Friday, August 16, 2013


Recently we were shown a new pain assessment tool. It fills an entire computer screen with about 42 different numbers, adjectives, identifiers, what makes it better or worse, how often,....amazing, since I began using it, all of my patients have no pain. It is indeed, a miraculous tool. And of course, a new document means something new to be audited about.


An overemphasis on pain
By calling it a vital sign,
It's a normal response
And quite often benign,
But as a Medical provider
It's the first thing we ask,
There will be an audit reprimand
If we don't perform the task.

My wife thinks it's too stupid
When she has a medical visit,
They ask, “Do you have any pain
The number, what is it?”
Because for her, pain is not the reason
For the appointment with her Physician,
She thinks that's a perfect example
Of their stupidity condition.

Is it any wonder
Addiction is out of control?
Medical care, created this problem
Asking if you have pain
As if it's the whole,
Summation of your existence
From the moment birth arrived,
By putting that first, we foster an industry
A painful diagnosis, neatly contrived.

So, we under-treated pain
In the young and the old,
The sick and infirm
The hot and the cold,
Until we offered Oxycontin
And created a nation of thieves,
Where we now ask about your pain
But which one of us believes,
When you say it is a “10”
Watching TV with your brother Hank,
A ten, is like having a baby
Or being run over by a tank.

We are supposed to record what number you choose
And apply future treatment, on this arbitrary measure,
You can be as stupid as a fence post and figure this out
It's pretty damn easy to read the map to this treasure,
The golden prescription, to your favorite drugs
We made it so easy and fostered your addiction,
And now upper-management, wants to audit my assessment
Did I document exactly, triggers, therapy and restriction.

If we were to follow this pattern of describing in excess
With every medical discipline invited to play,
There would be no time to perform our procedures
Physical assessments would rule our entire day,
So, who is the driver of this fancy new boat
The Captain, who audits my charting,
I didn't describe pain with the 42 adjectives
And now they threaten me with early departing.


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