One of the fruits of Anesthesiology’s cross-fertilization is the establishment this past spring of the new chronic pain medicine clinic at Children’s Hospital, the first of its kind in the Southeast.

Thomas Vetter (left) is the director of the new chronic pain medicine clinic at Children’s Hospital. Aimee Walsh is the medical director of the Pain Treatment Clinic. The chronic pain medicine clinic at Children’s is part of a collaboration with the UAB Department of Anesthesiology that will offer a variety of specialties —from anesthesiology to psychology.
While many physicians at Children’s Hospital have treated chronic pain for years, the new clinic provides a cohesive unit that will enable them to integrate their resources to help patients receive the best care available.

Thomas Vetter, M.D., the clinic’s director and an associate professor of anesthesiology, says the collaboration “presents a great opportunity for Children’s Hospital and UAB to raise the bar in pain management for children and adolescents.” Vetter knows the impact this type of clinic can have; he helped build similar clinics at children’s hospitals in Indiana and Ohio.

Published data, including some of Vetter’s own research, indicate that children and adolescents most commonly seek pain treatment for headache, chronic musculoskeletal pain, chronic abdominal pain and a variety of disorders including cancer-related pain, sickle-cell disease and rheumatologic disorders. Other common problems for young patients include sports-related injuries, chronic sports-related pain and back pain related to obesity.

“Many children suffer from chronic pain, just like adults,” Vetter says. The clinic can assist specialists who are comfortable managing these disorders and those who need more support. “It’s exciting that this clinic is a multidisciplinary effort,” he says. “Everyone wants to come together to improve clinical care for children and adolescents in this city, state and region. These initiatives are going to be good for the patients, and we also have an opportunity to make a name for ourselves.”

Integrating care
The same ideas behind the Children’s Hospital chronic pain medicine clinic also form the foundation of what Vetter calls the UAB integrative pain medicine center, which is targeting a 2010 opening. A variety of specialties — anesthesiology, palliative care medicine, physical medicine and rehabilitation, neurology, psychiatry and psychology — jointly will provide comprehensive care for adults, Vetter says.

It’s all part of a bio-psychosocial approach to treating chronic pain — the best approach, according to Vetter.

“You address not only the biomedical aspects but also the psychological and social aspects of pain,” Vetter says. “If you develop a chronic pain condition and are unable to perform your job, it will have a significant adverse impact on your pain symptoms and your ability to be the breadwinner for your family, a partner to your loved one and a parent to your children.”

Vetter says that developing an interdisciplinary, bio-psychosocial strategy to treat chronic pain will result in better care for patients. Physicians will be more satisfied, too, Vetter says, because they are more likely to see successful outcomes.

“I think any physician, including those of us in pain medicine, can take inventory of their practice and say, ‘I’ve got some patients with chronic pain who just aren’t doing as well as I’d like, and it’s because I don’t have all the skills and resources that I need,’” Vetter says. “What we need to do as an institution is to bring all of those various skills and resources together, using an integrated approach, for the patients’ well-being.”