Recently, I’ve been asked over and over again to rate my pain using that dumb 0-10 pain scale. I’m always at a loss as to what number to choose. One nurse told me that a 10 is surgery without an anesthetic. I’ve no experience with that!
The pain scale is relatively new. In 1995, the American Pain Society (now defunct), began a campaign—heavily supported by Purdue Pharma and other drug companies—to promote pain as a fifth vital sign, along with temperature, pulse, blood pressure, and respiration rate. Purdue, the maker of OxyContin, started working with the Joint Commission on the Accreditation of Hospitals in a effort to pursue this objective with the result that, in 2001, the commission started judging hospitals based on patient satisfaction of pain treatment. Now we’re stuck with that scale.
Of course, there’s not much validity to these numbers. A pain I might rate a four, you might rate a six. Patients hoping for strong medications might choose a high number. Doctors are faced with making tough prescription decisions based on the rating system. Dr. David Sherry, a pain specialist at Children’s Hospital in Philadelphia, thinks that recasting pain as a vital sign fundamentally changed the way both doctors and patients think about and respond to pain. It makes patients more conscious of pain and doctors more ready to treat it. Both attitudes, he believes are counter productive. He thinks it would be healthier for everyone to move toward the old way we saw pain—as a difficult but predictable and expected part of life.
I think they should get rid of the scale, but, from my vantage point at the moment, not the pain meds.
For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.
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