Specialty or Sub-Specialty??

[drusso]

At the June 2008 Annual Meeting of the American Medical Association (AMA), the House of Delegates adopted as policy Resolution 321, "Promotion of Better Pain Care." See attached.

This resolution asks that the AMA express its strong commitment to better access and delivery of quality pain care through the promotion of enhanced research, education and clinical practice in the field of pain medicine.

In addition, it asks the AMA to adopt a directive to encourage relevant specialties to collaborate in studying the following:

(1) the scope of practice and body of knowledge encompassed by the field of pain medicine;

(2) the adequacy of undergraduate, graduate and post graduate education in the principles and practice of the field of pain medicine, considering the current and anticipated medical need for the delivery of quality pain care;

(3) appropriate training and credentialing criteria for this multidisciplinary field of medical practice; and

(4) convening a meeting of interested parties to review all pertinent matters scientific and socioeconomic.

Fundamental to understanding these issues is addressing whether or not the practice of Pain Medicine constitutes the sub-specialty practice of medicine in its traditionally recognized "specialties of origin" (Anesthesia, Physiatry, Neurology, and Psychiatry) or if the practice of Pain Medicine has sufficiently evolved away from its specialties of origin to constitute an entirely new specialty?

Pain Medicine is currently recognized as a sub-specialty. Should it remain a sub-specialty or become its own specialty?

Please discuss.

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[PMR 4 MSK]

Pain Medicine is currently recognized as a sub-specialty. Should it remain a sub-specialty or become its own specialty?

Please discuss.

IF it becomes it's own specialty, what would they be called? Dyniologists? Doleologists? That'll be fun to educate the public. PM&R hasn't succeded at that yet...

You could ask the same question about other cross-specialty subspecialties, such as sports medicine, hand surgery, etc.

 

[Disciple]

I think the public can at least understand "Pain management or Pain Medicine Specialist" though.

It would definitely be good for patients. Less variability in medication regimens, amount of and types of procedures, diagnoses given, etc. There would be more consistency in the knowledge base and skills of those who are pain boarded. It's kind of a crap shoot for patients walking into pain clinics these days, so the need is definitely there. Prescription drug abuse is a growing problem.

The representative pain academy would be able to release stronger position statements and practice guidelines.

So, it would probably be good for patients. Good for pain doctors currently in practice? I don't really know.

 

[Disciple]

This link may help to put the above attachment into context:


http://www.abpm.org/pdfs/ABPM_news_summer08.pdf

 

[drusso]

Wow...almost 250 views and 14 votes. I think that the field needs to hire Sarah Palin to start talking about this issue!

 

[drusso]

IF it becomes it's own specialty, what would they be called? Dyniologists? Doleologists? That'll be fun to educate the public. PM&R hasn't succeded at that yet...

You could ask the same question about other cross-specialty subspecialties, such as sports medicine, hand surgery, etc.

I think that one name floated around in all seriousness was "algiatrist." It really does sort of flow trippingly from the tongue... "I'm not a physiatric algiatirst, but I play one on TV."

 

[olafa]

& if it were its own specialty what would the composite of the residency include, length & intern requirements- would they be gas based/ im/ surgery?

 

[Disciple]

The AAPM published proposed residency requirements for a 4 year residency:

Pain Medicine
Volume 9, Issue 4 , Pages473 - 484
© 2008 by American Academy of Pain Medicine


From the article:

Pain Medicine 18 months
Primary Care 6
Anesthesiology 2
Oncology/Palliative Care 1
Musculoskleletal 6 (at least 2 months PM&R, other recommended rotations
include Rheum, Ortho, Spine Surg)
Psychiatry 3
Addiction Medicine 1
Clinical Neuroscience 2 (Neurology and/or Neurosurg)
Craniofacial Pain 1
Diagnostic Imaging 1
Surgical Technique 1 (General Surg, Ortho or Neurosurg, 2 months
subspecialty surg acceptable)
Selective/Research 6


Looks pretty comprehensive.

 

[Ligament]

The AAPM published proposed residency requirements for a 4 year residency:

Pain Medicine
Volume 9, Issue 4 , Pages473 - 484
© 2008 by American Academy of Pain Medicine


From the article:

Pain Medicine 18 months
Primary Care 6
Anesthesiology 2
Oncology/Palliative Care 1
Musculoskleletal 6 (at least 2 months PM&R, other recommended rotations
include Rheum, Ortho, Spine Surg)
Psychiatry 3
Addiction Medicine 1
Clinical Neuroscience 2 (Neurology and/or Neurosurg)
Craniofacial Pain 1
Diagnostic Imaging 1
Surgical Technique 1 (General Surg, Ortho or Neurosurg, 2 months
subspecialty surg acceptable)
Selective/Research 6


Looks pretty comprehensive.

Man, I would have loved to do such a residency! I think 2-3 months of imaging woudl be better, and 2-3 months of surgical technique (real surgical experience such as opening/closing, assisting...not running a SICU or anything like that).

 

[PainMD23]

I vote for algologist.

 

[PMR 4 MSK]

I think that one name floated around in all seriousness was "algiatrist." It really does sort of flow trippingly from the tongue... "I'm not a physiatric algiatirst, but I play one on TV."

So would that be 'al-gee-a-trist' or al-geye-a-trist', and would the 'g' be soft or hard?