Interventional Pain Management: A Physician Specialty

The following article is written by Kenneth Elmassian, DO, a member of the American Society of Anesthesiologists.

 

Pain affects an estimated 75 million Americans, which is more than diabetes, heart disease and cancer combined, according to the American Pain Foundation. Patients who suffer from chronic pain have a right to receive safe interventional management. Many of these patients recognize the disparities between physicians and non-physician and have spoken out requesting physicians provide their care.

 

In a recent survey conducted by AMA, 80 percent of public respondents believed only a physician should perform pain management techniques like spinal injections to diagnose and treat chronic pain. AMA's findings are further supported with ASA's Vital Health survey findings in which 60 percent of respondents voiced preference for a physician to administer regional anesthesia and 59 percent for a physician to administer an epidural during labor and delivery.

 

Interventional pain management by unqualified providers can present serious risks to patients due to the complexities involved in the treatment of pain. Such risks include persistent or worsened pain, bleeding, infection, nerve damage, brain damage, paralysis or even death. Patients who suffer from chronic pain have the right to receive the safest care possible from anesthesiologists or other physicians who have advanced training in pain medicine.

 

The ability to properly diagnose pain and develop an appropriate treatment plan can only be done by physicians such as anesthesiologists who are specialized in pain medicine and have completed four years of medical school, four years of an anesthesiology residency, one year of a pain fellowship and are board certified in pain medicine. Other providers, like nurse anesthetists, simply do not have this same level of expertise or training. Anesthesiologists undergo more than 10,000 hours of pain-related training, whereas nurse anesthetists are only required to have 1,600 hours of training.

 

While some state nursing boards have tried to unlawfully expand the scope of practice by allowing non-physicians to practice pain medicine, it is important for state and federal policymakers to protect patients from needless pain treatment injuries received by unqualified providers. In a recent ruling upheld by the Louisiana Supreme Court, it was concluded that the practice of interventional pain management is not within the scope of practice of a nurse anesthetist, and is solely the practice of medicine.

 

Patients who have chronic pain have a right to be treated by physicians. As an anesthesiologist, I am part of a specialty that has been at the forefront of patient safety and quality initiatives. It is imperative that anesthesiologists and other physicians continue to safeguard patients and lead this practice of medicine.

 

Read more from the American Society of Anesthesiologists:

 

- ASA Publishes Q&A With Dr. Mark Lema on Cancer Pain

 

- ASA "Extremely Troubled" About Removal of Sodium Thiopental From Market

 

- ASA Clarifies Medically Induced Coma Versus Sedation

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