Demand for Pain Management Centers is Increasing

By Cynthia Hayward
Originally printed in the
SpaceMed Newsletter
Fall 2013
www.spacemed.com

BACKGROUND
Whether episodic or chronic, pain is the most common reason patients visit doctors
and hospitals. Because of this, pain represents a growing market for healthcare organizations. According to a 2011 Institute of Medicine report, pain costs the U.S. up
to $635 billion each year in medical treatment and lost productivity. As a result,
hospitals are creating pain management centers that use a variety of procedures
and therapies and are staffed by multidisciplinary teams including anesthesiologists, interventional radiologists, and acupuncture practitioners.
KEY CHALLENGES
Key challenges for hospitals and physicians include:

Dealing with prescription drugs. Many general practitioners are reluctant to

become involved in pain management because of their concerns about increased law enforcement scrutiny with widespread misuse of prescription
drugs. Much law enforcement and media attention has been placed recently on
so-called drug or pill mills where physicians overprescribe powerful drugs that
are linked to the abuse of painkillers. According to the Center for Disease Control, nearly three in four prescription drug overdoses are caused by opioid pain
relievers such as morphine, oxycodone, and methadone.

Co-managing pain. Patients typically undergo an evaluation that may include

x-rays, magnetic imaging scans, or nerve studies to find the specific cause of
the pain. Image-guided techniques may then be used to deliver steroids, burn
nerve endings, or perform other targeted therapies at the precise area causing
pain. Too often, primary care physicians lack knowledge about pain management so a major role of the pain management specialists is to educate primary
care physicians as to the alternatives available.

Patient satisfaction. Sometimes, patients just want more drugs to relieve their
pain which presents a major challenge for pain management. As a result, hospitals are implementing a multidisciplinary approach with an emphasis on
communication and proper protocols for medication administration.

SOME EXAMPLES
Barnes-Jewish Hospital in St. Louis expanded the size of its Washington University
Pain Management Center from 5,000 to 10,000 square feet to accommodate growing patient demand. It also restructured its pain program into two areas concentrating chronic and cancer pain in one area and acute perioperative pain in another
area of the center. At Massachusetts General Hospital in Boston, the number of
pain patients has also increased steadily. At least 70% of its patients seek treatment for spine-related pain with the balance of patients treated for pain conditions
such as musculoskeletal pain, arthritis, shingles, and cancer-relate conditions. To
increase efficiency, back pain patients are admitted to the observation unit in the
hospitals emergency department rather than to an inpatient nursing unit so that
consults, imaging, and injections can occur quickly thus reducing length of stay.
Cynthia Hayward, AIA, is founder and principal of Hayward & Associates LLC.

2013.6.3

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