Patients who mark down their doctors, pharmacists

The system, not the pandemic, is to blame for the painful prognosis.

patient with headache talking to doctor

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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    COMMENTS

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    JKB
    27th Jul 2020
    3:54pm
    Pain medications? What a joke. They don't work & the Drs still prescribe them.
    I have taken myself off all my pain medication lately - results I still have pain so am trying to manage with meditation, massage & gentle exercise.
    Laura52
    27th Jul 2020
    7:30pm
    Good for you JKB, well done!
    Hillbillypete
    28th Jul 2020
    8:56am
    JKB I would say you have no idea what real pain is all about!!
    Horace Cope
    27th Jul 2020
    4:54pm
    I mark down our pharmacy. Back when it was owned by a pharmacist as a one person operation there was service and the rules were followed. He sold it to a multinational group and retired and now we have young pharmacists who know it all and assume that we do as well. Our medication label has very small print showing B, 10a,12+, A* which are triggers for the pharmacist to attach warning labels such as "must be taken with meals", "do not drive heavy machinery", "may cause drowsiness" and so on. The one person pharmacist attached all of those labels, the young know all lot apparently don't have the time or inclination to do heir job properly.
    Laura52
    27th Jul 2020
    7:30pm
    Hi Horace. :)I am in my 50's and recently lost my job. I am a pharmacist. My workplace was a small ,family orientated pharmacy which catered for the elderly and provided good old fahsioned service. It was sold, bought by one of those "discount" multinational group pharmacies. That group needed new staff so myself and the "younger staff" were interviewed for less than 5 minutes. I was the only one who presented a resume. I have more than 27 years of experience. I was made redundant, whereas all the "younger" staff and pharmacists were transfered to the new store of the multinational group. The store is bigger with a focus on vitamins, skincare, cosmetics etc. My gut feeling from the start was to not even attend the interview as those stores do not provide personal service and I knew I wouldn't be a fit. Also, I am not flexible and can only work certain hours as I care for my 87 year old father and 79 year old mother. The staff members found out they got their roles 6 days before I got a redundancy email. I spent a lot of time getting to know my patients/customers for 5 years , explaining everything to them and getting to their life story/journey in life. You are correct...I have worked with younger pharmacists and they have have much knowledge but some lack common sense and emotional intelligence. I am now in the discarded pile I guess.
    Tarabelle
    27th Jul 2020
    5:10pm
    I was put on a DSP, and went through pain tolerance testing, etc. I was prescribed a drug which needed Federal Health Dept., approval. The authorization said that I could apply to have the dosage increased in 2019. Of course they knew that my body would become used to the medication and it's relief provided would decrease with use. That is exactly what happened. I now only have relief for a few hours, and by lunch time I am only good for sitting on my lounge chair, and using panadol osteo which I am told I can take as many of as I need. It is not really a life, but I suppose I should be thankful for the hours of relief I do have. In 2019 I asked the doctor to apply to the Fed to adjust my medication so I had a bit more of the day to enjoy. He was scared stiff ! Needless to say he didn't do it. Why ? I think he's scared. He is a "new" australian, and seems to be terrified of "rocking the boat". This wasn't the only time I had trouble with non Aussie doctors. When I moved to a new area, and needed my script renewed I was treated like a drug addict by these people, time and time again. So many times I left a doctors office in tears. Unfortunately it is difficult to find an Australian doctor these days. There are 24 doctors where I live ..... 3 of them are Aussies.....the rest....multiple ethnicity. It is difficult to understand so many of them, and they do not seem to understand what you are saying to them ........very dangerous. So I rush around in the morning, get things that need doing done, and settle in for the rest of the day, and the "break through" discomfort. Some don't even have those few hours, so I should be grateful. I do try, but it's winter, and that makes it a little more difficult to think of anything but the pain.
    Kali-G
    27th Jul 2020
    7:27pm
    That is the result of the faulty immigration policy...
    " Multiculturalism " Dad that preference is given to "all shades" instead of the western ideals.....
    sunny
    27th Jul 2020
    6:14pm
    Tarabelle
