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Pain Medicine: A Unique Specialty Blossoming in Difficult Times
In 1897, Sir William Osler said, "Know syphilis in all its manifestations
and relations, and all other things clinical will be added unto you."
In the beginning of the 21st' century, the same can be said about the
study of pain medicine. To be successful in our field, we must understand
the biology underlying the basic sensation of pain, the impact that
diseases have on this system, and the mind-body interface. Everything
from genetics to neurology to the most seemingly outlandish alternative
therapies is within our domain. We need to evaluate all therapies, determine
their efficacy, and integrate the effective therapies, separating the
chaff from the proverbial wheat.
As we all know, in 2001, the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) instituted a requirement that hospitals incorporate
the right to appropriate pain assessment and management into their patient's
bill of rights. JCAHO also underscored the right of patients to education
about their pain and its management. Also, legislation signed by President
Clinton that went into effect on January I, 2001 made the first decade
of the millennium the Decade of Pain Control and Research. This is only
the second time the US Congress has given a medical designation to a
decade.
These advances are timely. We have an aging population. It is estimated
that the number of elderly will increase from its current level of 18%
of the population to 22% by 2030. Because this population suffers from
a high percentage of diseases with painful sequelae, the need for pain
specialists is also growing.
Controlling pain is not easy, however. We need to continue to train
people to become experts in our field, and we must make paying for this
care a national priority. Unfortunately, reimbursement for patient care
in general is under siege. The Medical Payment Advisory Committee (MEDPAC)
estimates that physician services will be cut 17% between 2002 and 2005,
resulting in a lower reimbursement than in 1993. Spiraling malpractice
premiums and increasing office expenses exacerbate this situation. Now,
for the first time, physicians are refusing to accept Medicare patients
because the government reimbursement fails to cover the costs associated
with their care. If this scenario continues, patients with pain will
not have access to the care recommended by JCAHO. This affects all of
us. We need to let our legislators know that citizens want pain care
and that reducing the suffering of our elderly must be a national priority.
These payment cuts threaten our seniors and need to be llss challenged
at the grassroots level as well as by professional associations. The
officers of the Southern Pain Society will do our part, and we are asking
you, our members, to do yours by sharing your views with your legislators.
I have brighter words to say about the state of the Southern Pain Society.
In February, we hired a wonderful Executive Director, Lori Postal RNC,
MS who has been busy creating and updating our databases, revising our
information packets and certificates for new members, arranging for
credit card payment of dues, coordinating board meetings, and helping
increase the publication of these newsletters. Lori created a well-received
display for the American Pain Society meeting in Baltimore in March
and kept our information booth well stocked with newsletters and with
information on our educational opportunities.
Speaking of these, I want to say a special "Thank you" on
behalf of our entire membership to Dr. Shashidhar Kori, Dr.Winston Griner
and Mike Ainsworth for the invaluable service they provided by developing
the "Treating Pain in Your Practice" workshops, sponsored
by the Southern Pain Society in conjunction with Elan Corporation. To
date, our workshops in Nashville, Greensboro, and Lexington have attracted
nearly 150 attendees and generated 25 new SPS members. We will hold
the next four workshops in this series in Philadelphia (June 1), Baltimore
(June 8), Chicago (June 15), and St. Louis (July 20).
Finally, we are happy to report that the October meeting will be conducted
during a cruise from Port Canaveral to Nassau. Not only has Dr. Kori
put together an outstanding array of speakers but the venue is fantastic.
A flyer is included in this newsletter; brochures to follow.
As you can see by reading about our activities in this newsletter,
the Southern Pain Society is a vibrant group of energetic people engaged
in a wide variety of tasks to support and enrich our professional lives.
I hope that, if you have not already done so, you will volunteer for
one of our nine committees and add your effort to ours.
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