National Pain Summit calls for better pain care in America

American Academy of Pain MedicineNov 10 2009

'The science is in place. Why are so many suffering?'

Pain medicine physicians from the American Academy of Pain Medicine (AAPM) continued to advance the call for better pain care as they joined with physician leaders from across the country in a closed-door National Pain Summit that took place adjacent to an AMA meeting last week in Houston, Texas.

AAPM leaders have been vigilant in advocating for better pain care for patients. They released AAPM's Pain Medicine Position Paper documenting how to address the need for better pain care earlier this fall. More recently, they signed the Mayday Fund's Call to Revolutionize Chronic Pain Report, which demonstrates the disparity between patient suffering and the under-accessed pain care.

"The Pain Summit confirmed that the felt need for better pain care in America reaches across all medical fields. Every day, tens of millions of U.S. citizens are suffering from immobilizing pain that affects their jobs, their families, and their spirit; frankly, our doctors are often not trained well enough and our health care system is not organized appropriately to be able to help these patients. We can offer better care. We have the clinical science to start the process. But, funding is needed to educate patients and the public, to streamline medical systems, and to improve and standardize the education of medical students, the training of residents in all specialties, and the training of pain medicine specialists," AAPM President Rollin M. Gallagher, MD, MPH, explained.

The closed-door discussions in the Pain Summit were focused on several dominant themes:

• Better pain care is available for patients, but is not being accessed.
• Education on pain should be improved in medical schools, residency and fellowship programs, as well as in training programs for allied health workers.
• Additional funding needs to be made available for continued research in pain.
• A model of collaboration between primary care and specialty physicians should be evaluated and disseminated among physicians so patients can find the right physician to see for their pain.
• Consumers need to be told that better pain care is available and how to access it.
• Finally, the physician leaders uniformly agreed that changes have to be made within the structures of organized medicine to accommodate better pain care for patients, namely pain should be recognized as a specialty and pain should be treated as a disease.

The AMA Section Council Pain Summit was part of the pre-meeting activities of the AMA's Interim House of Delegates meeting in Houston, Texas, which takes place through Wednesday of this week. The Pain Summit was organized by the Pain and Palliative Medicine Specialty Section Council in response to Resolution 321, adopted by the American Medical Association House of Delegates in May of 2008 that expressed a strong commitment to better access and delivery of quality pain care through the promotion of enhanced research, education and clinical practice in the field of pain medicine.

In addition to over 28 prominent medical associations that participated in the overall summit process, representatives from the medical branches of the U.S. Department of Veterans Affairs, and the United States Air Force, Army and Navy were present.

The mission of the summit was "to strive for excellence in the delivery of high-quality, cost effective pain care to the patients we serve." To facilitate the process, physician leaders from participating medical associations had been queried prior to the summit to organize topics for discussions. Once together, physicians were divided into workgroups to discuss one of the following five topics related to improving pain care:

• What should all physicians know about Pain Medicine?
• How should Pain Medicine be taught?
• What are the parameters that define the field of Pain Medicine?
• What mechanisms do we need to establish the competency of a physician who practices Pain Medicine?
• And what are the barriers that prevent patients from receiving adequate pain care?

Participants looked at the state of how pain is treated within the parameters of their workgroups. They idealized how pain should be addressed in light of their workgroup topic, and then determined the next steps to bridge the gap.

The results were then shared as a whole with all constituents and further discussed. A list of approximately 30 action items was formulated and is being shared with participants. Funding will be key to actualizing better pain care for patients.

"The sentiment at the meeting was that 'the time is now' for better pain care," said AAPM Liaison Director Michel Y. Dubois, MD. "With the support of the summit attendees, we hope to expand this group of participants to include more medical and allied health organizations as well as government and insurance sectors in future Pain Summits. It is time to get the Pain Medicine specialty organized, to formally train all physicians in pain management, and to provide better care to patients," Dr. Dubois concluded.