How Psychologists, Physicians Can Coexist in Pain Medicine

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Psychologists have much to offer medicine as a profession, and pain medicine in particular.
Psychologists have much to offer medicine as a profession, and pain medicine in particular.

With the American Academy of Pain Medicine (AAPM) opening its doors to psychologists in 2015, the pain community has been witnessing a shift in how these healthcare professionals are being included in annual pain conference symposia.

This expanded presence is a reflection of the growing awareness and acceptance of psychology as a partner in treatment of pain. A recent national report revealed that pain physicians support improved education in pain psychology and lament barriers to access for this discipline.1

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Psychologists have much to offer medicine as a profession, and pain medicine in particular.

  1. Psychologists help patients learn skills and techniques to better manage their pain and symptoms. Doing so equips patients to begin leading more active lives, which further facilitates rehabilitation and recovery.
  2. By definition, pain is a psychosensory experience, thereby establishing psychology as an integral component of pain. Including pain psychology in comprehensive pain treatment yields better pain outcomes, which is advantageous for all involved.
  3. Psychologists can identify underlying problems such as depression or posttraumatic stress disorder (PTSD) that will undermine medical treatment outcomes if left unaddressed. Treating these and other conditions helps patients gain better results for all medical treatments, including pain medications and surgeries. 
  4. Psychologists help physicians identify who is most appropriate for medical intervention and who needs a different treatment pathway.  In short, they help match the right patients with the right care and can minimize the overmedicalization of high-risk patients — those who are most likely to have poor outcomes.
  5. Psychologists work collaboratively with physicians and help them gain good patient outcomes without competing for reimbursement or service delivery. It is a symbiotic relationship.

Physicians are looking to understand how pain psychology can help them comprehensively treat their patients, how they can better match patients to the right treatment, and how they can connect their patients with resources so they can perform the best self-care and achieve functional goals.

This is happening broadly throughout medicine, including in the primary care setting, where psychologists are often "embedded" in the clinic and deliver health psychology services in-house, thereby exemplifying an integrated model of health care. 

This integrated, interdisciplinary model of health care — and pain care — is ideal because it recognizes that mind and body not only influence each other, they must be treated together.

Beth Darnall, PhD, is a member of Clinical Pain Advisor's advisory board. 

References

1.      Darnall B, Scheman J, Davin S, et al. Pain psychology: a global needs assessment and national call to action. Pain Med. 2016;17(2):250-263. doi:10.1093/pm/pnv095.

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