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Contrary1 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 05:44 PM
Original message
Prescribing gap may leave blacks in more pain
"I’m going to tell you something — we have fabulous health care in America, just so you know. I think it’s very important — before people start griping about the health care system here — and of course there’s always grounds for complaint — just to compare it with other systems around the world." Dumbass in Chief: 12/17/07

Study shows minorities are less likely to get narcotics from ER doctors

"Emergency room doctors are prescribing strong narcotics more often to patients who complain of pain, but minorities are less likely to get them than whites, a new study finds.

Even for the severe pain of kidney stones, minorities were prescribed narcotics such as oxycodone and morphine less frequently than whites.

The analysis of more than 150,000 emergency room visits over 13 years found differences in prescribing by race in both urban and rural hospitals, in all U.S. regions and for every type of pain.

“The gaps between whites and nonwhites have not appeared to close at all,” said study co-author Dr. Mark Pletcher of the University of California, San Francisco..."

http://www.msnbc.msn.com/id/22463720/

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Fed_Up_Grammy Donating Member (923 posts) Send PM | Profile | Ignore Tue Jan-01-08 05:50 PM
Response to Original message
1. God almighty --racism in the ER? I can't believe this
type of thing is going on.
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UndertheOcean Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 05:52 PM
Response to Original message
2. if you're not passing out from pain, or dying from cancer
strong narcotics should never be prescribed , to anyone, they are easily abused.

Doctors hand them out like candy these days.

Also , the ER is not the proper place for managing chronic . non life threatening pain.
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pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:09 PM
Response to Reply #2
3. may you experience in your body what you wish for others
doctors do not hand out narcotics like candy, my best friend's father died screaming in pain from terminal cancer because of inadequate pain medicine

there are probably a thousand posters on this site who will tell you the same experience

i don't give a shit if morphine is "easily" abused, i would rather have every heroin addict have all he wishes and stop robbing drugstores and stop robbing cancer patients, than to have even one sick person in agonizing pain be cheated of their medicine because of doctor's fear of the DEA

be grateful you don't have a clue what you're talking about, too many of us don't have this luxury

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UndertheOcean Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:12 PM
Response to Reply #3
5. Didn't I include "cancer patients" in my post, your father should have gotten treatment
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pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:17 PM
Response to Reply #5
8. it's people with your attitude who GUARANTEES they don't get treatment
a doctor's only concern should be with proper medical care and proper pain management

however, if she wants to keep her license, these days, her FIRST concern is how many Rx's she writes a year and if by the DEA's unknown formula, she will trigger a loss of her license for over-writing

an oncologist ONLY treats cancer patients, and if he gives all of them all of the pain medicine they need, then apparently the DEA is going to be triggered

it is too bad that pain medicine can be abused, but frankly, as far as i'm concerned, people should have access to all the pain medicine they like -- genuine patients are not crucified on a cross of pain and DEA righteousness, drug addicts are not forced to beggar their families and then rob sick people and drug stores

there is NO good side to restricting pain medicine, as far as i'm concerned, sell it over the counter to all who are of age
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UndertheOcean Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:25 PM
Response to Reply #8
10. I thought that cancer patients in pallative care have access to all the pain medications
Edited on Tue Jan-01-08 06:27 PM by UndertheOcean
they need to keep them comfortable , atleast I read that in a Hospice document.

Am I mistaken in this belief , or was the document I read erroneous.

I am battling sever depression , and anxiety disorder with panic attacks that present as severe abdominal pain , and for years I would go to the ER , they would fail to find whats wrong , and just send me home with Vicodin , which is not pretty to get off from. This personal experience is why I think ER docs prescribe them like candy as a solve all.

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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:57 PM
Response to Reply #10
15. in other words, you have a history of addiction, so everyone else has to suffer...
... to keep you on the straight-n-narrow?


Let me tell you something. I had a bacterial ulcer on one of my eyes. It was hell, and it triggered a migraine that I couldn't get rid of. I could scarcely even open my other eye, because the bilateral pupil reflex to light felt like a knife in the affected eye. So I had to shut my eyes most of way behind dark glasses and cling to my mother to walk.

But at the hospital, I was never offered any pain relief, and I knew why:


It's because we've all got look out for the friggin junkies. Mustn't have too many narcotics out in society to add to the Problem.


Those little fuckers always come first. Never mind if the rest of us are in so much pain we can't sleep.


