Is treating chronic pain torture? Internal medicine residents' experience with patients with chronic nonmalignant pain.
OBJECTIVE
To assess internal medicine residents' confidence in, experiences with, and attitudes toward managing chronic nonmalignant pain (CNMP) in their outpatient practices.


METHODS
We surveyed internal medicine residents with regard to their experiences with and attitudes toward patients with CNMP. Mean responses across residency year of training were analyzed.


RESULTS
Sixty-three percent of respondents reported feeling somewhat or much less confident in managing CNMP than in managing diabetes. Confidence did not increase with level of training (p=.72). Sixty-three percent rated their preparation for managing patients with CNMP as fair or poor, and self-rated levels of preparation did not increase with level of training (p=.71). Thirty-eight percent of respondents reported having being threatened by a patient over the prescription of pain medication.


CONCLUSIONS
Residents in this setting found CNMP management to be difficult. They lacked confidence in managing CNMP and did not gain confidence over the course of training. Substantial opportunities exist for improving resident education in CNMP.
Chen
Joyce T
JT
Brown Medical School, Providence, RI, USA.
Fagan
Mark J
MJ
Diaz
Joseph A
JA
Reinert
Steven E
SE
D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D008297:Male; D059408:Pain Management; D014104:Torture