When Is Healthcare Noble?

This article, in a slightly edited form, first appeared on Pain News Network on May 9, 2020.


The following blog was inspired by conversations I’ve had with my friend, Steven Passik, Ph.D.

The Problem:

During this pandemic, our frontline healthcare providers have put their lives on the line, and many have paid the price. Their sacrifice is quintessentially noble, and we feel boundless respect and gratitude. Similar compassion is felt for the victims of COVID-19. We extol and are moved by the tireless efforts made to provide them with proper personnel, medication, and equipment.

This outpouring has led me, as a pain and addiction medicine physician, to reflect: When is healthcare noble? And why is some healthcare noble and other healthcare suspect?

There is a stark, bittersweet disparity between the esteem and appreciation we rightly bestow on COVID-19 frontline providers and the suspicion we direct toward chronic pain healthcare physicians.

Our frontline heroes in the coronavirus crisis–regardless of patient outcomes–are viewed as inherently noble and courageous. Conversely, those who treat people with chronic pain–especially in cases with an adverse outcome–are often threatened with harsh judgment, loss of medical licenses, even incarceration. Recently passed federal legislation provides “broad immunity” to providers treating COVID-19 patients; pain physicians have no such immunity.

This difference is mirrored in patient treatment–sometimes involving the same drug. There is a shortage of fentanyl and other painkillers ventilated coronavirus patients need, and The Department of Health and Human Services–understandably–has asked manufacturers to expedite production of these drugs. People in pain–whether they have the coronavirus or not–deserve effective, humane treatment.

On the other hand, as a pain physician, I have watched people with chronic conditions who are forced to live with undertreated pain for years. I have seen them fight to get through each day as the medications they need are tapered due to governmental regulations and cultural biases, rather than their physicians’ decisions. I have observed their struggles with desperate options, including suicide, in the face of daily, oppressive, almost unimaginable pain.

Even as I recognize the heroism of the frontline practitioners caring for people with COVID-19, I have to wonder: How did patients with chronic pain end up on the wrong side of the empathy divide?

Pain patients feel this empathy inequity. It’s not uncommon for some healthcare providers to treat them as exiles from society, drug-seekers, and malingerers. Criminals! But these “criminals” are people who have a disease that saddles them with long-term pain. Does their suffering matter less than coronavirus patients’ pain? How must they feel about society’s outpouring of love for COVID-19 fighters and victims compared to the suspicion, derision, and slander they receive?

I submit that the heroic and selfless medical response to those afflicted with COVID-19 can prompt valuable reflection by all providers on empathy and equitable treatment for all patients.

An Opportunity to Reflect:

What is it about certain medical conditions that results in unprecedented concern, a willingness to muster all resources, and an outpouring of  selflessness from practitioners and the public alike? Why are healthcare professionals willing to risk their lives for coronavirus patients, but not their reputations to treat chronic pain?

Some may argue that it is the immediacy of the threat and risk of death that makes the difference. But it’s a false argument.

All pain is immediate and, despite what is commonly thought, people with severe chronic pain have dramatically shortened life expectancy.

Providers on the frontlines of our world’s lengthier, more chronic, and socially complex pain crisis are as noble as those fighting the current pandemic. They take on patients others don’t want to treat. They show open-mindedness, concern, and great courage in risking the respect of their peers, running afoul of misinformed authorities, or being persecuted by misguided legislation. They put aside their professional well-being to serve a seriously oppressed and underserved population.

We need to find a way to professionally restore belief in the nobility of those providers who may not cure patients, but who do offer comfort and relief. These are professionals who are willing — often for months and years — to fight wearying, chronic battles for their patients. If such battles received the respect they deserved, there would be nothing bittersweet about watching all members of the same profession going–as they so often heroically do– above and beyond the call of duty for all.


Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book, The Painful Truth,” and co-producer of the documentary,It Hurts Until You Die.” Opinions expressed here are those of the author alone and do not reflect the views or policy of PRA Health Sciences.

You can find him on Twitter: @LynnRWebsterMD.



  1. David on May 9, 2020 at 11:18 pm

    I really object to the word heroes. Just appreciate Standard Precautions (like in hospitals and nursing homes and with mass transit, etc.) and their is little reason to fear the bug like a ‘monster under the bed’. Who I really admire are garbage men. We signed on and knew the risks and got good compensation for those risks. It’s this preoccupation with heroes that this country has had since 9/11 where many automatically turned over thinking, the fruits of labor and freedom to others who usually are not REALLY that qualified (we are all just “sinners” more in need of humility than pride) that has basically emboldened so many politicians, like the ones who have taken the reins of Health Care for pain medicines and Corona viruses, to entertain false narratives and delusions of grandeur in a greedy rush to get face time and famous or paid or re-elected.

  2. David Acevedo on May 10, 2020 at 2:11 pm

    Similarly is dispensed immense empathy and material relief handed to and thrust at the small numbers of willing participants in illicit opiate and illicit multi-drug abuse and the illicit use opiate overdoses parallel with an equal amount of derision for legitimate, severe, incurable pain sufferers who actually benefit from indicated medicinal opiates.

  3. Kristen Ogden on May 10, 2020 at 5:59 pm

    Well said Dr. Lynn Webster. Thank you.

  4. Brenda on May 11, 2020 at 4:11 pm

    Amen and Amen

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