So I took some aspirin and several shots of whisky. A lot of us end up doing that, because we haven't got anything else.


And you're okay with that, apparently. You think other people's pain is a small price to pay for the all-important goal of protecting you from yourself.


I don't agree.

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UndertheOcean Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 07:05 PM
Response to Reply #15
17. I don't understand why didn't the doctors administer pain meds for such a clear
and easily verifiable physical source of pain , your's is not the case of a mysterious 10/10 back pain that no test can find the cause of ....

Tramadol is very effective in taking the edge of migraines , why didn't they offer you that , and its not dangerous.

Common sense must prevail , sadly it does not.
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dogishboy Donating Member (150 posts) Send PM | Profile | Ignore Tue Jan-01-08 07:54 PM
Response to Reply #17
21. Here's why
because the * administration has been revoking the licenses of any doctor they think is over-prescribing pain meds to. In addition, the bush* admin wont tell the doctors what criteria they're using to decide is a doctor is over-prescribing, based on the theory that if they reveal it, doctors will "game the system" in order to continue over-prescribing, as if the doctors WANT to over-prescribe

Because doctors dont KNOW what over-prescribing means, they err on the side of caution, and as a result, they UNDER prescribe.
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dogishboy Donating Member (150 posts) Send PM | Profile | Ignore Tue Jan-01-08 07:01 PM
Response to Reply #10
16. You thought wrong
That's why facts are considered to be A Good Thing. They help prevent you from thinking the untrue is true.

As I explained before, my brother had a multiple coronary bypass operation, and his pain meds were limited. Can you imagine how painful it must be to have your breastbone split in two? The breastbone keeps all of your ribs from floaring around your chest cavity. Every movement puts pressure on the wound. Can you imagine how painful it must be ?

And he didn't get enough pain killers.

Hospice care is another matter, but hospice care is for people who are expected to die in the near future. IMO, we shouldn't wait until people are dying before we act to reduce their suffering. But thats just me.

I also suffer with an anxiety disorder and depression. Since the pain you felt was caused by your psychological problems, I'm very surprised that they would give you Vicodin when there was no medical problem. IMO, that's incredibly irresponsible. In my experience, the doctors were reluctant to even prescribe SSRI's, so I can see why your being prescribed Vicodin led you to your conclusion. However, I can assure you that your experience is an unusual. The difficulties gettin pain killers for valid reasons has been well documented, and corroborated by many people's experiences.

BTW: I've gotten a lot of relief from SSRI's a cognitive behavioral therapy. If you ever want to talk about it, or ask questions, feel free to PM me
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ncrainbowgrrl Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:10 PM
Response to Reply #2
4. When I go to the ER (happens occasionally)
Edited on Tue Jan-01-08 06:11 PM by ncrainbowgrrl
I have Migraine disease. After 72 hours in continuous pain without a 4 hour break, you're in something called "status migrainous" which raises your stroke risk- so it's real important that some people (like me) with chronic illnesses use the ER as a place to have their needs addressed.

I'm a white 28 y/o female

I'm allergic to hydrocodone, but am okay with oxycodone. But I want neither at that point, and sometimes that's all they want to do- slap a bandaid on the problem and send me on my way- instead of following proper protocols for migraine treatment.

I use a protocol designed by me and my migraine specialist to break the migraines, and that's what I ask for. But sometimes the first thing that they try doesn't get the whole migraine, and I need to try number 2 or 3 or even 4 on the list. When the ER is wicked busy, they wait until my pain level is lowered down to a 2-3 out of 10 and then try to give me oxycodone and toss me out of the ER.

But yes, the oxycodone is offered to get me out of there- not because it's the "right" treatment. It amazes me- that with the control needed to write for these meds, we can't control pain relief for the patients. All docs are not writing equally- and Some are handing 'em out much more easily- even if it's the incorrect treatment, while others accuse you of being a drug seeker if you are in pain.


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dogishboy Donating Member (150 posts) Send PM | Profile | Ignore Tue Jan-01-08 06:15 PM
Response to Reply #2
6. I call Bullshit on your post
"Doctors hand them out like candy these days."

Having spent a lot of time in hospitals these last three years, I can safely say you're claim is BS. The govt now tracks doctors who prescribe narcotics and come down very hard on doctors they feel have prescribed them innappropriately. As a result, doctors have become very reluctant to prescribe narcotics. Thank you, bush*!

