President's Message

The AMA and AAPM. A Historical Partnership Now Advocating for the “Future of Pain Medicine”

For several years now, our profession has been challenged by its efforts to balance the need for comprehensive multidisciplinary pain control with the growing societal epidemic of prescription opioid, heroin, and illicit opioid overdose deaths. For all intents and purposes, in the court of public opinion—and increasingly in the eyes of even non–pain specialist physician colleagues—the practice of pain medicine has been wrongly equated with a narrow approach to pain management: prescribing opioids.

But the practice of Pain Medicine is so much more than prescribing medicines. How often do you spend time just listening to your patients as they describe in detail how pain impacts their lives? How often do you struggle with prior authorizations to enable your patients to receive appropriate medications, access physical therapy, or behavioral health options for treating and better managing their pain? How often do you talk with primary care providers whose understanding of pain management is limited to prescribing?

Since its inception, the American Academy of Pain Medicine (AAPM) has advocated for better pain care for patients. And for over a decade, AAPM has actively partnered with the American Medical Association (AMA) to help further this advocacy.

Ten years ago, the Academy, along with several other organizations, including Addiction Medicine, Hospice and Palliative Medicine, Rheumatology, and Clinical Oncology, formed the AMA's Pain and Palliative Medicine Specialty Section Council (PPMSSC), giving the Academy and like-minded organizations a direct link to important policy-making activities within the AMA.

In 2010, the Section Council led the efforts to convene a stakeholder summit meeting to begin charting the future of Pain Medicine. With support from the AMA, the summit’s deliberations were captured and published in our journal, Pain Medicine (academic.oup.com/painmedicine/article-lookup/doi/10.1111/j.1526-4637.2010.00961.x).

More recently, our immediate past President, Daniel Carr, MD, represented AAPM on the AMA Opioid Task Force, which convened on several occasions to examine the epidemic of opioid misuse and abuse and its impact on legitimate pain care. The AMA just released a website with resources relating to the subject, which includes links to the AAPM (www.end-opioid-epidemic.org/treatment/).

This past June, our colleagues Bob Wailes, MD, and Donna Bloodworth, MD, who serve as AAPM’s Delegate and Alternate Delegate to the AMA, respectively, attended the AMA Annual Meeting in Chicago, where they presented a resolution initiated by AAPM.

Resolution 511, the “Future of Pain Medicine,” was crafted to begin taking back the narrative by shifting the focus back to Pain Medicine as we were trained to think of Pain Medicine. It was crafted to ride the momentum from the Institute of Medicine Report on Pain in America (June 2011) and the more recent release of the National Pain Strategy (March 2016) and implementation efforts of this year.

Resolution 511 was crafted to help expand the public dialogue about 100 million people in America suffering from some form of chronic pain. It was crafted to help improve access to pain care and to expand education focused on evidence-based multidisciplinary treatments (i.e., pharmacologic, behavioral health, interventional therapies, and complementary and integrative health approaches). The resolution specifically calls on the AMA to take the following actions:

1. convene a task force from organized medicine to discuss “medicine’s response to the public health crisis of undertreated and mistreated pain”;
2. explore and make recommendations for “augmenting medical education” focused on greater education of health care providers in the use of evidence-based treatments;
3. discuss strategies to better mitigate acute pain, educate clinicians about these techniques, and foster research to study strategies to prevent the chronification of acute pain.

In the coming months, the Academy and other professional medical societies will gather to enact the specifics of the resolution, first through the convening of the task force. Expect your AAPM to be a leading voice in those discussions.

One hundred million people won’t wait. The time for addressing this incredible challenge is now. One-size-fits-all answers will not work. The complexities of each patient’s unique pain problem—the impact on society, the community, and the health care system—cannot be a “problem” for one group or a single group of medical societies. Sustained progress will only be made with broader support by all physicians working together.

Steven P. Stanos, DO
President, American Academy of Pain Medicine

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