The secret to good outcomes with people in pain ...
People who have learned to manage their pain speak about the therapeutic value of their trusted relationship with their GP and primary care providers. They speak about high levels of partnership, a level playing field and a GP who helps them understand their chronic pain.
In 2012 we ran the "Painful Truths" workshop
at Parliament House Canberra. It was attended by 80 participants. The audienc was predominantly clinicians concerned with the problem of chronic pain. Guest speaker was Professor David Morris, author of “The Culture of Pain”. The analysis of the conversations of the day revealed:
What GP’s took away for immediate use in their practice:
- focus on the value of the patient’s story “Take greater care in eliciting and discussing a patients’ story”
- greater use of standardised patient pain assessment tools in management of chronic pain
- starting to implement the TEAMS approach discussed by Dr Chris Hayes
What GP’s would like to implement in their practice but what is difficult
- Employ practice nurse to help with triage and working with patients in pain
- Spending more time with people to elicit stories
What GPs identify as the barriers exist for the above
- Funding issues – unpaid time required
- Time poverty
- Creating the business model to accommodate the changes
- Lack of available services - Lack of available allied health or nursing staff
Challenges for GPs: Identifying patients that require and benefit from opioids vs those that are drug seeking
According to GP Dr Caroline West, practitioners are now seeing more and more people living with chronic pain. Doctors are used to "fixing" a medical condition whereas chronic pain is much more like a chronic disease where you treat it more like diabetes and focus on the patient's quality of life. Dr Caroline speaks about it:
Resources for health professionals
The NSW Agency for Clinical Innovation (ACI) has developed a kit of resources for clinicians working with people living with pain.
you can find this kit here: http://www.aci.health.nsw.gov.au/chronic-pain/health-professionals/management-of-chronic-pain