Talking about roles in pain management


If you’ve missed it before, you won’t in the future: I don’t like turf protection in pain management!  If there is one thing people experiencing pain really need, it’s consistency from all the people working with them – and the second thing they need is more people doing good pain management.  So IMHO there is no room for health professionals staking out an area and saying ‘its mine all mine’.

Nevertheless, there are certain areas of greater or lesser specialisation, and I’m not suggesting pain management becomes an area like many mental health ones, of generic ‘case management’.

What I am suggesting is elimination of the phrase ‘the [insert professional title here] role in pain management is…’ What I’d like to suggest is a new way of looking at what each professional does, and the phrase ‘what [insert professional title here] can offer a team is…’

The subtle difference is in how we view the team.  If I say ‘my role’ I’m staking out a specific are that I want to claim as ‘mine’ and distinct from anyone else.  If I say ‘what I can offer’ I’m acknowledging that others may offer similar things, but this is what I would like to contribute to a collective, or team, effort.

The thing is, in pain management, no single health profession has it all.
While I take my hat off to psychology because of the depth of research into so many factors that influence how a person experiences his or her pain – psychologists in a clinical setting often don’t help the person apply those skills in real life, that’s often the contribution of an occupational therapist or nurse.
Similarly, occupational therapists often don’t help people develop underlying and fundamental movement patterns or strength or fitness needed to carry out daily activity tasks, that’s typically the physiotherapist or exercise physiologist’s contribution.
Medications may be prescribed by the doctor, but it’s very often the nurse, pharmacist or psychologist who help the person understand both why they’re taking them and when to take them during the day.

We need each other in pain management.
The International Association for the Study of Pain has always called itself an interdisciplinary organisation.

Pain isn’t simply a medical problem, nor is it primarily about neuroanatomy or neurophysiology.  To understand pain we need to go beyond describing the microcellular components (although that is important) and recognise that pain happens to people, and people think, feel, do – and live within families, communities and societies. To understand the mechanisms of this experience, we also need to understand neuroanatomy and neurophysiology – oh and occupation, cognition, emotion, choice, decision-making, family relationships, intimacy, community, legislation…

If you’re asked ‘what’s your role in pain management’, think about answering the question this way:

‘My contribution is mainly [insert your favourite contributions here] but with the rest of the team, we help people manage their pain and live their lives.’

2 comments

  1. Hi Bronnie,

    Great post and so true. Thinking about which skills, values and abilities are unique to professional groups can brew up a real storm. Your post links well to another excellent post by Salford Uni about core skills, what is shared etc etc http://frederickroad.blogspot.com/2009/01/core-values-or-core-skills-you-decide.html It frustrates me that people see interdependance with other professionals or generic working as devaluing their own individual profession. Surely the goal for the team must be to support the patient, irrespective of how that is acheived with regard to skill mix.

    1. Yes, it’s one of those debates that go on and on without having a positive effect on anyone – except maybe helping the odd profession to momentarily feel justified in their ‘poor me’ status!
      As you say, the skills need to be put together with skills from other groups to contribute to the patient’s wellbeing. We need each other!

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