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About the Integrative Pain Center of Arizona
The Integrative Pain Center of Arizona is a prototype. It is a model of what we believe healthcare will look like in 10 years. The program is built around the concept of team-based healthcare delivery, sometimes called integrative medicine (not to be confused with alternative/complimentary medicine) or interdisciplinary healthcare (Interdisciplinary programs are more advanced and fully integrated multidisciplinary programs - click on the preceding link to see a definition of multidisciplinary clinic). Our near-term goal is to show that the team-based healthcare delivery model is the best way to provide value (the best possible care at the lowest possible cost). Our long-term goal is to help heal the healthcare system from within through innovation in healthcare delivery systems.
Why team-based healthcare?
Because healthcare has become too complex for one health practitioner to provide the four essential components of healthcare efficiently, every time, all the time:
- Diagnosis
- Education of the patient
- Collaboration with the patient to make the right decisions regarding treatment and/or prevention
- Treatment/intervention and evaluation of results
Our values reflect our goals:
- Listening: to the patient, to our staff, to our colleagues, so that we can gain -
- Understanding: Of the patient's situation from their perspective, of the medical diagnosis, and of the factors that shape the patient's response to the diagnosis.
- Evidence: Striving to integrate evidence derived from listening and understanding with published medical evidence to deliver the best possible treatment recommendations
- Education and communication: of the patient and their healthcare team so that they understand what is happening and can participate effectively in decision-making
- Integration: Coordination of the various healthcare providers involved in diagnosis and treatment of our patient (this value is very important and therefore appears in IPCA's name)
- Transparency: We want it to be easy those within and outside the program (patients, providers, and insurance companies) to understand why we do what we do and what outcomes we are achieving
- Consistency: In the use of various medical resources, particularly high technology/high expense or high risk resources
- Responsiveness: To our individual patients, our colleagues, and the healthcare environment
- Efficiency: in our use of healthcare, healthcare technology, and administrative resources
- Safety: Of our patients and our staff
- Leadership: To heal our patients, and to heal the healthcare system from within
The program specifics:
The staff of the Integrated Pain Center of Arizona brings to the Southwest the most advanced multidisciplinaryevaluation and treatment outpatient services for painful conditions. The clinic focuses on helping clients with painful conditions find the right path to improving their quality of life and to reduce their pain-related disability.
We have put together the mix of experts needed to help patients/clients find the answer to the three most common questions: What is causing my pain? What options are there to help me? Where can I get the best treatment? We have providers with expertise in pain medicine, neurology, orthopedics, occupational medicine, anesthesiology, medical psychology, physical therapy and complimentary/alternative medicine. We offer the more common treatments, and also the latest treatments for a wide variety of painful conditions. We are doing research in new and emerging pain treatments.
What happens in our clinic, and how this is different?
This is what a patient will experience:
· Precision diagnosis whenever possible – an accurate diagnosis is the key to effective treatment
· Make sure the painful disease is treated optimally. For example, when a patient has painful nerves from diabetes (diabetic neuropathy), good control of the diabetes is important to control the pain.
· Prevention – help patients understand how to keep the painful disease form getting worse!
· Palliation of pain – we offer medication management, injections, complementary and alternative medicine strategies, and more to control pain.
· Evaluation of the psychosocial factors that can aggravate pain, and coaching of patients to teach them how to keep the pain from overwhelming their lives.
· Coordination of care among the different specialists and primary care team. Coordination of palliation efforts wit physical rehabilitation, for example.
We offer a truly integrated multidisciplinary team-based approach.
Patients undergo an initial screening medical evaluation and from there the multidisciplinary team strives to work together as one to thoroughly understand all the challenges facing our clients. An evaluation with us will be as simple or as complex as needed, it will be customized to the client’s specific circumstances and needs. Not every patient needs to spend time working on goal-setting in evaluation with the medical psychologists, for example. Similarly, treatment may be straightforward or it may be technically complex and involve more than one specialist, this depends on the client.
Often, finding the answer to the questions “what is wrong and what are my options” requires evaluation by physicians in specialties such as neurosurgery, spine surgery, orthopedic surgery, urology, and other even less common specialties. It is common that we coordinate and help follow-up on referrals to the best experts locally, regionally, or wherever the right expertise is to be found. We pride ourselves on knowing where to find the right care for our patients who have more difficult or unusual problems. In fact, our motto is “the right care at the right time”. Click on this link to read more about the extended nerwork of providers that is so critical to the value of our program.
After treatment starts, we stick by our client and follow up as long as is needed. For example, as we work through all the reasonable options with a patient who sees us for back or neck pain, we may eventually arrive at a decision for surgical treatment. But, this patient remains our patient as long as pain care is needed after surgery (forever, if need be) - this is important because surgery doesn't always work to relieve pain.
Why we are different.
Identifying and integrating together the right services at the right time for a patient with a painful illness can be difficult and time consuming. This is the challenge to which we have dedicated ourselves, right down to the name of the clinic. Many clinics offer a limited menu of services and evaluate patients only for these services, with emphasis on medical procedures. But we have chosen a different path.
Why have we taken the more difficult road? Every day we are frustrated by health insurance plans that do not cover the evaluation and treatment our patients need. We see our patient’s suffering, and we watch the waste of resources as patients get uncoordinated and ineffective health care. This has made it clear to us that in order to help these patients we need to join the effort to heal the broken healthcare system, to change it for the better – from within. We are not content to work within the confines of a broken system, because it no longer serves our patient’s needs or our community’s needs. We believe that effective change must come from within the healthcare system.
We have come to realize that good decision making is the core product of a healthy healthcare system. We see that the health insurance industry’s attempts to control their costs, the medical malpractice situation, government regulation, over-emphasis on medical and surgical procedures, and fragmentation of health services have upset the process of sound medical decision-making. Patients, guided by their health care team, should be making the key decisions. Patients and their needs should be at the center of the decision-making process. But this is not at all how it works now, and as a nation we are paying a steep price.
With this sort of misaligned management of medical decision-making there are no incentives to improve value in health care. In fact, health insurance limitations on who a patient can see for their care almost completely stiffle value innovation in health care and cause much inefficiency and waste. The best care for a disease may be two towns away, with providers who are "Not in network". Good for the insurance company's cost budget, bad for healthcare.
Our providers and our staff realized that, in order to take good care of our patients, we must fight to restore decision making to the patient and their healthcare team. Our program is a prototype for how we think things should look in the future. We saw that we must build a healthcare team capable of effectively guiding patients toward the right decisions. We have come to realize that the most important thing to do is to serve as a guide for our patients. Therefore, we built the Integrative Pain Center on the vision of a health care system where patients and their healthcare team make the key decisions, one patient at a time.
Once that commitment was made, the only way to proceed was to develop a team-based multidisciplinary approach that has a reasonable chance of finding the right path for each individual patient. We tested this idea in 2000- 2001 with a community wide strategic planning program that used focus groups to ask what services and what capabilities the community wanted from a pain clinic. Multidisciplinary care with expert physicians who could connect patients with the latest treatment options emerged as the top priority. With the concept thus validated we have forged ahead.
What’s next?
Demonstrating outcomes!
Now that we have built a multidisciplinary program the principle of optimal, patient-centered, and timely decision-making, we intend to continuously improve the program and to measure and publish the results of the multidisciplinary approach. We have begun to assemble a team of experts in medical economics, management, behavioral medicine, multidisciplinary care, and pain medicine to guide the research under a research grant, and we appeal to the community to help us lead forward.
How can you help?
The 5 Foundations of Pain Treatment at IPCA
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About IPCA
