- Introduction: A Top-Level Look at the Future of Federal Medicine
- Military Health System in Time of Transition as Conflicts End
- Army Medicine: Redefining Its Role in the Generation of a Ready and Resilient Force
- Air Force Medicine: Averting an Identity Crisis
- Moving Forward with Reforming the Indian Health Service
- The Clinical Pharmacy Specialist's Growing Provider Role in VA
- Public Health Service Pharmacy: Accelerating Transformation
- Military Pain Management’s Future: Less Invasive, More Data-Driven Techniques
- Navy Medicine: Strong, Agile and Ready
- Telemental Health in VA: A New Source of Support for Veterans
Military Pain Management’s Future: Less Invasive, More Data-Driven Techniques
By Col. Chester “Trip” Buckenmaier III, MD, program director, Defense and Veterans Center for Integrative Pain Management
In August 2009, the Pain Management Task Force (PMTF) was chartered by retired Lt. Gen. Eric B. Schoomaker as the Army Surgeon General. The PMTF membership included pain experts with diverse medical backgrounds from the Air Force, Army, Navy, TRICARE Management Activity and the Veterans Health Administration (VHA). The PMTF mission was to review the status of existing pain-management services and provide recommendations for a “comprehensive pain-management strategy that was holistic, multidisciplinary and multimodal in its approach, utilizes state of the art/science modalities and technologies, and provides optimal quality of life for soldiers and other patients with acute and chronic pain.”1
The results of this review, along with specific recommendations for enhancements to military pain care were provided in the Pain Management Task Force — Final Report, May 2010. Soon after publication of the PMTF Final Report, the Institute of Medicine released its report, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research” in June 2011. Perhaps most interesting and intriguing about these two efforts at defining areas for pain-management improvement, was the high amount of correlation between the two documents in terms of the identified major issues and suggested solutions. Both documents recognized the tremendous national economic burden associated with chronic pain, both recognized that chronic pain could be a disease itself, and both efforts established the need for better pain data and research. With the call to action established by these two important federal documents, considerable effort and investment into federal pain medicine improvements has been under way during the last few years. This article will introduce some of the larger and more influential changes undertaken by the Department of Defense (DoD) that providers may see in the near future.
Defense and Veterans Center for Integrative Pain Management (DVCIPM)
The PMTF recognized that the scope and magnitude of change recommended in the final report would require a tri-service advisory board to ensure effective implementation of Task Force recommendations and a central point of contact on pain-management issues affecting the varied organizations within the DoD. This goal will be achieved with the establishment of a Military Pain Medicine Board of Directors for the DVCIPM consisting of Air Force, Army, Navy, VHA and civilian senior expert pain clinicians and researchers with diverse backgrounds in the management of acute and chronic pain.
The organization is tasked with providing clinical advice to the services on the best, evidence-based, integrative clinical pain-management practices. Additionally, the DVCIPM seeks to standardize military pain education for providers and patients and serve as a pain research and outcomes focal point (Fig. 1). Much of the available published and ongoing research into military pain issues during the current conflicts has come from or been directly influenced by the DVCIPM.
The DVCIPM has excelled as a resource for enhanced collaboration and cooperation for the services and the VHA. The DVCIPM has played a major leadership role within the PMTF and the major initiatives highlighted in this article.