Are Pain Clinicians Generalists or Specialists?

Abstract

Folk wis dom teaches that gen er al ists learn less and less about more and more un til they know noth ing about ev ery thing. Con versely, spe cial ists learn more and more about less and less un til they know ev ery thing about noth ing. What type of cli ni cians should man age dif fi cult pain prob lems? Does pain care be long in pri mary care or ter tiary care? Per haps, the an swer is both. Pain is the most com mon rea son that pa tients visit doc tors’ of fices, clin ics, emer gency rooms and phar ma cies. Most pain prob lems can and should be man aged in the pri mary care set ting. Pain man age ment spe cialty ser vices are im por tant con sul ta tion and re fer ral re sources for more dif fi cult pain man age ment prob lems. But it is well doc u mented that pain man age ment is taught min i mally and poorly in most health pro fes sional schools and post grad u ate train ing pro grams. If we pain prac ti tio ners iso late our selves from col leagues with pri mary care or other spe cial ized prac tice foci, won’t we miss im por tant op por tu ni ties to build en thu si asm for better man age ment of pa tients’ pain among those col leagues?