Select a medical ethics issue related to the urinary or nervous system. Deliver a prepared oral presentation that:
Clearly states your position on the issue
Supports your position with explanation and reasoning
Uses appropriate medical terminology
Demonstrates purposeful organization and professional delivery
Response
Introduction
I want to talk about pain communication.
I imagine most everybody here has been to the dentist.
And one of the most common procedures they perform is to fix a cavity.
Because of the pain and discomfort involved in dental procedures, they often numb the area with an anesthetic.
You'll often here, "this might hurt a bit", before they inject you.
But, this isn't very helpful to the patient.
The Problem
Doctor's often rely on very vague terminology to describe pain, using terms like "sting", "pinch", "some pressure".
But what does that mean? It's too open to personal interpretation.
So it fails in two ways:
First, it misses the subjectivity of how pain is perceived.
People are going to have different levels of pain tolerance, and different baselines of what it means to describe something as 'stings'.
I mean, there are people out there who avoid going to the dentist due to pain they receive from a general cleaning.
And second, what's lacking is communication on the type of pain you might experience if things go wrong.
Personal Experience
To the first point, I, myself, had a tooth sensitivity for several years that made it very difficult to go to the dentist.
Every time I would go, they would give me generic advice, that would never help.
But I didn't know how to communicate the level of pain that I was experiencing.
There was this disconnect between what I was experiencing as a patient, and what the doctor was assuming my pain level was.
These disconnects in the subjectivity and how pain is perceived and referenced, build distrust in the medical system.
Why This Happens
And, to the second point, looking back at the numbing procedure.
There's not a whole lot that can go wrong with a numbing shot.
But, a simple numbing procedure can actually hurt quite a bit.
If the doctor runs into the nerve with the needle, it can trigger a waterfall feeling, a feeling of paresthesia.
And, doctors, they want their patients to get better, so they may not mention severe iatrogenic pain as a possibility.
But that almost takes after the saying of, "It’s Easier To Ask For Forgiveness Than Permission".
Because it's ignoring the elephant in the room.
Nobody wants to talk about what could go wrong, and potentially scare somebody off of a procedure that may help them.
But, this also builds distrust in the medical system because things do go wrong.
And patients feel lied to, or misled, and that builds distrust.
Why This Matters
So, I think, there's quite a severe deficit in pain communication.
And it goes beyond what I've mentioned so far.
There's research that shows that racial, ethnic, and age-related biases exist that all have a hand in pain perception.
A young doctor treating an elderly patient might not have the experience to interpret the patient's correct level of pain.
Conclusion
So, I hope this sparks a re-evaluation in how you all self-evaluate pain in the clinic.
But, you don't have to shoulder, all of the responsibility for how to communicate pain.
For chronic pain especially, part of the responsibility is on the patient to communicate their needs.
But, they need to know how.
The patient needs to be able to describe pain in a way that a doctor understands.
And that responsibility falls on us.
There are pain scales that exist, for various procedures, and diagnosis, and those need to be displayed in a room, or handed out as hand-outs, to help educate the patient even before the doctor enters the room.
More thought needs to go into how best to communicate pain in a doctor's office, to help restore trust in the medical system.
Because how are patients supposed to know what's normal, if they don't understand what's normal, and what's abnormal?