Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why chronic pain patients and doctors are both under attack

Richard A. Lawhern, PhD
Conditions
August 21, 2025
Share
Tweet
Share

At age 81, I am one of “the old guys” who writes in online chronic pain support groups. I get a lot of emails from people in pain. One recent inquiry was from a lady named Marisa, who asked questions that are combined in the title of this article. The following is my response to Marisa and others.

My wife is a chronic pain patient who has multiple medical issues. I began researching medical literature on her behalf 27 years ago.

I had some unusual advantages in this research. I am trained as a systems engineer, technology analyst, technical writer, and data analyst. I can decode papers that to most patients and even some doctors might as well be written in ancient Greek. I’m also a trained public speaker with 50-plus years’ experience before highly partisan audiences. I also have a finely tuned nose for mythology masquerading as science, and zero tolerance for the darned fools who publish such nonsense.

I doubt that there are 100 working health care writers in the U.S. today who bring my kind of background to the work.

Very few working writers or clinicians — and almost no patients — have the combination of backgrounds and special circumstances that allow them to be effective. My personal circumstances include a forgiving spouse who is willing to tolerate my 60-hour weeks in patient advocacy; we also don’t have to work for a living, as we have a secure retirement from multiple careers.

People who have never suffered with severe pain may forget that pain can be profoundly disabling — physically, emotionally, and in families. Patients have written to me from public library computer terminals, after sleeping overnight in their cars. I hear from people who lost their homes and were deserted both by doctors and their own spouses. This doesn’t count the thousands who can’t write because they have committed suicide. Patients are not suffering from over-prescription of opioid pain relievers by their doctors. They are suffering from UNDER-prescription that destroys quality of life.

Many of the reasons why patients feel unable to act in their own behalf may boil down to what are called “the ten spoons.” Each day, a person with chronic pain or illness starts with a set number of energy spoons (for example, ten). Every activity — such as getting dressed, making breakfast, or going to work — costs a certain number of spoons, depending on its difficulty and the individual’s health on that day. When all spoons are used up, the person has no energy left for other tasks. Pushing beyond this limit can worsen symptoms or lead to exhaustion. Lots of people reach that point before noon each day.

Patients aren’t the only ones who are exhausted.

Clinicians who treat pain also face exhaustion — caused by unreasonable government policies and a punishing professional environment. Most doctors know that they are being targeted unfairly by federal and state regulators, state boards, and prosecutors who falsely blame them for having created what is called “the opioid crisis.”

Doctors know that when they prescribe opioid pain relievers to any patient for any reason, they risk being investigated or charged with professional misconduct. Even a successful defense from such actions can bankrupt a practice — especially if a prosecutor prominently advertises their pursuit of the doctor before trial. Many lawyers won’t even consider defending a doctor who can’t pay an up-front retainer of at least a half-million dollars. Such cases are time-consuming and complex. Lawyers have to pay off their educational loans too.

We should feel real sympathy for doctors who are leaving pain management practice or even medicine altogether. They face huge financial resistance from insurance companies that don’t want to pay the bills generated by chronic patients who won’t get better. These companies post profits in the many billions of dollars every year. The total annual revenue of all U.S. health care companies is projected to reach $7.7 trillion by 2032.

It is not accidental that insurance companies are among the largest political campaign contributors in the U.S. They want to prevent single-payer insurance being enacted — ever!

In politics, there is a tried and true saying: “Money talks.” And big money talks loud enough to drown out most protests.

ADVERTISEMENT

We should also not be surprised that the volume of money floating around in health care litigation today has attracted clinical predators willing to commit perjury before a judge, in order to cash in on the largess. When one is pulling down $750 dollars per hour for their testimony, it seems ever so easy to conveniently forget that absolutely no science supports one’s declarations.

Prosecutors or judges eager to be seen as tough on crime may also refuse to seriously examine qualifications of so-called “experts.” Is a clinician whose practice has focused on plastic surgery and who has never published a single peer-reviewed paper even remotely qualified to evaluate if a defendant is practicing good pain medicine? I have read at least one court transcript where this is exactly what happened.

It’s fair for readers who are in pain to ask, “What can I do about this mess?” My answer is that there are real answers “moving in the wind.”

The number of writers willing to contradict the lies being told by insurance companies, state medical boards, attorney generals, CDC, Veterans Administration, FDA, and DEA bureaucrats isn’t large — yet. But we have science and facts on our side. Some of us are teaching those facts to clinicians and others who must take a certain number of units of Continuing Medical Education each year. I am one of those teachers, in courses accredited by the Postgraduate Institute for Medicine and funded by the U.S. District of Columbia Department of Health.

If you are a pain patient, I urge you to spend one of your spoons and forward this article and the last link in the paragraph above to your doctors or a local TV station newsroom. You can tell your doctor “You need to read this — it could keep you out of jail.” You might also expend another spoon calling a newsroom director to say that “There is a Pulitzer Prize waiting for you if you cover this story … and if you won’t even read five minutes, then shame on you!”

Richard A. Lawhern is a patient advocate.

Prev

The overlooked power of billing in primary care

August 21, 2025 Kevin 0
…

Kevin

Tagged as: Pain Management

Post navigation

< Previous Post
The overlooked power of billing in primary care

ADVERTISEMENT

More by Richard A. Lawhern, PhD

  • The hidden battle of weight loss: Why dieting alone isn’t enough

    Richard A. Lawhern, PhD
  • The hidden bias in how we treat chronic pain

    Richard A. Lawhern, PhD
  • When state legislators are given the opportunity, they vote overwhelmingly for doctor autonomy in pain treatment

    Richard A. Lawhern, PhD

Related Posts

  • Think twice before prescribing opioids as a first-line treatment for pain

    Gary Call, MD
  • Merging the wisdom of pain medicine and addiction medicine to optimize outcomes

    Julie Craig, MD
  • Euphoria-free pain relief: A gabapentin alternative you’ve been waiting for?

    L. Joseph Parker, MD
  • The truth behind opioid use disorder

    Richard A. Lawhern, PhD
  • Beyond opioids: a new hope for chronic pain relief

    L. Joseph Parker, MD
  • Topoisomerase inhibitors and chronic pain

    L. Joseph Parker, MD

More in Conditions

  • The quiet work of dying: a hospice nurse’s reflection

    Christopher M. Smith, RN
  • Medicaid lags behind on Alzheimer’s blood test coverage

    Amanda Matter
  • Why transgender health care needs urgent reform and inclusive practices

    Angela Rodriguez, MD
  • Why the Sean Combs trial is a wake-up call for HIV prevention

    Catherine Diamond, MD
  • New surge in misleading ads about diabetes on social media poses a serious health risk

    Laura Syron
  • mRNA post vaccination syndrome: Is it real?

    Harry Oken, MD
  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • Why chronic pain patients and doctors are both under attack

      Richard A. Lawhern, PhD | Conditions
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
    • The quiet work of dying: a hospice nurse’s reflection

      Christopher M. Smith, RN | Conditions
    • A systemic plan for health worker well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Why physicians need a place to fall apart

      Annia Raja, PhD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • Why chronic pain patients and doctors are both under attack

      Richard A. Lawhern, PhD | Conditions
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
    • The quiet work of dying: a hospice nurse’s reflection

      Christopher M. Smith, RN | Conditions
    • A systemic plan for health worker well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Why physicians need a place to fall apart

      Annia Raja, PhD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...