Pain No Longer a Fifth Vital Sign
The AMA has removed pain as a “fifth vital sign” and it is pissing some people off. This from some pain website:
The AMA’s main “solution” to the opioid problem is to stop asking patients about their pain.
In fact, reading their site shows how everyone has their own perspective and how doctors are caught in the middle. As the site goes on to say:
Pain was first recognized as the fifth vital sign in the 1990’s, giving pain equal status with blood pressure, heart rate, respiratory rate and temperature as vital signs. The policy encourages healthcare providers to ask patients about their pain.
Not exactly. They try to elevate The Joint Commission as the gold standard of care but forgot to mention how The Joint Commission started giving out Pain Rating scales that were funded by Purdue Pharmaceuticals. The AMA wants the fifth vital sign dropped from the physician’s lexicon and I agree. How about dropping The Joint Commission as well?
As one reader, who pointed this article out to me, said:
Wow, the Placebo Journal was so ahead of our time. Finally The Joint Commission creeps who pushed this crap should have a special level of Hell reserved for them. They ruined medicine and have killed hundreds of thousands of patients. We just “do as we are told”. I’ll never forget these smug bastards with their little clip boards coming around an we docs were blamed. If you stood up to them you were labeled “disruptive”. Disruptive physicians were those pesky doctors who actually gave a damn.On the other hand, the physicians that The Joint Commission and hospital administration loved just kept the narcs flowing.
Exactly.
Kill the MOC.
Kill the Joint Commission.
Oh! So now we are to just stop asking about pain? Will punitive measures be applied if we document pain? Should we simply ignore presenting symptoms of pain? God no! While dropping the whole 5th Vital sign idea is fine…it should have never been started in the beginning. I believe the problem is not with the pain “campaign”, it’s with the idea if you don’t perform to some poorly constructed standard, you are to be flogged publicly, professionally, financially. And since opioids treat pain and the country has an opioid epidemic, what if your regimen of treatment fails the test of standard therapy? Might you be subject to felony arrest and conviction as well? In my opinion the adversarial system we have in place serves neither the patient nor the physician. It’s time for education, not pronouncements and punishments.
Medicine has a long history of “fads” . Pain as a vital sign was just one of many. Now we have Metrics. Patient centered medical home, Acountable Care Organizations all set by bureaucratic pseudo doctors who don’t practice medicine but manage medicine because it is so much more important to society than what we “grunts” do day to day.
5th vital sign my foot. It was a crock then and it’s still a crock. And don’t get me started on JCAHO
It’s high time for an attack on the worthless Joint Commission! When I worked in ER and these pricks walked through, checking for dust on bottom bed-rails so that the hospital wouldn’t lose its Medicare reimbursement, once my anal sphincter loosened I’d think, Boy, what I wouldn’t give to be on the JCAHO when I retire so I can aggravate the crap out of working doctors and nurses too! But no, I couldn’t do that, I’m not THAT big an a**hole.
Explain to me how pain, a totally subjective measure, can be treated the same as other “vital signs” that can are totally objective?