ABSTRACT
The chronic pain patient is one of the hardest challenges facing any phy sician. Axiomatically, this patient is the focus of the pain physicians’ practice; thus, it is vital that the pain physi cian be able to recognize and respond to the special issues, demands, and dif culties inherent to treating the per son in pain. Often distraught and uncomfortable, with lives sometimes re duced to near-inactivity, pain patients frequently approach the physician lit erally begging for relief from pain. But (not unlike most people who have been reduced to begging) they are also fre quently overtly or covertly angry, and disgusted with the limitations of medicine (as either science or art!). They desperately need help but may distrust or suspect the physician of not
Introduction ............................................................................................................ 229 Goal-Directed Health Care (G-DHC) ....................................................................230 G-DHC: A Background .......................................................................................... 231 Health Goals and Life Goals .................................................................................. 233 Changing the Dialogue ..........................................................................................234 A New Vision of the Healing Encounter ................................................................ 236
Case 1 ................................................................................................................ 236 Case 2 ................................................................................................................ 238
Conclusions ............................................................................................................ 239 Acknowledgments ..................................................................................................240 References ..............................................................................................................240
