stronger drugs are used. The result is our country has the highest consumption of prescribed medications in the world. We've been persuaded the best treatment always comes in a pill bottle. In other countries, doctors and other healthcare professional work hard to avoid prescribing drugs. This not only cuts down the long-term cost of treatment, but also tends to produce better results.

None of this takes anything away from Tramadol. Indeed, if you travel round the world, the drug is widely available for treating moderate to severe pain. Although the brand names can differ from country to country, the basic chemistry is recognized as highly effective. But outside the US, you will find Tramadol is prescribed as part of a wider range of treatments to manage the pain. Indeed, the aim is to enable you to have a good quality of life without having to depend on any drug.