ERNST & YOUNG
Pain levels are often a very subjective thing and in many cases, doctors ask patients to self-report their pain. Or, patients may come forward to talk about their pain before being asked.
For sufferers of chronic pain, a sad tendency is for doctors to ignore self-reported pain levels, or alternatively to dismiss them. How and why does this happen?
Why Doctors Don’t Believe You
The issue comes when you report that you are in pain, but your doctor dismisses it. They might tell you your pain is all in your head. Or they might insist that there is no physical reason for the pain.
There are a number of reasons why doctors might refuse to believe that a patient is in pain or that their pain is lower than it is. These include:Gender. There is, sadly, significant evidence that women are more likely to be dismissed or ignored. Women are also often told that gynecological pain is “part of being a woman” and “normal.” This has led to delays in diagnosis of significant issues. Some doctors may legitimately believe that gynecological pain is normal. Diagnosing some issues with the female reproductive system, such as endometriosis complicates this.
If a patient admits to being stressed, then the doctor will often blame psychosocial issues for their pain rather than investigating it properly. While stress absolutely can cause and exacerbate certain kinds of pain, especially headaches, doctors should always look for a cause.
Based off of a 2012 study, African-American patients are less likely to get pain medication from their doctors. In that year the disparity was 22 percent, and it does not appear to have improved. Racism amongst healthcare providers is an ongoing issue, with providers believing Black patients are more likely to abuse prescriptions and/or that African-Americans simply don’t feel as much pain.
Usually, pain in older patients is likely to be dismissed as “getting older”. At the same time, doctors ignore it in children, and young people because their symptoms don’t make sense for somebody who appears to be young and healthy.
A poor doctor-patient relationship. Sometimes, self-reported pain is ignored simply because the doctor and patient are not communicating well and have a poor relationship.
The impact of the opioid epidemic on doctors’ willingness to prescribe pain medication. In fact, some insurers are now paying doctors not to prescribe opioids, regardless of the levels of pain patients report.
The Consequences of Doctors Ignoring Self-Reported Pain Levels
The obvious consequence of your doctor ignoring your pain is low quality of life. Pain which is ignored may go away if it is acute, but it may also stick around. If the underlying conditioning is worsening, so will the pain. It can have other consequences, however, some of which are significant and can include:Loss of fertility
Untreated endometriosis can reduce a woman’s ability to get pregnant both directly and by causing pain during intercourse. Ovarian cysts can also be associated with reduced fertility.
Delayed Cancer Diagnosis
When doctors ignore pain, they fail to investigate the cause. This can result in delayed diagnosis of various cancers, reducing survival chances.
Aggravated injuries and a higher risk of needing surgery. Back pain is one of the most dismissed kinds of pain, especially as it can be hard to detect the immediate cause. It is particularly often ignored in young patients, which can result in the injury worsening until surgery is the only option.
Increased Risk of Suicide
Increased risk of suicide. Untreated chronic pain has been shown to increase the risk of suicide, and suicide notes often mention pain as part of the reason. While even treated pain can have this result, ignoring pain likely increases the risk.
Reduced ability to take care of yourself and your family. People with chronic pain neglect self care, eat poorly, and may lose their job because of poor performance or tardiness.
When doctors ignore pain, they can miss serious conditions and negatively impact a patients’ quality of life. So, what can patients and families do about it?
How to Get Doctors to Listen
You need to learn to self-advocate, although that can be very hard when you have untreated pain. There are, though, a few things that you should consider:
- Take backup. Someone else is always allowed in the room. Your partner, or a friend or family member can come to your appointment with you and vouch for how your pain is affecting you. For women with male partners, taking their partner can make a huge difference, and can sometimes reveal medical sexism when the doctor starts talking to the husband instead.
- Be aware of possible biases and bring them up. If your doctor appears to be using a stereotype, calling them out on it can make a huge difference.
- Make sure your doctor knows what the numbers on the pain scale mean to you. Some chronic pain sufferers get so used to pain that their scale becomes skewed, others find that the scale is too subjective.
- Keep a pain diary in which you record your levels of pain at different times. This can help get your doctor to take you seriously and can also help you get an accurate diagnosis. Record what you were doing, eating, etc, on bad and good pain days.
Know Your Pain Levels
If your doctor still does not listen, remember you can always switch to another doctor. If you are a woman or a minority, you might be better off finding a female or minority doctor if possible. (Although women can also be perpetrators of medical sexism).
You always have the right to a second opinion.
If, however, your doctor has ignored your self-reported pain and, as a result, you experienced complications such as a delayed cancer diagnosis, the need for surgery which might not otherwise have been required, reduced fertility, reduced quality of life, etc, then you may have a case for medical malpractice.
In this case, you should contact Weltchek Mallahan & Weltchek. We can talk to you about your situation and help you work out whether you have a case and, if necessary, pursue it. All initial consultations are free of charge.
Who Can You Trust with Your Case?
Have you or a loved one been injured due to negligence? We want to help. Don’t hesitate to contact us if you believe you have a case; time is an important factor. Interested in learning more? Get in touch with us so we can better evaluate and serve your needs in getting the justice your loved one deserves. You may very well be entitled to compensation.
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