There's terrible suspicion and prejudice when anyone mentions Europe. This all stems from their strange belief in socialism, not to say outright communism. Indeed, it's a miracle they ever managed to pull themselves out of savagery and joined the civilized world even with our help and protection. But, putting politics to one side for a moment, they do occasionally have a good idea. So the French developed fries, Italians wind-dry their pork in caves and the British developed the little blue pills we all depend on. This shows national priorities with the British notoriously weak in the sex department.

Anyway, with their communist insistence on teams rather than the individual, hospitals are organized in a rather different way. Instead of a patient being owned by a particular doctor throughout the period of treatment - the American way - the patient is passed from one individual to another until everyone has had their say. You might think this is a waste of resources but, since their governments pay for most hospitals and all their staff, it's up to the doctors themselves to decide how best to use the available resources. So they tend to put teams together. When it comes to a patient who finds continuing pain a real problem, there's a set routine. A separate group of doctors reviews the treatment to date to see whether there are any further options to explore. If not, they treat the pain as a separate problem. This involves contributions from doctors, physical therapists, cognitive behavioral therapists, counselors and specially trained nurses. They talk through the options within the team and with the patient. Just think of the value of all that labor focused on treating a single individual. That's unthinkable in our system. The cost would never be accepted by the health insurance companies. But in Europe, they waste resources like this, hoping to get the best results for each patient. Strangely, all their research evidence shows this gets very good results. Well, they would say that, wouldn't they. They need to justify the cost to their political masters.

There's one other really strange thing. They aim all their treatment to produce a lifestyle for the patient which either avoids using painkillers completely, or uses them only when absolutely necessary. Their extraordinary view is that the continuing cost of drug is not justified when people can be shown how to have a good quality of life without. This does not deny the use of Ultram. No matter where you are, this is the first drug of choice to deal with pain. Equally, even though patients are encouraged to do without, Ultram can still be used as and when the pain flares up. In such cases, the people take a relatively high dose to bring the pain under control and then slowly taper it down again.

So there you have it. These weird Europeans - it's a miracle any of them survive. Although there's one thing you might notice. The European patients feel they are important. They have access to trained people at every point - including by telephone from home for instant advice. And they say that helps them feel better about themselves and more confident in the treatment. But that's not something we are interested in, is it?