Biopsychosocial/Interdisciplinary Rehabilitation & Functional Restoration
Se Habla Español
|
| Patient Stories | About Us | Download Forms | Upcoming Seminars | Contact Us | Recent News | Our Scripps Hospital Webpage |
 |
I am delighted to introduce Rosa Moran who we are honoring today. On July 19, 2011, Ms. Moran was appointed Administrative Director for the California Division of Workers' Compensation, by Governor Edmund G. Brown. Among the many attributes which contributed to her being appointed, is her belief that workers compensation is a symbiotic system with employers and workers at its heart, and that all parties must be engaged to ensure the system is healthy, balanced and sustainable. As I prepared my introductory remarks for today, I was struck by the fact that Ms. Moran’s appointment came 21 days after the Institute of Medicine issued its report on the country’s most devastating health epidemic – chronic pain, a crises of such enormous magnitude that Congress’ mandated the National Institutes of Health to commission the IOM study, and make its recommendations: the results were that we have an unhealthy system, an unbalanced system and an unsustainable system, both in and out of work comp. Director Moran, you have your work cut out for you. 80% of work comp costs stem from 20% of injured workers who develop chronic pain syndromes, and who are being mismanaged. The almost exclusive biomedical paradigm from which we treat patients contributes to increased suffering, disability and costs. Chronic pain affects 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined. It is the largest health epidemic in the U.S. Pain also costs the nation up to $635 billion each year in medical treatment and lost productivity. This doesn’t include children, seniors or the military. Chronic pain, which typically is managed using almost exclusively pharmaceuticals, physical therapy and surgery will often grow into a chronic pain syndrome, where we will see pain spreading to other parts of the body, and will often contribute to depression, sleep problems, cognitive problems, hypertension, irritable bowel, obesity, weight gain, and disability if not nipped in the bud through prevention and early intervention. Congress in 2000 took the first step in focusing on the pain epidemic to little avail when it passed legislation declaring the decade of 2000-2010 the “Decade of Pain Control and Research.” Today, 12 years later, only 5 of the nations’ 133 medical schools have a required course on the treatment of pain. In 2000, 3% had an elective topic on the treatment of pain. That elective topic most often teaches the implementation of many of the interventions that actually contribute to increased chronic pain. Until we begin managing chronic pain syndromes correctly, we will continue increasing the magnitude of this epidemic, and costs and disability will continue to rise. Most of the treatment provided in work comp to workers suffering from a chronic pain syndrome results in increased suffering, disability and cost. Despite 30 years of outcome-based research demonstrating how we can systematically reverse chronic pain and disability, we maintain a system which fundamentally contributes to increased suffering, disability and cost, by using a biomedical model which still primarily employs pharmaceuticals, surgery and PT, rather than a biopsychosocial model which systematically reverses chronic pain syndromes, disability and costs by among other things teaching self-care. Today, by using biopsychosocial programs to empower patients on the road to sustained healing and recovery, we can systematically reverse chronic pain syndromes, suffering, disability and costs. The greatest risk we have however is that we repeat history, and our leadership does not recognize and implement the resources we have to make solutions a reality. The congressional “Decade of Control and Research” failed because not enough individuals in a position to function as a catalyst for improvement in the public and private sectors rose to the occasion. Today, once again the IOM report (06/29/11) calls on:
The solution is in providing all injured workers access to programs that help them reverse their chronic pain syndromes, and provide more effective care, which in turn translates to self-care promoting life-style changes. The Congress, NIH and specifically the Institute of Medicine, is calling for a cultural transformation on how we approach the epidemic of pain. I’m excited that with the new leadership we have in California’s DWC, and whom we are honoring today; we have the opportunity to take a leadership role in this transformation.
Dr. Anbar is Director of Chronic Pain Associates R&D program, and is Founder and former Clinical Director of the Chronic Pain Rehabilitation Program at Scripps Health in San Diego. He is Founder and former Chief of Clinical and Research Psychobiology at the National Institute of Neurology and Neurosurgery, a component of the World Health Organization in Mexico City. He previously served as President of the San Diego Group Psychotherapy Society.
|
|||||
|
|||||
