A new study published in JAMA Network Open found that chronic pain sufferers have a harder time finding primary health care because they have an active prescription for opioids.
According to the study, 40 percent of the nearly 200 primary care clinics contacted as part of study said they would not accept a new patient who takes Percocet daily for chronic pain as a result of a past injury, no matter what type of health insurance they had. An additional 17 percent of clinics said they would want more information about the patient before deciding if they would take them on, with two-thirds of this subset saying the patient would be required to come into a preliminary appointment before a decision could be made. Despite these findings, all of the clinics said they were currently accepting new patients.
The findings suggest patients with a history of chronic pain could face health care access problems.
“Anecdotally, we were hearing about patients with chronic pain becoming ‘pain refugees’, being abruptly tapered from their opioids or having their current physician stop refilling their prescription, leaving them to search for pain relief elsewhere,” said study lead researcher Pooja Lagisetty, M.D., M.Sc. “However, there have been no studies to quantify the extent of the problem. These findings are concerning because it demonstrates just how difficult it may be for a patient with chronic pain searching for a primary care physician.”
Dr. Lagisetty said for patients with chronic pain conditions, getting access to primary care goes beyond just checkups and preventative care. Having a regular physician could allow them to receive other pain-relieving treatments, and in some cases, work with the new provider to gradually and safely taper off their use of opioids. Primary care providers can also help recognize the signs of opioid use disorders or addictions, so not accepting patients simply because they are trying to manage their pain only works to further the crisis.
“We hope to use this information to identify a way for us to fix the policies to have more of a patient-centered approach to pain management,” said Dr. Lagisetty. “Everyone deserves equitable access to health care, irrespective of their medical conditions or what medications they may be taking.”
It’s easy to accept the healthy young adult at your clinic, and it can be harder to take on the patient managing multiple health conditions, but both should be guaranteed access to primary care providers. We need more doctors who are willing to take on the harder patient.