MDNews - Denver

PAIN MANAGEMENT SPOTLIGHT A New Perspective in Pain Management EVERY YEAR, CHRONIC PAIN COSTS THE UNITED STATES AN ESTIMATED $635 BILLION IN MEDICAL TREATMENTS AND LOST PRODUCTIVITY. GERALD M. ARONOFF, M.D., DABPM, MEDICAL DIRECTOR OF CAROLINA PAIN ASSOCIATES, OFFERS A NEW APPROACH TO CHRONIC PAIN TREATMENT DESIGNED TO REDUCE UNNECESSARY TREATMENTS AND IMPROVE PATIENT QUALITY OF LIFE. DURING HIS 32 years of treating patients with chronic pain, Dr. Aronoff has developed a unique pa radigm for managing pain symptoms. His phi- losophy of care focuses on five areas: relieving pain, reducing suffering, improving daily functioning, increasing quality of life for the patient and avoiding iatrogenic complications. "People who have chronic pain represent a very vulnerable group who are willing to undergo a lot of different surgeries and procedures in the hope that something will help them," Dr. Aronoff says. "I believe that physicians who treat patients in pain need to be cautious about the way we approach him or her, and we need to not take advantage of their vulnerabilities." Pain: More Than Physical Dr. Aronoff believes pain management requires a nuanced approach, treating pain as more than a physical condition. For him, pain is a biopsychosocial problem affected by many factors, including stressors, genetics, physical and emotional factors, and belief systems. To identify these factors and other underlying comorbidities, such as depression or sleep disorders, Dr. Aronoff invests signifi cant time in thorough evaluations of each patient's health status and medical history prior to treatment. "My initial evaluation with chronic pain patients takes 60 to 90 minutes. That's a problem for many practitioners because we live in a procedure-driven health care system," Dr. Aronoff says. "More often than not, I don't get reim- bursed adequately for the amount of time I spend with people, because I'm not doing any procedures to them. Practicing preventative care is under-reimbursed, so people don't do it generally. But I think that's what we have to do." This shift from procedure-focused medical practice represents only one dimension of Dr. Aronoff's pain management strategy. His paradigm also involves partnering with patients to improve their overall health, eliminating factors that contribute to their pain, such as smoking. In fact, Dr. Aronoff will not accept patients who are unwilling to stop using tobacco products. "There are some people who choose not to come back," Dr. Aronoff says. "However, many other people choose to stop smoking, even though they never thought they could. They choose getting good pain care as opposed to continuing smoking." Once obstacles such as smoking or substance abuse are removed, Dr. Aronoff believes patients are more able to enjoy normal daily activities. In turn, this allows the patient to return to fulfilling activities that improve their quality of life. "That's what we see as the hallmark of Carolina Pain Associates," he says. "We treat people in terms of improving their overall health as well as their pain care."

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