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A Better Way to Manage Pain

Seriously ill people need special care. Palliative medicine can help

Other research has shown that palliative care reduces spending on expensive hospital care that doesn't prolong or improve patients' lives. Although Medicare has no specific palliative care benefit, many treatments and medications for palliative care are covered through standard benefits. With private insurance, coverage depends on the company and the policy and what specific services you need.

The barriers

Sometimes doctors and patients confuse palliative care with hospice care, which is for people who no longer need or want to treat their condition but want help managing their pain. Palliative care, on the other hand, is often meant to help people who are still fighting their disease. But some fear palliative care because they think it means giving up. As a result, many patients don't seek this care early in the course of their illness, when it could do the most good.

Often patients assume their doctors will take care of their pain and don't realize that in our specialized medical system, the oncologist or the cardiologist has not been well trained in pain and symptom management.

Also, many patients and doctors have an all-too-human tendency to avoid talking frankly about the seriousness of a diagnosis, which may prevent the subject of palliative care from even being discussed.

"A lot of physicians aren't comfortable talking about what do we do if the chemo doesn't work," says Andrew Putnam, M.D., director of palliative care at Georgetown Lombardi Comprehensive Cancer Center in Washington. That's a missed opportunity, he says, because palliative care teams are trained to help patients understand all their treatment options as well as the quality-of-life ramifications, so they can make truly informed decisions about what's best for them.

Often patients assume their doctors will take care of their pain and don't realize that in our specialized medical system, the oncologist or the cardiologist has not been well trained in pain and symptom management, Meier says. Nor do specialists have a lot of time to spend on quality-of-life issues. Because they are focused on treating the illness, doctors may not realize how bad a patient's symptoms are or that they are overlooking better options for reducing pain.

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