The problem with the Likert Scale in the Medical Field

I remember having my wisdom teeth pulled out when I was 17 years old. It was a few days before Martin Luther King Day. This was 23 years ago now. I was given OxyContin for pain after the surgery. I looked at my mom thinking these people were insane after reading the side effects. Even at the young age of 17, I tried not to take medicine if I could. I already had congenital hypothyroidism (my thyroid was misshapen at birth) and so I tried to not use medication if at all necessary.

You may wonder what the difference between OxyContin and oxycodone is, because I wondered the same. OxyContin is the time-release version of oxycodone. OxyContin is the brand name.

My gut reaction to not using the OxyContinwas well informed. While I was prescribed it in 1999 for my tooth removal, in 2004 studies found that there was a serious addiction problem to this substance.

But, what is it with the Likert scale?

The Likert scale , developed in 1932, is a point scale on which you agree or disagree with a statement. In medicine, it was widely used to access your pain. As stated on, these tools can oversimplify pain. One of the issues with pain is that it is there to signify that there is something wrong, and many times people either ignore the pain or over amplify the pain in order to seek relief.

In the National Academies of Sciences, Engineering and Medicine, drug overdose came at a crux because of the overdosing of pain relief medications. Michael Jackson’s very public death put a spotlight on pain-killer addiction. However, the hospitals and staff are taught to help patients get out of pain. Staff are often reviewed on metrics of how they attended to their patients, how well they listened and solved the problems of their patients. An addicted patient who has figured out the system of the Likert Scale will understand this system and push for their next fix.

The medical system has created a disaster based on mitigating pain.

While hospitals are supposed to help patients fix their pain, they have also increased pain by creating this highly addictive and lucrative drugs.

When I was in the hospital for many of my fun stints (having babies, H1N1, a brain infection) I was asked on the Likert Scale what my pain was. I believe it was during my H1N1 stay, and I launched into a monologue about the problem with the Likert Scale. As a student of psychology, the Likert scale is very fallible. It is based on the feelings of the person at that one moment on time. It is not measurable. You can not quantitatively measure it and it cannot be rooted in science. You are dosing out medication that is highly potent based on a feeling.

Obviously, I wasn’t at the hospital because I felt 100%, but I didn’t feel like I was without a limb. I could be a whole lot worse, and I know that there are people who were doing a lot worse than I. Putting a number on what I felt could change instantaneously based on a quick movement at any time. So, I wasn’t really able to give a number based on this crazy scale. Especially for my whole body.

I think we are very soft as Americans right now. I know that we often feel uncomfortable and want something to soothe our pain that will take this uncomfortable feeling away. But sometimes we have to get through that feeling to find something better in life. Working through something is important. Often the pain we are feeling is to let us know that there is something wrong and if we mask that pain with medication we won’t be able to find out that there is something wrong. If we continually take Tylenol every time we have headaches, we might not find out we have brain cancer.

There are reasons for pain, and there are reasons to push through pain. The Likert Scale is not a good way of measuring pain and has lead our society into a very dark place with OxyContin and Oxycodone.

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