David Nagel
New Hampshire Pain Group, USA
Title: Five steps to social responsibility in pain management
Biography
Biography: David Nagel
Abstract
The practice of pain management within and without America is challenged by a number of social factors. Health care reform demands increased access to services at a lower cost. Corporate take-over of medical practice increasingly moves the locus of control of clinical decisions from the bedside to the corporate boardroom. Insurers increasingly challenge all medical decisions. These factors and more challenge the viability of the pain management practice forcing pain physicians to choose between the needs of the bottom line and the needs of the patient. In this scenario, too often the patient suffers needlessly. In the midst of these challenges, it is imperative that the pain physician do what the Hippocratic Oath admonishes him and her to do, to advocate for the patient. In this discussion, we will examine these challenges with a focus on five issues: 1: Define what pain management actually is; 2: Define the various social entities that are involved in pain management and what their roles are. 3: Develop a patient centered, inter-disciplinary focus in the pain management practice; 4: Take a look at what the role of evidence based medicine should is and what it should be, and how this affects pain management; 5: Take a look at how the needs of the bottom line must be kept in proper perspective and what happens to the patient when this does not happen.