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Senate Panel Explores IOM Recommendations on Pain

February 17, 2012—The Senate Health, Education, Labor and Pension (HELP) Committee Feb. 14 held a hearing entitled “Pain in America: Exploring Challenges to Relief.”  The hearing largely focused on the recommendations of a June 2011 Institute of Medicine (IOM) report “Relieving Pain in American: A Blueprint for Transforming Prevention, Care, Education, and Research.”

HELP Committee Chair Tom Harkin (D-Iowa) opened the hearing by noting, “We need to do a better job of educating in medical schools and in our residencies about the different forms of pain and how they should be treated.” 

Lawrence A. Tabak, D.D.S., Ph.D., principal deputy director, NIH, and co-chair of the NIH Pain Consortium, told the committee the Interagency Pain Research Coordinating Committee (IPRCC), established by the Secretary of Health and Human Services (HHS) as mandated by the Affordable Care Act Act (ACA, P.L.111-148 and P.L.111-152 ), would hold its first meeting Feb. 27.  Dr. Tabak said the committee, which includes seven federal, six academic, and six public members, is responsible for “summarizing advances in pain care, identifying gaps and duplications of effort across the federal research portfolio and recommending how to disseminate information about pain care.”  Story Landis, Ph.D., director of the National Institute of Neurological Disorders and Stroke, will serve as interim IPRCC chair.  Dr. Tabak also explained that NIH currently is working with other IPRCC member agencies “to gather and analyze the agency’s pain-related scientific advances, their scientific portfolios, get an overview of their public/private partnerships, and their individual efforts towards education and dissemination” to be discussed at the committee’s first meeting.

Philip A. Pizzo, M.D., dean of the School of Medicine, Stanford University School of Medicine, and co-chair of the IOM committee, noted the panel had concluded 16 recommendations focused on public health issues, pain care and management, education of patient communities and providers, and research.  He highlighted four recommendations the committee agreed should be implemented by the end of 2012:

  • The Secretary of HHS should create “a comprehensive population-level strategy” for pain prevention, treatment, management, and research;

  • The secretary along with other federal, state, and private sector entities should develop strategies for reducing barriers to pain care;
  • The Centers for Medicare and Medicaid Services (CMS), the VA, Department of Defense, health care providers, insurers, and others should support collaboration between pain specialists and primary care clinicians, including referral to pain specialists when appropriate; and

  • The Director of NIH should designate a lead institute that is responsible for moving pain research forward, along with an increase in the support for and scope of the NIH Pain Consortium.

William Maixner D.D.S., Ph.D , director, Center for Neurosensory Disorders, University of North Carolina at Chapel Hill testified that, “Similar to the polio epidemic, a transformative national effort is needed to crush the epidemic of chronic pain worldwide.”  He noted that 14 percent of the Medicare budget is used to treat chronic pain while only “only about 0.8 percent” of NIH resources are used for the study of chronic pain, and called for additional resources to be provided to NIH targeted towards chronic pain and pain initiatives “or a proportionate allocation of NIH appropriations that are used to further address pain-related conditions.”

He also testified that the current medical curriculum “is inadequate… to provide confident individuals who are able to diagnose, assess, and treat patients with chronic pain conditions.”  He recommended “major curriculum reform that is associated with discussions with accrediting agencies, and perhaps discussions with the Department of Education….”

The committee also heard from John E Sarno, M. D., professor of Clinical Rehabilitation Medicine, New York University School of Medicine; and Christin Veasley, executive director, National Vulvodynia Association.


Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559


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