Nashville, Tenn.-based Hospital Corporation of America and Brentwood, Tenn.-based LifePoint Health are working to change patients' pain expectations to help curb the nation's opioid overdose crisis, according to a report from Nashville Public Radio.
Here are four things to know.
1. HCA is introducing a new pre-surgery protocol to help manage patient expectations of pain. Under the new protocol, physicians will tell patients they "will treat the pain, but you should expect that you're going to have some pain. And you should also understand that taking a narcotic so that you have no pain really puts you at risk of becoming addicted to that narcotics," Michael Schlosser, MD, CMO for HCA, told Nashville Public Radio.
2. Schlosser spent a decade as a spinal surgeon at Nashville-based Centennial Medical Center, HCA's flagship hospital, where he prioritized soothing patient pain.
"I just wanted my patient not to be in pain, thinking I was doing the right thing for them and certainly not an outlier among my colleagues, but now looking back on it, I was putting them at significant risk for developing an addiction to those medications" Dr. Schlosser told Nashville Public Radio.
3. LifePoint Health is also working to change patient expectations of pain management and making a special effort to identify patients presenting at the emergency department specifically for the purpose of obtaining opioids.
"We really do have a lot of responsibility and culpability and this burden, and so we have to make sure we do whatever we can to stem this tide and turn the ship in the other direction," John Young, MD, national medical director of cardiovascular services for LifePoint Hospitals, told Nashville Public Radio.
4. The new approach to managing patient expectations represents a shift in care priorities. In 2001, The Joint Commission referred to pain as the fifth vital sign in its "Examples of implementation" manual. HCAHPS patient satisfaction surveys included questions on pain management for years, potentially spurring further reliance on opioid painkillers.
Editor's note: The fourth point in this article previously stated The Joint Commission declared pain as a fifth vital sign in 2001 instead of accurately describing the phrase's appearance in an implementation manual. In 2002, the commission took efforts to address the problems in the use of the fifth vital sign concept and does not endorse pain as a vital sign.
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