Doctor/patient relationships sour

Australians suffering chronic pain say their relationship with their GP and pharmacist has worsened in 2020.

When asked to rate how people felt their GP was managing their pain, the average score was 5/10 and when asked to rate their pharmacist’s performance in managing their pain, the average was 4/10. In 2018 and 2019, when these same questions were asked about GPs, the average score was 9/10 and 8/10 respectively. Last year when this question was asked about pharmacists, the average score was 8/10.

The results come from the annual survey of 1200 people by grassroots advocacy group Chronic Pain Australia (CPA), released at the start of National Pain Week, which aims to promote a better understanding of chronic pain.

President of Chronic Pain Australia Jarrod McMaugh, a pharmacist, says the survey results are “very concerning”.

“It easily demonstrates that healthcare professionals need to improve their approach towards how pain is managed in Australia and, importantly, how people in pain are treated,” he said.

Akii Ngo, executive director of Chronic Pain Australia, who lives with severe chronic pain, says it can be “extremely isolating and terrifying, especially without the support of good doctors and health professionals who understand, believe you and want to help”.

“A dedicated doctor can truly make all the difference to your quality of life and hopes for the future,” she says.

The survey revealed that people in pain often felt “unheard, not believed”, when they visited their GP and pharmacist. They often felt they were suspected of being a drug seeker and said they just wanted to be treated with “kindness, compassion and less suspicion”.

“Unfortunately, like many of our community members, there have been multiple times where doctors and other health professionals have actually turned me away because dealing with chronic pain is too complex or ‘too much of a headache’. Some doctors, however, who did want to help, stated that due to certain government regulations or as they said ‘politics’, were either not able to or were not comfortable to.”

Mr McMaugh told ABC local radio “tension around access to medicines” had increased following the tightening of regulations around the prescription of codeine and other opioids. Doctors must ask more questions of their clients before prescribing medicines many have used for long periods. In some cases, people whose conditions had stabilised were abruptly stopped by doctors “fearful they would be audited” for their prescriptions.

He said the health system was over-reliant on medicinal treatments because allied healthcare was not funded, but doctors’ visits were bulk-billed, and medicines subsidised.

“The system has to rely on medicines because that’s the only thing being funded,” Mr McMaugh said.

Kate Gill, a pharmacist, and chronic pain patient, says if she can access services such as acupuncture, remedial massage, and physiotherapy, she uses less pain relief. She says healthcare professionals apart from doctors play a huge role in keeping her moving.

She’d prefer understanding and empathy rather than sympathy and endless suggestions for treatment, which get “a little tiring”.

The survey and Ms Gill report some positives from the COVID-19 crisis. Ms Gill says the provision of online Pilates classes and telehealth – which means she doesn’t have to visit a doctor’s clinic – were good things.

“It’s helped me manage my pain better … I hope it sticks around after COVID.”

 Mr McMaugh said a lot of chronic pain patients were happy about improved access to telehealth and the flexibility it offers.

Sixty-nine per cent of survey respondents have used telehealth options during COVID-19 restrictions, 60 per cent of people feel they have benefited from using telehealth and 59 per cent want to continue using telehealth for their treatment when COVID-19 restrictions are fully lifted.

“What we are hearing very clearly from people in pain is that it has been challenging managing their care during COVID-19. It has been difficult accessing the medical professionals they are used to seeing face to face, but the majority are happy with telehealth options and many would like to see telehealth continue in the future as a universal standard option in healthcare moving forward,” said Mr McMaugh.

Mr McMaugh also noted that the condition of many people in pain worsened during COVID-19 restrictions because they were not able to access hydrotherapy, swimming pools, massage therapy, gyms, and other physical therapies.

Other respondents reported that self-isolation and working from home arrangements had slowed the pace of life and given their bodies respite.

During National Pain Week, people living with chronic pain are encouraged to share their experiences and ideas on the chronic pain forum or on social media using the hashtag #NPW2020.

Has COVID-19 changed the way you interact with your doctor? Have you had a battle getting medical professionals to recognise your chronic pain? Are drugs too often the only treatment?

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Written by Will Brodie

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