New Report Sounds 'Call to Revolutionize Chronic Pain Care'

Chronic pain costs the United States more than $100 billion a year in direct medical costs and lost productivity, and it leads to more than 50 million lost workdays annually. That's according to a new report from the Mayday Fund that has been endorsed by the AAFP and more than 30 other professional medical organizations.

The report, "A Call to Revolutionize Chronic Pain Care in America: An Opportunity in Health Care Reform," addresses chronic pain, which affects more than 70 million Americans.

"We're really facing an epidemic of undertreated and mismanaged pain," said Lonnie Zeltzer, M.D., director of the pediatric pain program at Mattel Children's Hospital at the University of California-Los Angeles, or UCLA, and co-chair of The Mayday Fund committee that drafted the report. She called the situation "a major disaster" during a Nov. 4 media teleconference.

According to Zeltzer, who also is a professor of pediatrics, anesthesiology, psychiatry and biobehavioral sciences at UCLA's David Geffen School of Medicine, one in four Americans suffers from chronic pain, and one-third of those people are disabled by the condition.

Zeltzer said that a number of factors contribute to the problem, including inadequate training about pain diagnosis and treatment in medical schools, a lack of time that primary care physicians are able to spend with their patients, and limited access to specialty care.

Committee co-chair Russell Portenoy, M.D., chair of the department of pain medicine and palliative care at Beth Israel Medical Center, New York, and professor of neurology and anesthesiology at the Albert Einstein College of Medicine there, said during the teleconference that if health care reform passes, primary care physicians will face enormous strain, as millions of new patients seek treatment for chronic pain.

Portenoy said medical training shortfalls and a consequent lack of established best practices lead to repeated tests, unnecessary surgeries, inadequate or unproven treatments, more hospital admissions, longer hospital stays and unnecessary emergency room trips.

"All of this drives up the nation's medical care spending and contributes to a system that is ineffective and wasteful," he added.

The Mayday Fund report stresses the importance of primary care and calls for all Americans suffering from chronic pain to have access to a well-trained primary care physician who can coordinate high-quality, effective care.

Furthermore, says the report, patients who do not respond to best practices in the primary care setting should have access to evaluation and treatment by a pain medicine specialist.

According to the committee that created the report, chronic pain must be recognized and treated as a chronic illness. The committee recommended several steps to improve access to quality, cost-effective pain care:

The report says that with 75 million baby boomers at or near retirement age, pain-related costs to the health care system likely will rise sharply in the near future.