QUALITY: No Pain=Health Care Gain

If you've been reading this blog, you know I've done a fair amount of reporting in the past few years on palliative care and end of life care (they aren't synonyms, but we'll leave that for another day). I haven't blogged as much about pain management, per se, but untreated pain has huge implications for the health care system (not to mention the toll it takes on the millions of people who suffer needlessly.) People in pain miss work or underperform. They may be less physically active, increasing their risk for chronic diseases or aggravating diseases they already have. A diabetic, for instance, isn't going to get off the couch if he aches terribly because of some other health problem. For our elderly, chronic pain can further isolate them. And if you find yourself in an overcrowded emergency room, look around and find how many people are there simply because their pain—including cancer pain—just got unbearable.

The American Cancer Society, with help from the University of Wisconsin's Pain & Policy Studies Group, has been tracking how state policies and regulations affect pain management. Bill Hendrick reported in the Atlanta Journal Constitution this week that the latest survey found only five states got an A. Georgia had a B, it had the best improvement, moving up from a D+ a year earlier. (We couldn't find this year's survey on the Cancer Society web site yet—we'll check again and update if a link is available. If you find it before we do, please note it on our comments section.)

According to the Atlanta paper, the study did find momentum for "positive policy change" over the last year. In addition to Georgia; Maine, Minnesota, Oregon, Rhode Island, Utah, and Washington had policy changes that improved their pain management.

John Seffrin, chief executive officer of the American Cancer Society, was quoted as saying the research showed "a very encouraging improvement in state pain policies, but more needs to be done to effectively address the national health crisis of undertreated pain."

Managing pain isn't always easy. There can be all sorts of emotional, cultural, religious, generational, attitudinal and communication barriers. Medication can be expensive. But those aren't excuses. Med schools need to do a better job of training doctors in the field. Physicians need to treat pain more aggressively and effectively. States have to promote appropriate policies. And of course, people need access to affordable health insurance so they can get their pain (and the disease or condition causing it) treated. So good for Georgia for making so much progress. But there's a lot more to be done.