    I am sorry you live with such pain, and understand you trying to talk to non-speaking or should I say non-intelligible speaking doctors, would be the arsenic on the cake!
    We are fortunate to be able to shop around, (transport reqd) because in the UK, if you live in a particular area, that's who you get, and cannot change unless you move!!. Such degrading to people and so archaic. Please shop around.
    Troubadour
    27th Jul 2020
    8:40pm
    How blessed are we , after reading some of your comments. We have a very good and understanding Dr. who listens to us and makes sure we get the right medications - also we have been with our Pharmacist for about 28 years and he knows our needs well and makes sure the new younger Pharmacists and assistants look after their clients well too.
    Thoughtful
    27th Jul 2020
    9:57pm
    You are blessed Troubadour. Unfortunately, with the coming depression, the multinationals will be taking over doctor's surgeries and pharmacies. Good service and care comes at a price. Ethics come at a price.
    Laura52
    28th Jul 2020
    7:19am
    This made my heart swell how your pharmacist is instilling a sense of good old fashioned care and service into the younger pharmacists!
    Laura52
    28th Jul 2020
    7:22am
    I agree Thoughtful...the big companies are taking over. The discount pharmacy chains, for me, cheapen the profession, send shivers down my spine. The stores look cheap, like a junk store. Not for me. I am looking for new work were the pharmacy is smaller and doesn't have sell, cheap staring at me in the face. Also, I want to chat with people, not push customers through quickly.
    Denny
    27th Jul 2020
    9:31pm
    Both my husband and I have had accidents that have caused damage to our spines, both top and bottom, but my husband is in worst condition as he has had a laminectomy to his neck (decompression) on several upper vertebrae in 1997, problems to both shoulders and a lower back injury from an accident in 1979, to add to his misery. He is also currently suffering from dizziness which they can't seem to diagnose. We have a blood pressure machine but when checking his BP is normal. Our doctor is an Australian and is very caring. My husband will not take any strong medication. Our pharmacist/s here are pretty helpful too. They will even deliver medicines to us and I am able to scan and email them the script/s for delivery. The chemist is one of several in the discount group. Sorry to hear about Laura 52
    Laura52
    28th Jul 2020
    7:18am
    Thank you Denny, I am so sorry to hear about you and your husband's medical issues. I have a young patient, 24, who has had 2 hip replacements, due to a genetic condition but still needs very strong painkillers. He wants to get off them. Even though I am not working, I keep in touch with him, researching on how he can off them safely. The younger pharmacists don't have time to do this...but I did it all of the time for my customers at my old workplace. I have found a beautiful looking small pharmacy near my home to get my father's prescriptions. It is not a big discount pharmacy. The nice pharmacist knows of my situation and goes above and beyond to help my father with phone calls, deliveries, the old fashioned way.
    Denny
    29th Jul 2020
    3:39pm
    Laura 52 - thanks for your reply and I must say that there always others worse off than oneself. Your example of the 24 year old with his hips and being on such strong painkillers is very sad. I have bad nights with my spine and cannot take sleeping tablets so just get up and read for a while and then try to sleep or just even relax in bed. I am however, more uncomfortable in bed than when being up and active. I take an occasional Celebrex but only for a few days and then I just put up with the discomfort. I have scoliosis as well as the injuries from a car accident and also a fall. I go by my late mother's saying 'count your blessings'
    Maggie
    14th Aug 2020
    4:29pm
    My heart goes out to all chronic pain sufferers.
    I too have debilitating pain, but have an empathetic doctor who prescribes opioids for me.
    The problem with these drugs is that one becomes tolerant and thus needs larger amounts.
    To anyone struggling with tolerance or wanting to come off opioids, who has not heard of ketamine infusion treatment which takes a week in hospital- do ask your doctor about it.
    It can get you right off opioids, or if not it can re-set the dose you need to a much lower level.
    Thoughtful
    27th Jul 2020
    10:03pm
    Healthcare professionals need to improve their approach to all health problems. Unfortunately the almighty dollar rules and employed healthcare professionals are under extreme pressure in order to turn a profit. Care is the casualty.
    Laura52
    28th Jul 2020
    7:18am
    This is so true Thoughtful...it is all about fast turnover, and convenience.


    Tags: pain, healthcare, GP

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