At-Home Teaching Materials For Chronic Pain
by David Schechter, MD and Arthur Preston Smith, PhD
 One of the critical differences between the human organism and a machine is the
capacity for self-repair, a capacity that modern medicine — modeled largely on
machine repair — has greatly underutilized. The concept of at-home patient self-care
is predicated on the reality that mental and emotional factors play a significant role in
both etiology and treatment.
When compared to the total elapsed time it takes to recover from an illness or injury,
the time it takes to actually administer treatment is relatively short. Writing a
prescription or giving an injection takes about a minute, and swallowing a pill, even
less. Prescribed physical therapy may take but two to three hours a week. Between
treatments, however, patients continue to have needs that, if met, may allow them to
harness their own recuperative powers.
The educational materials physicians may give the patient to take home, such as a sheet
explaining their condition, an exercise program, or a suggestion to look something up on
the internet is intended to involve the patient in their own treatment and, if
successfully executed, may actually enhance and accelerate pain treatment. Discussed here
is one example to encourage and assist other doctors to develop similar programs for their
own patients.
Limitations of Ad-Hoc Patient Instruction
While most physicians try to enroll a patient’s own healing powers to treat pain by
encouraging patient self-care, an ad-hoc approach may not be effective. Most physicians
will at least explain their particular philosophy and approach to the patient. Typically
this is a brief, office-based, face-to-face discussion (or more often a monologue), in
which they succinctly explain (in three minutes or less) how they will treat a condition
the patient may have endured for months, or even years. The more conscientious physician
may supplement these encounters by putting them in writing, so patients can study and
reread them at their leisure. The latter not only improves educational efficacy, it may
also reinforce an image as a “healer,” enhancing the power of the
physician’s authority, an often underrated — but beneficial — effect of the
“art” of medicine.
Please refer to the May/Jun 2004 issue for the complete text. In the event you need to order a back issue, please click here.
— May/Jun 2004
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