The World of Chronic Pain
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The World of
Chronic Pain

More than 125 million Amercians are suffering.

Diseases &
Conditions

These conditions can cause a world of pain.

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& Treatment

Be sure you know the cautions and side effects.

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Finding help is not always simple for those in pain.

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These tips can help prevent a lifetime of pain.

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Up-to-date news on pain-related issues.

Malpractice

Referring to the patients they will treat, all new physicians are sworn by the Hippocratic Oath: "I will keep them from harm and injustice."

How simple life would be if physicians remembered that oath and lived by it. Yet each year doctors DO harm. Patients in their care suffer injuries and die. True, physicians are human -- much as some of them act like gods -- and to err is human.

When they err, though, there is a wide gulf between those who truly regret it and those who callously go on to the next patient.

For the ultimate in hypocrisy, one has only to look at an Independent Medical Examiner. Chronic pain patients are well familiar with this type of doctor though few other people have heard of them. In a legal battle for Worker's Compensation, Social Security, and private insurance, the mighty lying Independent Medical Examiner is brought in.

This is often a physician who failed in private practice or simply found a fast road to riches. Paid by his client, he will examine a patient for five minutes or less than write the equivalent of "War and Peace" saying whatever his client wishes him to say, such that the patient doesn't even recognize the examination that took place and the novella that falls forth from this "doctor's" lips describing the patient as a malingerer with nothing whatsoever wrong with them.

These "physicians" are well-known within the justice system. Their names are despised because they wreck lives right and left and best of all -- for them -- they need not pay malpractice insurance at all because they never prescribe treatment; they only render opinions. They cannot be sued! People who have had the misfortune of seeing the greatest percentage of their lot say they took the hypocritic oath not the Hippocratic Oath for they harm tens of thousands of lives each year.

They are anathema for other physicians.

Even so, each year the odds of bringing a successful malpractice suit to conclusion decrease as it becomes more difficult to find doctors who will testify against other doctors and lawyers who will even talk to a patient. Forget obtaining an actual appointment to discuss how you have been wronged.

This story from Florida illustrates how laws are being passed to limit malpractice settlements:

State Says Insurers Should Lower Rates for Malpractice Insurance By Nearly 8%

Medical malpractice insurers must file for rates nearly 8 percent lower than they otherwise would have because of Florida's new law limiting monetary damages victims can receive, state officials said Monday.

Several insurance companies have said already that the figure won't lower rates, but make them lower than they would have been had the sweeping malpractice law not been passed this summer.

The new law limits how much victims can collect in non-economic damages, such as for pain and suffering, in most medical malpractice cases. Insurance companies say rising damage awards have caused them to dramatically raise rates, and many companies have stopped writing malpractice policies.

A number of doctors have said the insurance problem threatens health care in some areas. Doctors, particularly in high-risk specialties, have cut back their practices, some quitting entirely.

The new law requires insurers to factor in the ``presumed factor'' _ announced Monday as negative 7.8 percent _ into their upcoming rates starting in January. The rates must be retroactive to Sept. 15, meaning some doctors will get refunds.

However, many insurance companies have already said they expect to show the need for a rate increase based on losses. For example, if a company could show a need for a 20 percent increase based on its losses, it would then have to subtract 7.8 percent - filing instead for a 12.2 percent increase."

-- The Associated Press

Doctors complain that malpractice insurance is the highest part of their overhead and is putting them out of business. Pain patients will tell you with a sad smile that it is because they are still "practicing" on the patients' bodies.

While it may be true in the past malpractice suits flourished and were brought indiscriminately, today it is extremely difficult to even file one.

Take the case of a recent patient with Chronic Regional Pain Syndrome. His doctor in a fit of pique at being bothered by this patient whose pain continued to get worse, drew a blood sample and showed the patient that none of the pain medications the patient was on showed on the sample. The doctor "fired" the patient, saying he had broken their "pain contract" and in essence labeling the patient a "drug seeker."

Mystified because at the time of the test the patient was wearing a Duralgesic Fentanyl patch, one of the chemicals the blood test came back negative for, the patient went to another doctor. This doctor said first of all a urine test is far more accurate and took one. When this test too came back negative, the doctor investigated the potential reasons. He discovered that an entirely different test was required to detect Fentanyl and that the patient simply hadn't taken enough of the breakthrough medication -- since he was driving -- for it to show up in the test.

A simple explanation but one the first doctor was too spiteful and determined to rid himself of a pain patient to pursue. Thus an honest pain patient was labeled a drug seeker, but did he have any recourse under the law? Of course not. No lawyer would take on such a puny case even though damage had been done.

Much worse harm has been visited on pain patients. Infections around pumps and spinal cord stimulators, denial of refills of intrathecal pumps because "it's not time yet" according to a nurse's opinion leaving the patient in severe pain. These may seem minor, but those infections can lead to infections of the spinal cord and death. The severe pain and insult from medical professionals the patient is completely dependent upon leads to suicide.

These are not minor infractions, but examples of the power pain specialists have over patients in chronic pain and the lack of power patients have in their care.

Finding a medical malpractice attorney in your area is easy. The yellow pages are filled with them. A search on the internet by "medical malpractice _________" filling in the blank with your state or city and state will turn up dozens.

You can also contact the Bar Association or Attorney Referral system in your town or state capital.

A personal reference is often the most effective method. Ask your friends. Ask members of your support group. If you don't belong to a support group, contact your doctor or local hospital and ask if there is a support group for your type of injury or disease. When you call the attorney's office, saying "Mike Jones (for example) referred me" can open doors quickly.

Be prepared. If you think the treatment you're receiving is off the beaten path, keep records from the onset. Dates of visit, topics discussed, treatment and medications received, any improper actions. Listen to waiting room gossip. Patients know more about a doctor than any of the staff will ever admit, though the staff may gossip too when they think they're out of earshot.

Keeping a little notebook with you at all times is essential. You can always call it a book of poems you're writing if you get "caught" with it and no one has any right to confiscate it. It is your personal property. If a doctor tries to grab it from you, that's a strong indication he has something to be concerned about. Every patient has a right to take notes during an office visit. After all, if you're on medication, in pain, or tired, you can't count on your memory, right? Comments that seem trivial at the time may add up to a series of conflicting statements over a period of months.

Malpractice Information

Injury Board - "Public Citizen" blames high malpractice insurance costs on repeat offenders.

Questia - One of the world's largest collection of medical malpractice information.

Doctors Should Be Gardeners - Doctors should weed out the losers among themselves.

Anesthesiologists' Dilemma - Medical malpractice haunts anesthesiologists too.