All Politics Is Local

Abstract

In the relative scheme of organized medicine, the American Academy of Pain Medicine (AAPM) remains but a small voice surrounded by the many primary care and specialty medical societies competing to be heard on the national scene. Certainly, there is a strong legitimacy to our message, as there is to the message of each and every special interest group; unfortunately, with the escalating competition from so many of medicine's “voices,” being heard in the crowd is becoming increasingly difficult. It does not take an actuary to recognize that we are rapidly approaching a point at which health care expenditure cannot be sustained. The threat of cuts in physician payment has loomed over the already meager Medicare reimbursement for the past several years. Employers are increasingly limiting both pension and health care funding, potentially leaving many patients facing the possibility of going without health care coverage. Significant change must take place in the U.S. health care system, and it is essential that we, as pain physicians, become authors of this change to ensure that our patients continue to have access to effective and appropriate pain treatment. In this environment of escalating competition for health care dollars, there are no guarantees that the proper decision-making process will occur, unless we assume an active role in guiding and implementing that process with our ultimate goal being the best pain care for our …