Pain Medicine Fellows Need Explicit Training in Engaging Patients in Patient‐Centered Pain Management

The majority of pain medicine physicians complete residency in anesthesiology, during which they learn to safely care for patients rendered unconscious or insensible to pain and stress during surgical, obstetric, and other medical procedures. During pain medicine fellowships, trainees learn to examine, diagnose, and treat these challenging patients. Most training is on learning the administration of regional nerve blocks, other injection interventions, and the pharmacological management of acute and chronic pain in both outpatient and inpatient settings [1]. In addition to these somatic interventions, the ACGME requires fellows to 1) perform several complete mental status examinations (both supervised and unsupervised) and 2) “understand the principles and techniques of the psychosocial therapies, with special attention to supportive and cognitive behavioral therapies, sufficient to explain to a patient and make a referral when indicated”[1]. Given the need for a strong working alliance between patients living with chronic conditions and their physicians, more training is needed to effectively engage patients with chronic pain in a patient-centered model of chronic care.The article by Matthias and colleagues [2] describes the experiences of military veterans participating in a multicomponent intervention for chronic musculoskeletal pain. Their article identifies the interventions deemed of value by chronic pain patients. The 12 telephone-based sessions, delivered by a nurse clinician, included training in 1) analgesic management; 2) pain self-management instruction; and …