Stanford’s new Gastrointestinal (GI) Pain Program, a partnership between Stanford Hospital & Clinics and the Stanford Pain Management Center, is taking a multidisciplinary treatment approach to battling GI pain.
Chronic pain has become a serious health issue in the United States: over 100 million Americans suffer from chronic pain each year, costing the United States about $600 billion in medical expenses and lost productivity — double the figure for cancer.
“The magnitude of human and economic toll of pain in America is far greater than any of us imagined,” said Dr. Philip Pizzo, dean of the Stanford University School of Medicine, in his July newsletter to the Stanford community. As chairperson of a 19-member committee commissioned by Congress and supported by the National Institutes of Health (NIH) to report on the far-reaching impacts of chronic pain in the United States, Pizzo has been an advocate of effective pain management.
School of Medicine assistant professor Ravi Prasad stressed the necessity of collaboration between different medical specialties as a focal point of the program.
“Our integrated program is comprised of an evaluation with a GI physician, a pain physician, a pain psychologist and a physical therapist,” he said. “After all evaluations have been completed, all providers meet and discuss the case in a multidisciplinary conference and formulate a comprehensive treatment plan that addresses biological, psychological and social factors that can be playing a role in the onset and maintenance of the patient’s condition.”
School of Medicine assistant professor Linda Nguyen further emphasized the multi-faceted roots of pain.
“When we request a referral for patients to see a pain specialist, psychologist and nutritional therapist . . . we’re acknowledging that pain doesn’t occur in isolation,” she said. “The unique part about this program is that we work together — at the end, patients are actually presented with the results of their conference.”
The GI Pain Program was initiated because doctors found that earlier chronic pain treatment practices were insufficient to the task.
“The motivation came from taking care of patients over the years and finding that there was a void in taking care of patients in chronic pain,” Nguyen said.
“We often hear of patients feeling like they are lost in the shuffle of medical providers, and we are constantly seeking ways to address this issue,” Prasad added. “Due to the large number of patients who present to our clinic with GI issues and the high number of GI patients who present to that service with pain issues, both divisions felt a need for closer collaboration.”
The program highlights a possible model of collaboration for other medical fields.
“We hope to expand this to other medical departments and use the GI model as a template,” Prasad said. “We are in the process of examining what works and what doesn’t work in our current framework before trying to apply it in other settings.”
“We’re interested in looking at the outcomes of this program compared to potentially historical controls or the patients’ viewpoints before they’ve gone through the program,” Nguyen added.