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The Pain Problem

Pain is a pervasive problem that the medical community has not yet addressed in a comprehensive way. That’s the dilemma facing an interdisciplinary group at UC Davis. The UC Davis Center for Advancing Pain Relief started in 2011 with the goal of transforming pain care. The Institute of Medicine, now the National Academy of Medicine, reported in 2011 that 100 million Americans have chronic pain, costing approximately $600 billion a year. As the opioid crisis shines a light on the issue, it’s clear this is a big job, but UC Davis is already making progress. “The problem is at least in part due to the intrinsic fragmentation of medicine, science and higher education. In many ways, our center is an ‘un-center’ in that the goal is not to create another silo but just the opposite,” said Scott Fishman, director at the Center for Advancing Pain Relief and chief of the Division of Pain Medicine at the UC Davis School of Medicine. “We want to link all the groups that together would contribute to the future solutions for people in pain.” To that end, the team is addressing the issue through four main pillars: education, research, clinical care and policy. They have already created nationally and internationally endorsed competencies for educating healthcare professionals in pain management across all schools of health. And the group recently completed a review of the U.S. Medical Licensing exam, which every physician must pass. Their intention is to change accreditation requirements for schools. For those who are already accredited, Project Echo Pain is a peer-to-peer video conference mentoring program designed to support primary care clinicians in California’s rural communities. And this year, they welcomed the first recipients of the Primary Care Pain Management Fellowship. Eighteen primary care physicians from all over California will spend a year (both in-person on weekends and virtually on a weekly basis) learning about chronic pain management. “The idea is that they will go back and be the trainers for their community of primary care doctors,” said Fishman. Next, the group would like to create a consortium with the other University of California medical centers. “Our work isn’t done until pain is alleviated,” said Heather M. Young, the center’s co-director, associate vice chancellor for nursing and founding dean at Betty Irene Moore School of Nursing at UC Davis. “That takes many different projects, over time, working and influencing many people at the policy level, changing curricula and changing practice.” Added Fishman, “Our programs are basically pilots right now. We need to scale them to a national level. So these are big visions indeed.”

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