When balancing patient satisfaction & adherence to CDC guidelines, do providers face a lose-lose situation?

In the wake of a costly opioid epidemic, the CDC released new prescribing guidelines which advise physicians to prescribe small doses and only when needed, according to Kaiser Health News.

However, CMS is implementing a value-based payment system in which patient satisfaction will likely dictate provider reimbursement. Patients often come to facilities seeking a solution to their pain, and opioids are usually that solution despite being highly addictive. In 2014, the CDC found 2 million Americans abused prescription painkillers, with more than 14,000 suffering fatal overdoses.

Therefore, healthcare is giving physicians "mixed signals" where they have an obligation to adhere to CDC guidelines while also ensuring patients' have minimal, if not zero, pain. Organizations including the American Hospital Association and Physicians for Responsible Opioid Prescribing are imploring CMS to get rid of questions about pain from the official hospital survey. However, many are skeptical whether this call for action will gain traction.

A HHS spokesperson said CMS is trying out different phrasing to better form questions about how providers discuss pain with patients, rather than questions that focus on how providers treat pain. Like antibiotics, many physicians prescribe opioids even if they are not truly necessary because patients want a physical remedy to their condition, even if opioids or antibiotics don't fix the problem. Patient would rather walk away with a painkiller than instructions to get more rest.

CMS officials claim there is no evidence proving a relationship being prescribing opioids and enhanced patient satisfaction scores, yet Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, argues the point is physicians still believe prescribing more opioids will yield better patient satisfaction scores, thereby increasing their revenue.

Because no studies have assessed how physicians' prescribing impacts the opioid problem, many claim it is difficult to quantify the effect removing the survey questions will have on the epidemic. Mr. Kolodny said the healthcare community needs to focus on the scope of the problem.

"We're dealing with an epidemic of addiction. Some people develop addiction because they took drugs to feel effects. But many people develop addiction by taking drugs prescribed by doctors," he said. "Once people are addicted, they're not using the drugs because it's fun. They're taking them because they're addicted, and feel that they have to. And it's awful."

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