Often times when people think about palliative care, they associate it with hospice, but palliative care, which helps get people’s pain under control higher doses of medicine, isn’t only for those on hospice nearing the end of their life.
Dr. Richard Brittingham, an internal medicine doctor at Comanche County Memorial Hospital and Palliative Care Physician, said the idea behind palliative care is patient comfort. He says he’s trying to help people live a less painful life.
“I know they’re never going to get rid of the disease, but I can at least make the disease less painful for them, less sickening for them, and give them a better quality of life,” Brittingham said. “The palliative care physician is interested in the symptoms. Trying to control pain, shortness of breath, nausea, vomiting, diarrhea, and so forth. In palliative care, we’re much more interested in symptoms and giving a person quality of life rather than quantity of life.”
He said any doctor can perform palliative care services.
“But many physicians are not comfortable with doses that are required to achieve good pain control for patients, let’s say for an example that are having cancer pain. Some of those patients require pretty high doses of opioids to control their pain and anxiety,” Brittingham said.
He said as a certified palliative care physician, he’s not bound by the same pain medication dosage rules as other providers may be.
“And the reason for that is that people that, for an example, have a malignancy, their pain might be far and above the average person who might be on a medication two or three times a day,” Brittingham said. “I’m not limited by that. Oklahoma law limits how much you can prescribe to people, but if someone is on palliative care, of course, we want to focus on safety and what’s a safe dose for people, but there really is no ceiling for opioid dosing for people that have malignancies or end of life issues.”
But, because he’s willing to do those types of dosages for people with extreme pain, doesn’t mean he’ll do them for anyone who walks in his door asking for it.
“I want to make sure that distinction is clear,” Brittingham said. “I’m talking about people that have legitimate pain, pursuant to a legitimate condition. I’m not talking about someone coming to my office seeking drugs for the purpose of getting high on drugs. That ain’t going to happen.”
Brittingham said he gets palliative care patients through the hospital, Home Health and from patients of their families calling his office.