Selective, Tailored, Biopsychosocial Pain Treatment: Our Past Is Our Future

Abstract

Like an adolescent finding his or her true identity, pain medicine tries one promising treatment after another. Meanwhile, diligent investigators behind the scenes sort the wheat from the chaff to shape a more secure and mature identity and future for pain medicine practice and better care for the multitudes needing effective treatment. We have many treatments, but in the coming era of performance-based medical care, which will survive? There is one treatment, integrated multimodality biopsychosocial care, that is virtually established at the core of our identity. This treatment historically survives, despite poor reimbursement in a managed care environment, because it works to improve functioning and quality of life—even in the most desperate of cases. Its effectiveness is established in several meta-analyses. Our challenge is to assure that this model survives and expands in its relevance and use in the health care system. The American Pain Society's (APS) new awards for clinical centers of excellence, described below, will help. Meanwhile, we should work assiduously to increase the numbers of other treatments that are available to pain practitioners because of their established efficacy and value to society, and lead the effort to improve the overall performance of the health care system in caring for pain. Because of the way humans are wired, establishing the …