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 ...