Media release from Australian and New Zealand College of Anaesthetists
(ĐTĐ) - Many young doctors in Australia and New Zealand are not being adequately taught how to treat severe acute pain and pain medicine specialists are working to have basic pain medicine skills formally taught to medical students and doctors training to be GPs and specialists.
The Faculty of Pain Medicine (FPM) of the Australian and New Zealand College of Anaesthetists (ANZCA) recently wrote to all medical schools and training organisations in Australia and New Zealand with a suggested pain education curriculum.
"Relieving pain is such a big part of medicine," said the Dean of FPM Dr David Jones today (Monday October 18), the first day of the IASP Global Year Against Pain which this year is focusing on acute pain that can be experienced following surgery, injury, childbirth and various acute illnesses.
"Yet old attitudes and beliefs still dominate much of daily practice, with many doctors ignoring acute pain as if it is harmless and inevitable. An older belief was that to cure the disease would stop the pain. This is usually not the case, and early attention to acute pain may reduce the risk of that pain becoming chronic.
"We are constantly increasing our understanding of pain, so if doctors are armed with skills based on this, many more patients will benefit today than was possible when more senior doctors began their careers."
Dr Jones said all young doctors had a phase working in hospitals when they were guided by senior doctors, so information learned in medical school could be added to during this time.
"Much depends on what importance individual senior doctors place on pain and its relief," Dr Jones said. "Some do it very well and junior doctors seem to be eager for help to do better. This is an opportunity."
One of several studies suggesting the inadequate education of junior doctors was undertaken by Dr Jane Trinca, a Melbourne pain specialist. In a survey of interns, she found that 70% of recent medical graduates at the Austin Hospital felt their understanding of pain was inadequate for clinical needs.
Fewer than half said they had received any formal pain management education, according to the survey which was presented at last year's ANZCA Annual Scientific Meeting.
However, the study found that over a 10-year period, pain knowledge had improved with the number of interns scoring at least 70% in pain knowledge tests improving from two out of 23 (53%) in 1998 to 15 out of 23 (65%) in 2009.
In a further bid to improve pain medicine awareness amongst young doctors and their medical specialist supervisors, FPM will next year offer a total of $5000 in prizes to medical students in 10 medical schools throughout Australia and New Zealand for the best essay on pain management.
Dr Jones said severe acute pain experienced after surgery has been associated with an increased risk of developing chronic pain, which is defined as constant daily pain for three months or more. After some types of surgery this risk can be high, but this risk may be decreased with effective management of acute pain.
According to statistics listed in the internationally recognised book Acute Pain Management: Scientific Evidence (third edition) published by ANZCA and FPM in 2010, chronic pain is experienced by 30-85% of patients after amputation, mastectomy (5-65%), inguinal hernia (5-63%), coronary bypass (30-50%), caesarean section (6-55%).
Aside from the human toll, the cost of chronic pain to the community is enormous. According to the 2007 Access Economics report "The High Price of Pain", one in five Australians report chronic pain, which costs the Australian economy $34 billion annually in lost productivity and healthcare costs.
In its submission to the Confederation of Postgraduate Medical Education Councils in Australia and the New Zealand Medical Training Board, in March last year, FPM pointed out: "There is no formal pain education at many medical schools and no minimum standards can be assumed."
The Global Year Against Pain is an initiative of the International Association for the Study of Pain (IASP) and its affiliates the Australian Pain Society and the New Zealand Pain Society.