The Journey From Interdisciplinary to Integrative Pain Management

As we look at the difference between interdisciplinary and integrative, it really helps to back up the train, so to speak, to see what the words actually mean. Over the years, we’ve seen progress from multidisciplinary to interdisciplinary care, and the medical home model that emphasizes how the patient should be at the center of care. Integrative care actually moves into that patient-centered model with a more life perspective on healthcare. One of the prime obstacles to full-blown integrative care centers on ‘who’s going to pay for that? ‘and/or ‘where do you get those resources?’ Then do you have an electronic record system that bridges all the spectrums of practice and specialties so that they can have a collective patient-centered look. Where does the patient visually come into play? Is this telemedicine? Is this video on-demand medicine? So, staffing, review, environment, payer—it really does take a village to up the standard of healthcare for the patient and to see it as a life focus and not just a symptom.

>As the healthcare system transitions to whole health model, the medical home model brings resources that primary care needs in their pressure cooker schedules. They have nurse care managers, nurse care coordinators; they have pharmacists embedded in the clinic, psychologists embedded in the clinic, social workers embedded in the clinic. Starting the day with a huddle for instance, every player knows their role. PDMPs are ready. We know who’s coming potentially with infectious situations, who has a pain situation. The frontline clinician needs this support structure, and payers need to be to recognize that. Insurance providers who decide what we can and cannot have for our patients also need to change to meet this new, better standard of patient-centered care. I can just share with you briefly that I have been given the honor of serving on the HSS task force for best practices in pain management, and we’re diligently working on this, coming up with a recommendation for Congress on a very short timeline because of the CARA budget and funding and the tasks set forth from President Obama through President Trump.