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01-31-2003, 10:33 AM
Patients suffer as pain doctors quitÂ*
Joanne Laucius
The Ottawa Citizen
Friday, January 31, 2003Dr. Ellen Thompson
Â*
You can hear Dr. Ellen Thompson's next patient before you see her. There's the hissing intake of breath, like someone who has just felt a stab of pain.
Pain experts calculate pain on a scale of one to 10. For women, 10 is the pain of childbirth without an epidural. For men, it's the pain of a good swift kick to the testicles.
Most people can function with a pain of five. You can ignore a pain of three. Martie Whitaker, standing gingerly in Dr. Thompson's Civic-area office, is somewhere around 9.5.
Ms. Whitaker has suffered constant pain for five years after a back injury. Even when she sleeps, she dreams she has been stabbed or shot.
Dr. Thompson is one of only a handful of pain specialists in Ottawa. And today is her last day in pain practice.
Across the city, at the General campus of the Ottawa Hospital, Dr. Dennis Reid, head of the department of anesthesia, will be spending his last day at the pain clinic there.
Both doctors warn of Ottawa's growing inability to manage the pain of people whose agony is fierce and never-ending.
After Dr. Reid and Dr. Thompson bow out, there will be only a handful of pain specialists left in Ottawa; four at the Ottawa Hospital, two at the General campus and two at the Civic campus. Two anesthesiologists have recently started pain treatment at the Montfort Hospital.
"The remaining physicians are already having trouble dealing with the patient load. When I stop doing pain management, I will be the fourth pain specialist to do so in the last two years," said Dr. Reid.
The two remaining doctors at Dr. Reid's pain clinic will take his patients, but they have already said they won't pick up his more "challenging" patients. Most have been sent back to their family doctors.
"The problems in Ottawa are insurmountable for the foreseeable future," said Dr. Reid. "We are light years behind Toronto and Halifax."
Chronic pain practitioners have a high burnout rate. It is exhausting and frustrating treating patients who can't be cured. Patients who see no end to the torture of being in their own bodies sometimes succumb to suicide.
There is a lack of recognition and support from other doctors, said Dr. Reid. And pain patients don't have the money or the political clout to turn pain into a major issue -- despite the fact that chronic pain costs society as much as heart disease, he said.
"It became apparent that even if I ran this office seven days a week, 24 hours a day, I couldn't fill the need and I would kill myself," said Dr. Thompson, who will continue to work as an anesthesiologist. "I go into the operating room to relax. Compared to pain management, it is so much easier."
In recent years, pain management has improved in labour and delivery, in post-operative pain, and for cancer patients. But not for those with chronic pain, said Dr. Thompson.
Prescribing narcotics leaves many pain doctors uneasy.
Dr. Thompson has turned one of her patients over to a doctor who has refused to prescribe narcotics. "If I discontinue prescribing, he'll go back to toxic amounts of Tylenol," she said.
Dr. Reid and a group of other other physicians are waiting for word from the provincial government on a proposal to develop a holistic pain treatment centre in Ottawa like those in multidisciplinary clinics in Toronto and Halifax. The plan has been in the works for six or seven years, but Dr. Reid says he has run out of energy and enthusiasm.
Ms. Whitaker can understand the frustration. "We're miserable and they can't fix us," she said.
She considers herself one of the lucky ones. Her family physician has agreed to
prescribe the medications recommended by Dr. Thompson. But she's still worried about flare-ups. Pain clinics are booked solid, and won't offer her an anesthetic on demand.
http://www.canada.com/ottawa/news/story.asp?id=B9BAC592-9032-40EB-AC80-D5BF83403E89
Joanne Laucius
The Ottawa Citizen
Friday, January 31, 2003Dr. Ellen Thompson
Â*
You can hear Dr. Ellen Thompson's next patient before you see her. There's the hissing intake of breath, like someone who has just felt a stab of pain.
Pain experts calculate pain on a scale of one to 10. For women, 10 is the pain of childbirth without an epidural. For men, it's the pain of a good swift kick to the testicles.
Most people can function with a pain of five. You can ignore a pain of three. Martie Whitaker, standing gingerly in Dr. Thompson's Civic-area office, is somewhere around 9.5.
Ms. Whitaker has suffered constant pain for five years after a back injury. Even when she sleeps, she dreams she has been stabbed or shot.
Dr. Thompson is one of only a handful of pain specialists in Ottawa. And today is her last day in pain practice.
Across the city, at the General campus of the Ottawa Hospital, Dr. Dennis Reid, head of the department of anesthesia, will be spending his last day at the pain clinic there.
Both doctors warn of Ottawa's growing inability to manage the pain of people whose agony is fierce and never-ending.
After Dr. Reid and Dr. Thompson bow out, there will be only a handful of pain specialists left in Ottawa; four at the Ottawa Hospital, two at the General campus and two at the Civic campus. Two anesthesiologists have recently started pain treatment at the Montfort Hospital.
"The remaining physicians are already having trouble dealing with the patient load. When I stop doing pain management, I will be the fourth pain specialist to do so in the last two years," said Dr. Reid.
The two remaining doctors at Dr. Reid's pain clinic will take his patients, but they have already said they won't pick up his more "challenging" patients. Most have been sent back to their family doctors.
"The problems in Ottawa are insurmountable for the foreseeable future," said Dr. Reid. "We are light years behind Toronto and Halifax."
Chronic pain practitioners have a high burnout rate. It is exhausting and frustrating treating patients who can't be cured. Patients who see no end to the torture of being in their own bodies sometimes succumb to suicide.
There is a lack of recognition and support from other doctors, said Dr. Reid. And pain patients don't have the money or the political clout to turn pain into a major issue -- despite the fact that chronic pain costs society as much as heart disease, he said.
"It became apparent that even if I ran this office seven days a week, 24 hours a day, I couldn't fill the need and I would kill myself," said Dr. Thompson, who will continue to work as an anesthesiologist. "I go into the operating room to relax. Compared to pain management, it is so much easier."
In recent years, pain management has improved in labour and delivery, in post-operative pain, and for cancer patients. But not for those with chronic pain, said Dr. Thompson.
Prescribing narcotics leaves many pain doctors uneasy.
Dr. Thompson has turned one of her patients over to a doctor who has refused to prescribe narcotics. "If I discontinue prescribing, he'll go back to toxic amounts of Tylenol," she said.
Dr. Reid and a group of other other physicians are waiting for word from the provincial government on a proposal to develop a holistic pain treatment centre in Ottawa like those in multidisciplinary clinics in Toronto and Halifax. The plan has been in the works for six or seven years, but Dr. Reid says he has run out of energy and enthusiasm.
Ms. Whitaker can understand the frustration. "We're miserable and they can't fix us," she said.
She considers herself one of the lucky ones. Her family physician has agreed to
prescribe the medications recommended by Dr. Thompson. But she's still worried about flare-ups. Pain clinics are booked solid, and won't offer her an anesthetic on demand.
http://www.canada.com/ottawa/news/story.asp?id=B9BAC592-9032-40EB-AC80-D5BF83403E89