Issue link: https://viewer.e-digitaledition.com/i/72776
completed his transitional internship and physical medicine and rehabilitation residency at Walter Reed Army Medical Center in Washington, D.C. In 2009, prompted by a desire to provide expert-level pain management to soldiers returning from Iraq and Afghanistan, Dr. Goff completed a pain medicine fellowship at The Johns Hopkins Hospital in Baltimore, MD. Currently, the Army is undergoing a significant overhaul of its pain management services wherein it is creating "interdisciplin- ary pain management centers" at its large medical centers, including SAMMC. "We're in the process of hiring additional pain psychologists, physiatrists, pain nurses, acupuncturists, massage therapists, chiropractors, physical therapists, occupational therapists, movement therapists and other integrated medicine practitio- ners. They will complement our traditional pain physicians," Dr. Goff says. Dr. Goff reports that about half of the patients treated at the pain management center at SAMMC present with combat- related issues, and among the most common are extremity trauma, back pain, spinal injuries, amputation and burns. During deployments to Iraq in 2008 and 2010 as a brigade surgeon and cavalry squadron surgeon respectively, Dr. Goff saw these battlefield injuries firsthand. Interdisciplinary Approach Dr. Goff says pain management center personnel regularly hold interdisciplinary meetings in which patients' cases are discussed and comprehensive care plans are created. "We'll have a pain physician, a pain physical therapist, a pain physician's assistant, a pain psychologist, a board-certified pain nurse, a case manager, and various associated and related surgical specialists and primary care providers all sitting around a table, discussing a patient and coming up with a plan for pain management," he says. "We're really proud of our ability to develop a comprehensive plan involving all the different special- ties. We're also proud that one of our areas of expertise is finding first-line medical treatments other than opioids for patients." Dr. Goff says any treatment or therapy offered at a traditional pain clinic is offered at the pain management center at SAMMC. "In terms of innovative treatments, we do all manner of spinal interventions under fluoroscopy and under ultrasound guidance," Dr. Goff says. "We offer spinal cord stimulators, peripheral nerve stimulators, minimally invasive spinal procedures, mild [minimally invasive lumbar decompression], water-cooled radiofrequency treatment as well as traditional radiofrequency treatment, cryotherapy, osteopathic manipula- tion, intrathecal pumps, SCENAR, cold laser therapy, Calmare Pain Therapy Treatment, HIVAMAT therapy, and auricular, or ear, acupuncture — in the military it's called 'battlefield acupuncture.' We're also using platelet-rich plasma injections, MDNEWS.COM s MD NEWS San Antonio | 7