Lack of research in pain medicine cause for action, UF researcher says
The physicians most responsible for mitigating pain and shepherding people through surgery have not been publishing many research papers, which means fewer advances in the field, a group of University of Florida Health physicians and their colleagues have found.
“The positive thing is that we are trying to do something about it,” said Robert W. Hurley, M.D., Ph.D., an associate professor of anesthesiology in the UF College of Medicine and chief of pain medicine at UF Health. He and his colleagues Patrick J. Tighe, M.D., of the UF College of Medicine department of anesthesiology; Phebe S. Ko, M.D., of the University of California, San Francisco; Peter J. Pronovost, M.D., Ph.D., and Christopher L. Wu, M.D., of Johns Hopkins Medicine and Kevin Zhao, M.D., of Massachusetts General Hospital, published their findings in the journal Anesthesia & Analgesia.
Chronic pain costs the United States between $560 billion and $635 billion a year in medical treatment and lost productivity, according to the Institute of Medicine. The Institute of Medicine has put together a blueprint for providing pain relief to patients nationally, and key components include research and education. By examining the state of research in anesthesiology departments today, Hurley and his colleagues hope to galvanize researchers across the nation into action.
The scientists looked at the research productivity of academic anesthesiology departments between 2006 and 2008. They examined the number of papers produced by anesthesiology faculty and looked at the demographics of the faculty, including gender, academic rank and appointment type, the effect of post-residency training and subspecialty certification and academic degree, to see if these factors had an impact on publication.
They found that 63 percent of anesthesiology faculty did not publish any papers during that time frame. While previous work had shown that publication rates for anesthesiologists were low, this study also showed that academic rank, board certification, appointment status, gender and additional post-residency training all appear to impact publishing. Although the cause of these disparities may be unknown, these findings allow the field to move forward with plans to examine and address the issues identified.
“In the paper, we argue that we must train clinician-scientists early in their medical training, before they become faculty,” Hurley said. In the study, faculty with an M.D.-Ph.D. or a Ph.D. degree accounted for 15 percent of the total number of faculty members, but published 51 percent of the research. The researchers suggest that this discrepancy is due in part to the Ph.D. training in research study conceptualization, design and execution, which may be lacking in the clinical focus of medical school, residency and fellowship training programs.
To that end, faculty from the UF department of anesthesiology and UF department of psychiatry have created a weeklong intensive training course for second-year medical students that focuses on the management of pain and addiction. The course includes faculty from anesthesiology, neurology, orthopedics, psychiatry, community and family medicine, the College of Public Health and Health Professions, pathology and urology, as well as an ethicist.
“One of my goals with this course is to expose medical students to pain specialists and anesthesiologists early on and interest them in developing scholarly fields of pain medicine and anesthesiology,” Hurley said.
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