List date(s) this work was published or aired.
Oct. 1, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
Over the past three years, Angie’s List has received 1,900 reviews from patients on their experiences in the pain management category, with 20 percent giving their provider a C, D or F grade. It was this data that prompted us to take a deeper look into why patients struggle with finding adequate treatment for pain. A study published in June by the Institute of Medicine revealed that pain remains untreated or is improperly treated in many cases due to a range of factors that include doctors’ lack of training and insurance companies’ reluctance to pay for the most effective treatment. That treatment can involve a combination of medical management, psychological or interventional therapy, and alternative treatments like acupuncture. Ultimately, experts say the health care industry needs to change their attitude of blaming or not believing people who live with pain and instead help them focus to focus on managing it.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The Institute of Medicine had just released a study — “Relieving pain in America” — in June, which helped us in our reporting efforts, and revealed that there are 116 million sufferers of chronic pain in the U.S. To learn more, we posted an online poll that indicated 60 percent of our members suffer or have suffered chronic pain and 21 percent haven’t found a good approach to pain management. Other sources included the IOM chronic pain committee’s webcast about its report; the Centers for Disease Control and Prevention’s report titled “Prescription Drug Overdoses: An American Epidemic”; and the American Medical Association’s “First National Pain Medicine Summit – Final Summary Report.” We also looked at the National Survey on Drug Use and Health; and reviewed websites for the Association of American Medical Colleges; Alliance of States With Prescription Monitoring Programs; Office of National Drug Control Policy; PubMed; and the Agency for Healthcare Research and Quality. All of these sources helped us find experts and prepare effective interview questions. Although we used many public documents, none required a formal request.
Explain types of human sources used.
To truly understand the life of chronic pain sufferers, we interviewed five Angie’s List members who revealed the difficulty in finding health care providers to help them manage their pain. The IOM reported that doctors’ lack of training on pain, so we spoke with Dan Carr, the founding director of the Tufts University School of Medicine’s pain research, education and policy program in Boston. We also interviewed six other chronic pain specialists, including Dr. Perry Fine, the president of the American Academy of Pain Medicine. He spoke to us at great lengths regarding the importance of consumers asking doctors questions and also trying to find multiple ways to manage pain, including counseling since “pain lives in the brain.” He says sufferers need to learn healthy ways to combat depression, anger and frustration that go hand-in-hand with pain. The IOM committee exhorts the insurance industry to take further strides in covering these different approaches to treat pain, so we asked the America’s Health Insurance Plans to respond.
Results:
After the article published, we received a lot of feedback from consumers, many of them thanking us and sharing their own stories of how they’ve suffered with pain. Walter R. Schillinger of Illinois, for example, told us how he had been suffering with peripheral polyneuropathy for two years. With the topic of pain getting more attention in the media, he was hopeful it would lead to more research. We also were contacted by Dr. Paul Christo, a leading expert on pain at The Johns Hopkins Hospital and hosts of a radio show, Aches and Gains. He said he appreciated the article, noting the perception of pain parallels that of cancer 40 years ago: a veil of shame, secrecy and fear hover over those who battle this silent epidemic. Dr. Philip Pizzo, who we interviewed for our story, recently reinforced in the New England Journal of Medicine the importance of primary care providers becoming better prepared to help manage their patients’ pain. He also has urged doctors to attend PAINWeek, the largest national conference on pain, in September.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
We have not run any corrections or clarifications, and no one has challenged the story’s accuracy.
Advice to other journalists planning a similar story or project.
Pain can’t be seen, felt or heard by anyone other than the patient, yet it’s a disease that often is untreated. The challenge we faced was allowing as many players in this drama as possible to speak about the challenges they faced in seeking treatment for pain while also giving the story backbone with quantifiable data. That data included looking at the number of hydrocodone prescriptions, board-certified pain specialists and cost of treatments. Our advice to others would be to let every side speak, from the drug seeker to the world-weary doctor, and allow them to shape the story. It’s important the reporter doesn’t approach the story with preconceived notions that all patients are quacks and exaggerating their pain, but rather remain objective. In this instance, the IOM report and interviews with doctors really helped us to give the patients credibility.