PAIN ISSUE COMPLICATED

In view of all the recent attention given to the arrest of Michael McSween,
ARNP, and Dr. Darshan Shah of Advanced Care Emergi-Center, I feel compelled
to respond.

Much focus has been on the compassion and medical expertise of these fine
men. I would like to point out another aspect of this rather complicated
situation: the issue of pain.

The medical society has been given a mandate by the federal government to
address the issue of pain. The patient has the right to actively participate
in all aspects of pain management and the right to pain relief. Pain has
been added as the fifth vital sign, next to temperature, pulse, respirations
and blood pressure.

How do you decide if the patient is actually experiencing pain? Good
question since there is no single definition of what pain is. Pain is
subjective and only the patient can decide if, or not, he is having pain.

Just because someone is smiling or joking and able to continue normal
activities without obvious signs of pain does not necessarily mean he is not
actually having serious pain. When a patient complains of pain, a
practitioner is required by law to address that complaint.

Now the issue becomes something of a nebulous sort. The practitioner is
supposed to be able to determine whether the patient is lying about the
complaint in order to obtain medication. How can this be managed while still
complying with the law? Most practitioners will order tests to confirm the
presence of pathology as the cause of the pain. Even without the presence of
pathology, the patient may still be experiencing pain that cannot be
substantiated. So what is the patient to do at this point?

Suffering with pain is unnecessary; however, patients are now having to
suffer because practitioners are afraid to prescribe medication to control
or relieve for fear of accusations of overmedicating or unnecessarily giving
medication to "drug seekers."

Mike McSween and Dr. Shah have been a part of the local medical community
for many years and have been colleagues of mine for as long as they have
been here. Both my family and I have used their services many times through
the years. I have never witnessed any behavior, professional or private,
that would jeopardize the well-being of any of their patients. Their
professional commitment to their patients is above reproach.

By the way, the picture of Advanced Care Emergi-Center as a "pill mill" is
rather distorted since there is a license to dispense medications in place.
Most of the confiscated drugs were antibiotics and other medications that
have nothing to do with pain management.

Thank you for your continued support of Mike McSween and Dr. Shah. They
deserve to be exonerated and hopefully will be sooner rather than later.

Brenda Gibbons, R.N., Fort Pierce