Some physicians working in hospitals now openly admit they went too far in prescribing opioids as they tried to make a patient’s stay as pain-free as possible. With creating an addiction now a major concern, physician habits have changed, which means preparing patients for more pain.
David Alfrey, MD, an anesthesiologist at Nashville’s Health Trust consulting firm, was one of those prescribers, saying to NPR it was “a matter of enormous pride” to have a patient awaken from surgery without any pain. Now, he says patients have to be conditioned that having no pain after a surgery is “an unrealistic expectation.”
This involves more than an unpleasant conversation. Hospitals will have to find the most effective blend of non-narcotics, deal with nerve blocks and get nursing staff to stick to the regimen. Some have worried prescribing fewer opioids will lower their patient satisfaction scores, though studies have shown prescribing more hasn't helped clinicians on those surveys.
HCA, the nation’s largest for-profit hospital chain, has been rolling a new protocol that explains the risk of narcotic addiction to get patients to understand why taking opioids to numb their pain now may mean they’re addicted to the drugs later. HCA’s chief medical officer, Mike Schlosser, MD, said he now knows the drugs he prescribed for spinal surgeries made post-surgical opioid addiction the greatest risk for patients undergoing orthopedic and back surgeries in HCA’s hospitals.
“I just wanted my patient not to be in pain, thinking I was doing the right thing for them and certainly not [being] an outlier among my colleagues,” he said.
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