Pain Medicine: Business or Profession?

Michael E. Schatman, PhD


May 13, 2011

In This Article


In conclusion, the present state of pain medicine as a profession is discouraging. The number of physicians who are truly specialists is declining because too many find it more lucrative and concomitantly less emotionally taxing to provide expensive procedures as opposed to treating the person with pain from a biopsychosocial perspective.[18] The armamentaria of primary care physicians who attempt to treat chronic pain have deteriorated, with fear of regulatory sanction resulting in a dramatic reduction in the number of physicians who are willing to prescribe opioid analgesics as a last line of defense.

However, the future of pain care in the United States need not necessarily be bleak. Although what Schofferman[17] refers to as the "medical-industrial complex" currently maintains a stranglehold on the field of pain medicine, patients, their physicians, and the public in general are beginning to recognize the profoundly detrimental impact that the special interests, such as the health insurance and pharmaceutical industries, are having on the care of people with pain. Awareness is a critical first step, and the efforts of those of us who believe that much human suffering can be ameliorated through the restoration of pain care as a profession rather than merely a business will ultimately result in change.

The leaders of the movement include a wide range of true stakeholders in this process: physicians; mental healthcare professionals; attorneys; bioethicists; media consultants; and, most important, persons with pain. Together, we can aim to restore pain medicine to a profession in which treatment decisions are returned to the partnership of suffering patients and the healthcare professionals who treat them.


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