Team approach needed to treat pain

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.