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Federation of State Medical Boards' New Policy Promotes Balanced Oversight of Pain Care by Medical Regulators
For Immediate Release: September 30, 2004
DALLAS, Texas - It is a daily dilemma for many physicians across the United States. A patient complains of chronic pain and seeks medication to ease the suffering. Is this patient truly in pain, the doctor wonders, or is he or she a drug abuser seeking drugs for non-medical purposes?
Lacking up-to-date knowledge about current research and clinical guidelines for appropriate pain management, some physicians do not do enough to ascertain whether the patient is truly in pain and oftentimes end up failing to adequately treat the pain. In other circumstances, physicians are declining to treat patients' pain because they fear regulatory scrutiny.
Add to the mix news coverage about physicians who are prosecuted for prescribing powerful opioid medications, the growing problem of prescription drug abuse, and confusion about addiction, physical dependence and tolerance, and it is not surprising that patients with both acute and chronic pain continue to receive inadequate care. So, where's the right balance?
The nation's state medical boards are addressing this quandary head-on with a new policy aimed at encouraging appropriate pain treatment for all patients. The Federation of State Medical Boards' (FSMB) Model Policy for the Use of Controlled Substances for the Treatment of Pain updates the FSMB's influential 1998 guidelines on pain treatment. The 1998 guidelines were adopted in whole or part by 24 state medical boards and more than 300,000 copies were distributed nationally.
"This model policy tells physicians they need to view pain management as important and integral to the practice of medicine," said James N. Thompson, M.D., president and CEO of the FSMB. "A medical board that adopts this policy is in effect saying that when a physician inappropriately treats pain, he or she is providing substandard care. This is a strong message to send."
The policy simultaneously recognizes the growing problem of illegal trafficking and abuse of prescription medications, while clearly communicating that physicians who prescribe opioid analgesics for legitimate medical purposes and in the course of professional practice should not fear disciplinary action.
The Model Policy reflects significant progress made in the medical community's understanding of pain management in recent years by:
- Recognizing the inadequate management of pain and barriers to appropriate treatment;
- Emphasizing the dual obligation of government to develop a system that prevents abuse, trafficking and diversion of controlled substances while ensuring their availability for legitimate medical purposes;
- Revising definitions of addiction, chronic pain and physical dependence to reflect current consensus and expertise in the medical community; and
- Updating criteria for evaluating the appropriate management of pain.
Beginning this fall, a series of regional workshops, "Promoting Balance and Consistency in the Regulatory Oversight of Pain Care," will help medical regulators encourage accessible and appropriate pain care, identify policy and legislative barriers to appropriate pain care, and distinguish the difference between criminal, negligent/incompetent and acceptable practice. The workshops are scheduled as follows:
- Nov. 14-15, 2004 - Fort Worth, Texas
- Feb. 3-4, 2005 - Las Vegas, Nev.
- March 1-2, 2005 - Birmingham, Ala.
- April 7-8, 2005 - Boston, Mass.
- June 13-14, 2005 - Seattle, Wash.
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