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APS Bulletin • Volume 14, Number 5, 2004
Past Presidents’ Perspectives
John L. Reeves II, PhD ABPP, Department Editor
An Interview with Michael Ashburn, MD MPH, APS President, 2000–2002
How did you get into the field of pain and who has influenced you most?
When I was selecting residency programs, I was torn between family practice and anesthesiology. I found the personal, long-term contact with patients seen with family practice as very appealing. However, I also enjoyed the practice of anesthesiology. After months of struggling, I ended up selecting and entering into an anesthesiology program. It should come as no surprise that when I was introduced into the world of interdisciplinary pain management by Brad Hare and Perry Fine at the University of Utah; I found this experience a wonderful addition to my professional career. For the first decade of my career, I really enjoyed providing pain care in addition to the practice of anesthesiology.
There are several individuals that have influenced my career in pain management. First, Brad Hare and Perry Fine at the University of Utah provided me the opportunity to experience the world of interdisciplinary pain management. My department chair, K.C. Wong, encouraged me to assume a leadership role in developing the pain programs further, and strongly supported these efforts. The introduction of our acute pain program was, of course, modeled after the work that Brian Ready shared with the world. My understanding of the richness and limitations of the information offered in the scientific literature, as well as a better understanding of the critical role that pain care plays in our society, was fostered by Dan Carr.
What are you doing now?
I left academic medicine in 2002 and joined the management team of ZARS, Inc. ZARS is a drug delivery company that I cofounded in 1996. I am currently the vice president for clinical and regulatory affairs.
How do you view current U.S. pain research and treatment?
So much has been accomplished, and so much has yet to be done. The last two decades have brought great increases in our understanding of pain mechanisms, as well as the development and implementation of effective pain treatment methods. However, our methods of pain treatment are still elementary and often produce significant adverse side effects. Many robust pain research programs have lost funding or institutional support, and as a result, there seem to be fewer individuals actively involved in basic science and clinical research. Likewise, many interdisciplinary pain programs have been downsized or eliminated, and I worry about where the next generation of healthcare providers with an understanding of—and a commitment to—pain care will arise. Support for robust interdisciplinary programs often are lacking, and I fear that people experiencing pain will continue to have difficulty finding qualified individuals to provide evidence-based care. This is especially true if the patient will not benefit from interventional therapy, or is a child, is older, or does not have adequate funding to pay for health care.
What is your forecast for the future?
Cautious optimism. Pain professionals have been underdogs before and have a habit of landing on their feet. If the pain community works together, it can be a strong force for change—change that can lead to improved access to and quality of care for those served. As the population ages there will be growing pressure for healthcare providers of all specialties to document that what they do adds value. If we develop and implement the tools to show that we add value, then pain professionals will do fine and may in fact improve support for the care provided. Likewise, pain professionals can be better advocates for robust support for pain research, research that includes basic science and translational research that will ultimately improve our ability to diagnose and treat painful conditions. This will require that academic centers strongly protect their basic science and clinical interdisciplinary pain programs. Such support will require vision. It will be up to the pain professional community to encourage its members to take positions of leadership to create an environment that leads to long-term success.
Please direct your comments or suggestions about this article to John L. Reeves, Department Editor, at reeves@ucla.edu.
