The study’s results were so disparate that the U.S. Surgeon General at the time of the release of the study was prompted to explain the differences in care, although a true answer could not be given, Dr. Green said.
Both women and minority groups tend to experience chronic pain more often than other patient groups. Minorities report more pain, less access to pain management … and are at risk for undertreatment.
—Carmen R. Green, MD
A number of government- and organizational-based studies also found differences in pain treatment. The Institute of Medicine’s reports, “Unequal Treatment” and “To Err Is Human,” both find disparities in pain care, Dr. Green said.2,3 “Sadly, many patients fail to receive state-of-the-art pain relief,” she said, quoting a line from “Crossing the Quality Chasm,” another Institute of Medicine report.4 At the same time, healthcare expenses related to pain continue to be higher than those for cancer and diabetes combined, Dr. Green said.
Both women and minority groups tend to experience chronic pain more often than other patient groups, Dr. Green explained. “Minorities report more pain, less access to pain management … and are at risk for undertreatment,” she said. She shared some quotes from patients who were seeking pain treatment but never felt they received what they needed, such as the following from a female patient:
“I see my primary care physician every three months, and each time I was there he’d ask me why I am walking with a cane. I’d tell him it’s because of the pain in my back, that the arthritis pain kept getting worse, and Tylenol and physical therapy didn’t help me. I’d talk to other patients with arthritis who were taking opioids, but all I could get was Tylenol, and I knew there had to be something better.”
Sometimes the barriers to pain treatment are based on one’s neighborhood. Dr. Green cited data based on a zip-code study of certain neighborhoods in Michigan that found that those living in a mostly white neighborhood had a 90% chance of obtaining opioids at their local pharmacy compared with a 50% chance for those living in a mostly minority community.
Dr. Green said that future research should address whether or not disparities in pain treatment should actually be considered medical errors. “People go to the emergency room every day with high pain scores, and yet we send them out not really believing them. Is that a medical error?” she asked. She believes that the healthcare field in general and those who treat pain should focus more on access, assessment, treatment, and pain care.
Disparities Based on Location
Dr. Williams focused on pain treatment disparities for patients in rural settings.
