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Sunday, November 17, 2013

A Framework for Reducing Suffering in Health Care

Today's post was shared by NEJM and comes from

Patients suffer — predictably and so obviously that they bring clichés to life. They wince with pain. They shudder with fear. They lose sleep because of anxiety and confusion.  And, as they suffer, they turn to medicine for help. But medicine, increasingly, has not provided them with relief.

A century ago, little could be done to alter the course of disease, but clinicians understood suffering and their role in addressing it. They acknowledged it, they gave drugs to relieve pain, and they took the time to bear witness to what their patients were enduring. But in recent decades, spectacular medical progress has made many diseases treatable, and some even curable. Super-specialized physicians learned how to attack disease in various organs systems, and fatalism has gone out of fashion. Much good has resulted from that aggressiveness and the narrowed focus of clinicians — but patients’ suffering has been pushed from center stage into the background. Suffering still goes on, of course, but it is often overlooked. Perhaps it is overlooked because clinicians are so busy focusing on the technical details of care, or perhaps it is due to their uncertainty about how to respond. In fact, the profession so systematically avoids acknowledging suffering that medical journals don’t even use the term to describe a patient’s experience. Compliance rates may be said to “suffer,” but not patients. (See Thomas H. Lee’s essay...

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