Next week's question is: What is the most important factor for building a positive relationship with local hospitals?
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Three pain management specialists discuss how they and other pain management professionals can work to shape healthcare policy.
Myra Christopher, Committee Member, Institute of Medicine: Effective pain management is a moral imperative, a professional responsibility, and the duty of people in the healing professions. The 2011 Institute of Medicine report "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research" was developed from this underlying principle. Pain specialists can and should become involved in shaping policy as part of fulfilling that obligation.
One of the first ways to do this is to learn more about the policy issues that affect pain care. There are many reasons that the treatment of pain has become controversial and challenges the ethics of both policy makers and healthcare providers, including: abuse of prescription pain medications; inappropriate reimbursement; fragmentation of healthcare delivery; consequences of public policies; and lack of data, to name a few. There is a place for the pain specialist as a critical stakeholder within all of these issues.
The second way to get involved is to lead the medical community in embracing integrative pain care. Based on a biopsychosocial model of care, this patient-centered approach has been shown to be the most effective and cost-effective way to address pain. However, policy decisions that limit treatment options can stand in the way of this best practice. Finally, good policy starts with good facts. Evaluate your sources of information. As a stakeholder, what biases do you bring to the table that might be inadvertently hurting some of your patients? Challenge policy that is based on political interest, flawed data and misperceptions, and work to correct those.
Moshe Lewis, MD, MPH, Chief, Department of Physical Medicine and Rehabilitation, California Pacific Medical Center (San Francisco):
As the amount of people living with chronic pain increases, it is important for pain management specialists to advocate for their patients to receive their services. Specifically this means being aware of upcoming coding changes, new reimbursement policies and legislative updates that relate to pain physicians being able to continue to practice autonomously. The local medical societies as well as the national pain organizations have excellent special interest groups and PACs which are always looking for volunteer members.
Ginger Garner, MPT, Founder and Creator, Professional Yoga Therapy: My activism to shape healthcare policy through being a healthcare provider led me to develop a holistic conceptual model, called the Pentagon of Wellness, more than 10 years ago. It is that model which has allowed me to shift pain management and healthcare from its current medical model, curative based, to a more preventive or wellness based model. The results are very positive.
The model operates on the notion that CAM, a multi-billion dollar industry in the U.S., can be effective at both preventing and managing disease. The vehicles I use for shifting the healthcare paradigm include yoga, Pilates, TCM, massage, aromatherapy, Ayurveda, Native American medicine, Feng Shui, color therapy and music therapy. I combine all of these modalities with my license and background in physical therapy.
In less than 10 years, and working outside the current insurance model in order to lower healthcare costs (and since most insurance denies or caps treatment for those in chronic pain coverage) — I have been able to work with patients of all types — from pediatrics to geriatrics, from low back pain to cancer — and see them for a drastically lower cost through group physical therapy using the PYT model.
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