Rapid Responses to:

EDITORIALS: Edward H Wagner Chronic disease care BMJ 2004; 328: 177-178 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Chronic Pain as a Chronic Disease

Alfred PJ Lake   (16 February 2004)

Chronic Pain as a Chronic Disease 16 February 2004
Alfred PJ Lake, Consultant in Anaesthesia and Pain Management Glan Clwyd Hospital, Rhyl LL18 5UJ. Send response to journal: Re: Chronic Pain as a Chronic Disease	Linking and coordinating primary and specialist care for patients with chronic illness, as stated, is important and can reasonably be expected to lead to enhancements. Improved care of chronic disease makes sense but we must not lose a sense of proportion and recognise the huge costs which are unsustainable without some form rationing on a ‘fair innings’ or similar basis as the bulk of the work of secondary care is now about improving the quality of patients’ lives rather than through lifesaving work and hospitals are becoming repair factories for pensioners (1). Much care of chronic disease does not necessarily need to be ‘medicalised’, in fact we should step back and let patients take their own charge with the help of alternative approaches particularly psychological. The pharmaceutical giants, however, recognise chronic disease as a growth industry which they are keen to continue to exploit, facilitated by the medical profession. May I suggest that Chronic Pain be included in any consideration of chronic disease, affecting so many, the similar needs are for sensible, balanced management with the prevention of secondary effects/damage/complications and the promotion of rehabilitation. In addition, Chronic Pain should usefully feature as a specific item in the theme issue on chronic disease planned for January 2005. 1. Gray DP. Role reversal between primary and secondary care. Medical Education 2003; 37: 754-5. Competing interests: None declared