The Problem (and the Answer?) to the Limited Availability of Pain Psychologists: Can Clinical Social Workers Help?

Michael E Schatman,1,2 Matthew G Fortino1,3,4 1Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA; 2Department of Public Health and Community Medicine, Tufts University School of Medicine, ALL Boston, MA, USA; 3Department of Clinical Psychology, William James College, Newton, MA, USA; 4Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USACorrespondence: Michael E Schatman Tel +1425647-4880Email [email protected] chronic pain medicine has been in a state of crisis for many years, with the overall quality of care continuing to deteriorate.In a 3-part series published in 2008, Giordano and Schatman discussed this crisis,1–3 elucidating the notion thatchronic pain care would not reach its potential if we failed to emphasize multidisciplinary care focused on the needs of patients.

More than a decade later, it is quite apparent that our warnings were not heeded.Much of this failure has been related to the devolution of Bowl Spider the “profession” of pain medicine to the “business” of pain medicine,4 which has been due to numerous factors.These have included, but not necessarily been limited to, the malevolent dominance of the health insurance industry,5,6 progressive corporatization,7 fraudulent marketing,8 industry’s detrimental influence on medical education,9,10 a lack of undergraduate medical education in pain management,11 and, of course, the profound swing of the “opioid pendulum” from reckless opiophilia to its current zeitgeist of often cruel opiophobia,12–14 and last but not least, the demise of interdisciplinary paincare.15–18.

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