In most post-op rooms, there are limits on how much narcotics the nurse can give a patient without having the doctor give permission. These limits have nothing to do with overdosing, as these limits are way below the level at which an overdose occurs. They are meant to keep the hospital from getting into trouble with the Feds.

My brother, my mother, and I, all go to a pain mgmt specialist. If anyone should be handing out meds like they were candy, it's these doctors because their patients have painful conditions. Even they, no...make that ESPECIALLY they have watch what they prescribe because the Feds are paying particularly special attention to the pain mgmt specialists.

My brother's meds were limited after he had his chest cut open for a multiple coronary bypass operation. My meds were limited after my operation for a torn rotator cuff.

And this is WHY these ER's are underutilizing painkillers, particularly when it comes to blacks. Think about it. We have a conservative govt. They don't like blacks and their bigotry informs them that giving meds to blacks is a bad idea. In addition, hospitals that see a lot of black patients are more likely to have patients with drug dependency problems. Their experiences make them more wary of patients who desire painkillers.
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pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:20 PM
Response to Reply #6
9. thanks dogishboy
this is what i've seen also
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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:29 PM
Response to Reply #2
11. I hope you end up regretting your words...
It would serve you right.

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UndertheOcean Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:31 PM
Response to Reply #11
12. See post #10,
I was speaking from my personal experience , which was probably a mistake , one should try not to generalize his experience to all .
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Webster Green Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:34 PM
Response to Reply #2
14. "Easily abused"..
What a fucking load of crap!

It's better to leave people in pain because of the possibility of abuse by some?

My guess is you are a cop or a wannabe cop. A control freak.
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malaise Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:16 PM
Response to Original message
7. I saw that and could not believe it
then I thought about it and believed it.
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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 06:33 PM
Response to Original message
13. Doctors care even less about black suffering...
...than they do about non-black suffering. That's saying something.


When it comes to pain relief, there should be no gatekeeper. Whether an individual wishes to suffer or not should be strictly up to him and no one else.

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Pavulon Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 07:09 PM
Response to Reply #13
18. Statistical Bias?
Now I am not saying there is no racism. I am saying that low income people, in some areas, black and hispanic use the ER system for primary care more than people who can afford a primary physician or specialist.

Any one taking a schedule 2 drug for more than 30 days has NO REASON to be refilled in an ER.

In other words if you have a chronic illness you should be not be getting scripts from an ER doctor.

How the study works is key, if they are just counting decline to prescribe schedule 2 medications on straight race lines the outcome could be skewed.

My wife works in the medical field and prescribes medication. Schedule 2 drugs are highly regulated.
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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 07:55 PM
Response to Reply #18
22. RTFA! The study broke it down by ailment and hospital type (rural, urban...)
In more than 2,000 visits for kidney stones, whites got narcotics 72 percent of the time, Hispanics 68 percent, Asians 67 percent and blacks 56 percent.



Not easy to spin that. No doubt you'll try.

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laureloak Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 07:27 PM
Response to Original message
19. Who keeps cooking up all this racism crap.
The numbers can always be manipulated to get the desired results.
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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 08:05 PM
Response to Reply #19
23. Study: Doctors less likely to administer life-saving drugs to blacks...
Edited on Tue Jan-01-08 08:07 PM by NorthernSpy
"This racism crap" kills people:


Researchers have known for years that African-Americans in the midst of a heart attack are far less likely than white patients to receive potentially life-saving treatments such as clot-busting drugs, a dramatic illustration of America's persistent healthcare disparities. But the reasons behind such stark gaps in care for heart disease, as well as cancer and other serious illnesses, have remained murky, with blame fixed on doctors, hospitals, and insurance plans.

In the new study, trainee doctors in Boston and Atlanta took a 20-minute computer survey designed to detect overt and implicit prejudice. They were also presented with the hypothetical case of a 50-year-old man stricken with sharp chest pain; in some scenarios the man was white, while in others he was black.

"We found that as doctors' unconscious biases against blacks increased, their likelihood of giving treatment decreased,"said the lead author of the study, Dr. Alexander R. Green of Massachusetts General Hospital.



http://www.boston.com/news/local/articles/2007/07/20/tests_of_er_trainees_find_signs_of_race_bias_in_care/



Okay, "Laureloak": why don't you come right out and tell us all why you want us to ignore this stuff?

