First-of-Its-Kind Law Requires Doctors to Take Pain Management Classes

Under a first-in-the-nation law, California physicians must take classes in pain management and end-of-life care as part of their continuing education required to renew their medical licenses, the San Francisco Chronicle reports. Sponsored by Assembly member Dion Aroner (D-Berkeley) and signed by Gov. Gray Davis (D), AB 487 also requires the state medical board to "track complaints of doctors mishandling pain care and ensure that those complaints are reviewed by a pain specialist." The law stems from a lawsuit against Dr. Wing Chin, an internist at Eden Valley Medical Center in Castro Valley, who was found guilty of elder abuse and "reckless negligence" for undermedicating 85-year-old William Bergman while he was dying of "probable" lung cancer in 1998. Several studies have shown that untreated pain is a "widespread" problem, particularly among elderly patients, the Chronicle reports. "Some doctors treat pain conservatively out of fear that the patient may become addicted to painkillers," Aroner said, adding, "When it comes to individuals in pain during the end of life, worries about over-treatment and addictions are simply absurd." Dr. Russell Portenoy, past president of the American Pain Society and head of the Palliative Care Department at Beth Israel Hospital in New York, said that the law represents a "very extraordinary step ... to address what is clearly an enormous problem." He added that if the program is successful, "it would be a major incentive for other states to do the same thing" (Hendricks, San Francisco Chronicle, 10/30).