Should Pain Scoring Be Eliminated As A Vital Sign?

Last September the American Academy of Family Physicians (AAFP) 2016 Congress of Delegates voted to eliminate pain scores as the "fifth vital sign."  Subsequently in December, over 2,100 doctors and nurses participated in a Medscape online survey asking if they supported the AAFP vote.

The results of the Medscape survey generally followed the AAFP vote, with almost two thirds of physicians from multiple specialties said they “strongly agreed” or “somewhat agreed”, and 19% saying they “strongly disagreed”.  The balance had no opinion.  Nurse opinions followed the same statistics.

From the Medscape Survey, respondents were also asked about how often they use pain scores and functional status when assessing a patient's pain. “More than half of physicians — 55% — said they often or always use pain scores, while 71% said they often or always evaluate functional status. Only a very small single-digit percentage said they did not use either measure”, the report said.

Pain management specialist Ralph laraiso, M.D., commented that patients don't use the Visual Analogue Scale in the way it was originally developed, "while others have learned to manipulate that scale to obtain the maximum amount of narcotic medications."

Dr Iaraiso said he relies more on functional status. "Many of these patients have psychosocial issues that will not be relieved by pain pills, but they will not admit to that nor seek appropriate professional services on their own, or, when referred, they are resistant," he said.

Perhaps your individual case could benefit from both pain scoring and functional status evaluations.  For a full reading of the recent Medscape report summary, please click here >>