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laureloak Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 08:09 PM
Response to Reply #23
24. Oh, I read it. I just think it's hooey cooked up to divide people.
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NorthernSpy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 08:17 PM
Response to Reply #24
26. that's absolutely THE most retarded comment I've read on DU...
Oh no, for heaven's sake don't find out why doctors aren't treating their black heart-attack patients -- that might "divide" people!


Doing nothing about this shit WILL divide some black folks from their LIVES, but apparently that doesn't matter to you. Why is that?

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College Liberal Donating Member (561 posts) Send PM | Profile | Ignore Tue Jan-01-08 07:47 PM
Response to Original message
20. Yea, I agree with this assement
We all know those coloreds are in the ER just to get free dope and then hopefully "man up" and get "clean" and then run for president :eyes:
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flashl Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-01-08 08:14 PM
Response to Original message
25. Black health care disparity reports goes back 25 years with no changes
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flashl Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jan-02-08 09:10 AM
Response to Original message
27. Feb. 26, 2004 letter from Racial and Ethnic Health Disparities Coalition Member Organization
Dear Majority Leader Frist and Minority Leader Daschle:

The undersigned organizations are writing to thank you for your continued support for the elimination of racial and ethnic disparities in health and health care. And, like you, we are steadfastly committed to eliminating health disparities. As you are aware, disparities in health and health care continue to cost families and the nation far too much – in pain, suffering, illness, disabilities, premature deaths, and economically.

Collectively and individually, we are very encouraged by the attention that you have brought to this national health crisis. We appreciate the assistance provided through your leadership and efforts. And,we applaud your expressions of support.

"We know that African Americans, Hispanics and Native Americans die younger and suffer from heart disease, diabetes and HIV/AIDS at higher rates than everyone else. These numbers are unacceptable. We are beginning to understand why, and as majority leader I am going to address them."

“A year and a half ago, a major report was released by the distinguished Institute of Medicine. That report, entitled "Unequal Treatment," confirmed what many people had long known, or at least suspected: In America, minorities receive poorer quality health care than non-minorities -- even when both groups have roughly the same insurance coverage, the same income, the same age and the same health conditions. This is more than a minority issue or a health care issue. It is a moral issue. ……… We must end these deadly disparities in health care.”

As we are all keenly aware, communities of color are disproportionately burdened by acute and chronic diseases. Communities of color, also, are subjected to disparities in the quality of care they receive. This occurs across the full spectrum of disease categories, and in medical and surgical procedures. The compilation of Federal government findings and scientific studies – from those outlined in the 1985 Report of the Secretary’s Task Force on Black and Minority Health, to the 2002 IOM Study entitled,Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, to those on HIV/AIDS,cancer, heart disease and all that fall in between – document a compelling case for a national Federal response. Indeed, racial and ethnic disparities in health and health care are an ongoing national crisis in health that must be addressed comprehensively.

It is against this backdrop of continuing disparities that we respectfully request that you combine your efforts and work to ensure enactment of an elimination of health disparities bill that –
• Implements the IOM Unequal Treatment Study recommendations;
• Reduces the number of uninsured;
• Ensures delivery of quality health care;
• Responds to the cultural and linguistic voids in care;
• Effectively addresses data collection, reporting, analysis and utilization;
• Strengthens the health care safety net infrastructure;
• Ensures accountability;
• Strengthens the Office for Civil Rights and the Office of Minority Health;
• Enhances research opportunities;
• Appropriately funds elimination of health disparities programs and projects including the Minority HIV/AIDS Initiative, REACH, OCR and OMH;
• Establishes community health empowerment zones;
• Fosters innovative outreach programs;
• Reduces disease and related complications;
• Promotes wellness and prevention;
• Increases workforce diversity throughout the health arena; and
• Establishes offices of minority health at key Federal agencies including CMS and FDA.

Clearly, the measure must not weaken existing minority health programs and funding. Please know that we are fully committed to working with you to help ensure enactment of such legislation.

We strongly believe that the elimination of racial and ethnic disparities in health and health care is within your combined reach. The American people in general and communities of color in particular are counting on you. Please – work together -- far too many lives are at stake. It is against this backdrop of health challenges and opportunities that we, the undersigned organizations, request a meeting withyou.

We look forward to working with you on this national health crisis.


How many more studies do we need?

DOJ's John Tanner was right, "Black People Don't Grow Old".
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