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A well-managed pain management center is more than an economically successful pain clinic; it provides high-quality multidisciplinary care that meets the changing needs of today’s health care environment.


Pain management centers have had long-standing credibility issues with payers.1–5 Costs of care, narrowly focused specialty specific care, seemingly endless treatment without endpoints, along with unsubstantiated subjective outcomes have resulted in chronic pain management programs being placed under increasing scrutiny. Meanwhile, numerous studies have documented that multidisciplinary pain management centers have better outcomes. These studies have shown that multidisciplinary pain management centers provide improved care, are cost-effective, and have improved long-term outcomes.2–4 Anesthesiology as a specialty is expanding beyond its traditional role in the operating room to provide leadership in the treatment of chronic pain.5 Anesthesiologists have an opportunity to participate in the development of, and provide leadership in, the development of multidisciplinary pain management centers of excellence. To succeed in this role, anesthesiologists must recognize the complexity of chronic pain.6,7


The successful treatment of chronic pain requires the understanding that chronic pain is a multifaceted problem. Chronic pain is not only a sensory complaint but it has profound impacts on a patient’s affect, social circle, vocational pursuits, and cognitive abilities. Pain management centers of excellence understand the unique needs of each of their patients and provide cost-effective care based on those needs. The characteristics of a well-managed pain management that set it apart are:


  • The recognition that chronic pain is multifactorial problem that requires specialized care delivered by a team of specialized providers with a full-time commitment to the treatment of chronic pain.
  • The organization of the pain management center administration is set up to recognize that different patient groups are affected by chronic pain.
  • Specific emphasis on accessibility and customer-focused initiatives that enhance treatment outcomes and facilitate referrals.
  • Recognition and planning for outcome measures that understand and trace the specific outcome important to specific payer classes.
  • Creation of a network of mutually beneficial relationships that sustain the center’s growth with the center’s various customers including hospital administration and payers.
  • Innovative products and services to help patients recover all aspects of their lives, as part of a continuum of care.
  • The commitment to increase the visibility and viability of pain management as a discipline within the health care environment.


Single-modality pain management centers that emphasize procedures and short-term relief that these blocks produce do not meet the previously mentioned characteristics. An overemphasis on procedures for short-term relief serves only to enhance the perception of disability and does little for the long-term pain management problems that need to be solved for enhanced patient function. Well-managed pain management centers are organizations that are equipped to manage all aspects of chronic patient disability. A broad focus such as this requires long-term commitments toward multidisciplinary team and program development.


Formulating a strategy is key for successful program development. Separating a multidisciplinary ...

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