Chronic pain, credibility, and clinical practice

​

(Work in progress, in draft)

​

Abstract Chronic pain is a public health challenge, a leading cause of disability, and a source of significant emotional distress for a large percentage of the population. Many chronic pain patients report that their pain testimonies are unfairly doubted or disregarded, especially if their pain presents with unknown etiology. My goal in this paper is to interrogate the underlying causes of these “credibility deficits,” with the intention of removing barriers to improved quality of care for people in persistent pain. After a brief overview of chronic pain in the context of mainstream biomedicine, I discuss two potential causes of credibility deficits in testimonial exchanges between pain patients and clinicians: identity prejudice and clinicians’ misconceptions about pain. Acknowledging that these factors likely interact in complex ways in real-world clinical settings, I then consider how person-centered approach to medicine, appropriately implemented by epistemically humble clinicians, might help tackle both.