By Ed Coghlan.
A generation ago, pain was treated in an integrated manner.
Dr. Bob Twillman is trying to turn back the calendar.
Twillman is the executive director of the Academy of Integrative Pain Management (formerly the American Academy of Pain Management) which promotes an integrative approach to managing pain.
He was a featured speaker at the 2017 Pain Summit organized by For Grace—a Los Angeles-based non-profit that is working to increase awareness and promote education of the gender disparity women experience in the assessment and treatment of their pain.
Twillman was promoting the importance of implementing the National Pain Strategy, which was adopted early last year but has not been implemented in any meaningful way.
“People have not recognized the importance of it, particularly in contrast to the issue of prescription opioid abuse,” said Twillman. “The government is throwing billions of dollars at the opioid abuse issue – if they would invest the money in treating pain the right way, we would be able to prevent people from any addiction problem.”
Part of what has happened is that insurance companies and the government health plans aren’t covering many therapies that can help people address their chronic pain.
Twillman’s group is trying to change that.
“Oregon Medicaid is now paying for massage, acupuncture and chiropractic for lower back pain. California now covers acupuncture as an essential health benefit in California Medicaid,” said Twillman. “We can look in a year or two and see how effective these benefits have been in improving outcomes.”
Twillman also believes that providers should be paid for performance – and reimburse them only when they achieve a good outcome for their patients.
“We’ve been pushing people at CMS and at Insurance companies to make more demonstration projects,” he said.
They are being urged to try alternative therapies with a group of 100 patients – see if they improve outcomes and reduce costs and then adopt those therapies as covered benefits.
The Academy will continue to concentrate its work on making sure there’s coverage for more pain therapies.
In the meantime, he believes that the voice of the pain patient must be heard.
He urged pain patient advocacy organizations to keep telling the story of what is happening to people in pain. Taking the data and telling the story of what happens to people in real life is the recipe for change.
“They need to tell real life stories to elected leaders and government bureaucrats of what happens when patients are denied their medications and provided no alternative,” he said.
Twillman was willing to give those decision makers the benefit of the doubt.
“I don’t think policy makers are unsympathetic, they just haven’t thought through the complexities of it.”
He added that he knows some people make decisions by thinking through things, looking at data – others make it on emotion.
“The pain patient story needs to have both of those elements,” he said.