Team ap­proach needed to treat pain

Modern Healthcare - - COMMENT - By Cather­ine Underwood

For all its im­per­fec­tions, the Pa­tient Pro­tec­tion and Af­ford­able Care Act puts health­care de­liv­ery in a whole new light. I re­cently vis­ited a pain clinic and what I saw changed me for life. A pa­tient who was clearly in phys­i­cal pain talked to a psy­chol­o­gist about how the pain af­fected him in other ar­eas of his life. He said no one had ever asked him that.

What was dif­fer­ent about this pain clinic was that it had a team of health­care providers, which un­for­tu­nately is not the norm. Physi­cians, nurses, psy­chol­o­gists, phar­ma­cists, so­cial work­ers, phys­i­cal and oc­cu­pa­tional ther­a­pists all worked to­gether to find the best re­lief and im­prove his qual­ity of life. All people liv­ing with chronic pain should ex­pe­ri­ence this same whole-per­son treat­ment, mul­ti­dis­ci­plinary pain pro­gram. The ACA sup­ports such co­or­di­nated care.

Ac­cord­ing to a 2011 In­sti­tute of Medicine re­port ti­tled Re­liev­ing Pain in Amer­ica, people with pain re­ceive care in many ways: med­i­ca­tions, surgery, be­hav­ioral in­ter­ven­tions, psy­cho­log­i­cal coun­sel­ing, re­ha­bil­i­ta­tive and phys­i­cal ther­apy, and com­ple­men­tary and al­ter­na­tive ther­a­pies. For many, how­ever, pain preven­tion, as­sess­ment and treat­ment are in­ad­e­quate. Chronic pain af­fects 100 mil­lion people and their fam­i­lies, yet find­ing the right treat­ment the first time is very dif­fi­cult.

As a for­mer hospi­tal ex­ec­u­tive, my pri­or­i­ties were driven by the re­im­burse­ment sys­tem. But now, ob­serv­ing the people who pro­vide the care at this type of clinic, I be­lieve we must con­sider a dif­fer­ent ap­proach that will not only be far bet­ter for the pa­tient, but also will lower costs in the long run.

Chronic pain costs the na­tion up to $635 bil­lion each year in med­i­cal treat­ment and lost pro­duc­tiv­ity, ac­cord­ing to the IOM re­port. The struc­ture of our health­care sys­tem bears some of this blame. By ap­ply­ing a one-size-fits-all ap­proach to treat­ing a dis­ease that is very in­di­vid­ual, we tie our hands.

I re­cently heard it put this way: “Treat­ing a pain pa­tient can be like fix­ing a car with four flat tires. You can­not just in­flate one tire and ex­pect a good re­sult. You must work on all four.” That re­quires a team ap­proach, more re­search into ef­fec­tive ther­a­pies, and in­sur­ance sup­port and re­im­burse­ment changes to make this ap­proach more ac­ces­si­ble.

The team ap­proach must be­come the stan­dard of care for people in pain. It changed that one pa­tient’s life; imag­ine how many oth­ers could ben­e­fit.

Cather­ine Underwood is CEO of the Amer­i­can Pain So­ci­ety, Chicago.

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