Family Physician Perceptions of Their Role in Managing the Opioid Crisis

Desveaux et al explore family physician perspectives of their role in managing the opioid crisis and the extra stress that this burden places on an already stressed group of physicians.(1) This study highlights the unease many family physicians feel surrounding the management of chronic pain, including feeling unprepared and unsupported. Future research is needed to know more details about why physicians have these specific perspectives. Family physicians can likely use their skills in staying current with constantly evolving guidelines to help alleviate this feeling of being "unprepared" and to provide the best care for patients.

One of the key themes of the study was that many family physicians felt "unprepared" to manage chronic pain in lieu of the evolving guidelines regarding opioid management. In medical school and residency, family physicians are taught that medicine is never stagnant, and it is important to keep up with change. Though management of chronic pain in the setting of the opioid crisis has certainly been a significant change, it is no different than the way physicians have had to adapt to other shifts in medicine. The challenging part of this change may lie in the emotional component of prescribing opioids. A recent study identified family physicians' hesitation in prescribing opioids due to known risks, such as overdose, addiction, dependence, or diversion.(2) With proper training, most family physicians should have the tools (i.e. evidence-based medicine curriculums) to navigate through an ever-changing field so that they never have to feel like they have been left behind.

The key themes identified in this study are important issues to address among family physicians to increase comfort with managing chronic pain. Providing more depth to the reasons given by these providers would be helpful for readers to think about their own role in changing these perspectives. The study identified that years in practice affected physicians' comfort with managing chronic pain, so it would be helpful to see what challenges need to be overcome to make the necessary resources easily accessible. Identifying more specific challenges is key in developing plans for change so that physicians will feel confident managing chronic pain and patients will receive the best care possible from their family physician.

1. Desveaux et al. Family Physician Perceptions of Their Role in Managing the Opioid Crisis. Ann Fam Med July/August 2019 vol. 17 no. 4, 345- 351.

2. Kavukcu et al. Chronic non-cancer pain management in primary care: family medicine physicians' risk assessment of opioid misuse. Postgrad Med. 2015 Jan;127(1):22-6. doi: 10.1080/00325481.2015.993572. Epub 2014 Dec 25.

Competing interests: None declared