The Future of Pain Medicine Essays

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The Future of Pain Medicine Think of all the medical specialties as pebbles in a bowl. Pain Medicine would be, or, more aptly, should be the water filling the bowl and surrounding all the pebbles. Pain Medicine affects virtually every discipline that prods, pokes or cuts. However, pain management is an integral part of every physician's practice. Alarmingly, prior to ten years ago, no medical school curriculum devoted any appreciable time to teaching students about pain. Nociceptive pathways were often mentioned more as a neuroanatomical fact that as a powerful human motivator.

'Nociception' is not synonymous with 'pain'. Nociceptive signals are the data
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However, the rapid advancements in pain research are changing our knowledge of the fundamental molecular mechanisms that generate nociceptive signals. Newer concepts bring newer, more target-specific drugs which work better to alleviate previously intractable pain conditions. Drugs that more effectively treat chronic pain reduce the need for invasive procedures. Less invasive procedures result in a lesser demand for invasive pain specialists. That is the way of medical progress.

Will pain medicine as we know it today survive the changes brought forth by medical advances? Probably not. However, the question to ask is "When will pain specialists' skills no longer be in high demand?" The answer is: "Not in the foreseeable future".

In general, the status of medical care is in major disarray. Most specialists gravitate toward the more profitable procedures or consultations to remain solvent. Charity care is carefully avoided because private practice physicians can't afford to provide pro bono work. Health care costs are skyrocketing at a time when access to providers has never been more restricted. A new paradigm for medical care will be developed. It will most likely be a single-payer, partially socialized scheme. Attitudes and practice arrangements as we know it will change as reimbursements and time-commitments shift among physicians in the various medical specialties.


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