Let’s Talk about Power in Pain Management

Thursday, 4th November 2021
6:00pm7:00pm EDT

Local Time: to

About the Session

Please note this session takes place on Friday 5 November in Australia. 

It is widely known that pain has not only physical, but psychological, social, and cultural dimensions that can affect treatment outcomes. A related element is the power dimensions in healthcare, with research demonstrating that a more equal power dynamic between patients and clinicians has a positive influence on pain experiences. Although patient empowerment has been highly advocated in pain management, power dynamics have been discussed without a critical exploration of the interplay of contextual factors (e.g., economic, political, societal) in the patient-clinician relationship. In this presentation, we will discuss the socio-cultural-political context of power dimensions involved in healthcare interactions and how clinicians and patients can work collaboratively to ensure more equitable practices. The ideas and discussion in this presentation come from our research project at The University of Queensland where we observed more than 80 consultations of how clinicians interact with patients with back pain. Throughout the project, we collaborated with clinicians and people with lived experiences of back pain to make care more ethical and respectful. Using ideas from philosophers and sociologists, in this presentation, we will shed light on how power is actually “everywhere” and is very relevant to healthcare and pain management. Although power can have many different meanings, we will consider power as understood in particular social ways, for example in how we see ourselves and interact with others in daily life. In the context of pain management, seemingly benign and subtle practices (e.g., what pictures and information are depicted on clinics’ walls, what type of questions clinicians ask, and the seemingly ‘trivial’ use of a computer) exercise a form of power that may affect power dynamics and signal who and whose contribution is usually valued. We will provide a critical reflection on the socio-cultural-political context of the recent push for patient ‘choice’ and for patients to have a more ‘active’ role in their treatment. We will reflect on how patients from marginalized groups can be further marginalized with this expectation that they are ‘active patients’ and ‘choose’ their treatments. Finally, we will share some ideas for patients and clinicians to take to attend to these power differences in practice to have a more collaborative interaction. At the end of the presentation, participants will be able to reflect on how a more fluid power-sharing arrangement can allow clinicians, patients (and anyone else relevant to the interaction such as family, friends, and community) to make collaborative and ethical health decisions.

In line with our presentation aim to make healthcare practices more collaborative, we intend to use poll, live word clouds and chat function to not only ask the audience questions, but also to reimagine together how collaborative and ethical healthcare practices may look like. For example, we plan to ask the audience’s understanding about ‘power’, ‘power dynamics’ as well as ask the audience to share their perspectives, experiences and strategies in how they attend to power dynamics in pain management practices. We will maintain the word cloud and polls active for a longer period of time so that those watching the recording can still participate and add to our collaborative ‘reimagination’ of more equal power dynamics in pain management.

One of the biggest strengths of this presentation is the diversity of presenters and researchers in our project. We are a multidisciplinary team coming from different disciplines and with diverse backgrounds. We have important overlaps and distinctions regarding interests in pain management and healthcare more broadly. Dr. Megan Weier’s experience as a research psychologist and an expert patient provides both an inside and outside perspective about healthcare practices. Associate Professor Rebecca Olson is a sociologist with key contributions in sociological approaches to conceptualizing health and illness, healthcare practice, and emotions. Dr. Nathalia Costa and Karime Mescouto are both trained physiotherapists, researchers in the field of low back pain, experienced with engaging with critical social theories and collaborative research practices. Our different perspectives, experiences, and backgrounds, together with the audience’s perspective, will allow a critical exploration of power dynamics (both in the context of healthcare and research practices).

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Presented By

Rebecca Olson, PhD

Associate Professor
The University of Queensland, School of Social Science (Australia)

Nathalia Costa, PhD

Postdoctoral Fellow
University of Sydney and The University of Queensland (Australia)

Karime Mescouto

PhD Candidate
The University of Queensland, School of Health and Rehabilitation Sciences (Australia)

Megan Weier, PhD

Expert Patient and Research Fellow
University of New South Wales (Australia)