Great point, Jimmie
When hunting, however, there is always time to get into "the zone"; where all factors can be weighed and a decision made. Pain management is more like combat. A patient arrives in the office, you have limited time, pressure to make a decision, and limited information. It is the essence of Von Clausewiz's "fog of war". And, as he also said, "the first casualty of any battle is the plan".
It is easy to criticize the decisions that are made in these conditions. It is quite another to be the one forced to make them.
