Multidisciplinary Pain Management: Implementing the Standard of Care

Multidisciplinary care is the use of multiple modalities and multiple disciplines to achieve holistic pain care. That includes psychology or mental health services; physical therapy and body modalities in terms of improvement and physical outcomes, safety, and movement. It includes the use of different pharmaceutical agents – opiates when appropriate but also looking at other types of pain medications for those individuals with neuropathic pain or with mixed pain, cancer pain; and then also not forgetting that we have interventional therapies that can be quite valuable. Also understanding the resources that are available in the community for more advanced therapies. For mental health services, there are evidence-based modules that patients can access for education. There are online resources for clinicians on how to assess pain, how to talk to your patient. The message I try to deliver to clinicians is it’s not enough to offer patients the ability to go online or to utilize apps; we need to hold patients accountable for actually following through with doing the self-education. It allows the patient to have exposure beyond just the medical modalities that the clinician may offer in the office.

I think advanced practice providers, nurse practitioners, nurses, clinical nurse specialists, physician assistants add a lot to the delivery of multidisciplinary pain care, on one level by bringing their different experiences to the patient situation. A lot of these clinicians, particularly physician assistants, have been medics or physical therapists and really have a good understanding of other treatment modalities. Usually the advanced practice provider within a clinician’s office is the one who has more time to spend with the patient and winds up being the one that is the continuity provider. It’s bringing the wealth of experience that they have, that can enable them to have better patient communication overall.