Featured in the December 2011 Issue of ENews
Fellowship Director
Brigham and Women's Hospital
Boston, MA
What is your area of specialty?
I have an interest in several areas related to pain medicine. Clinically, a large part of my practice revolves around the diagnosis and management of patients with pain related to spine disorders. I also have an interest in treating patients with severe pain who are on high-dose opioid therapy but who have had less than satisfactory results.
What initially sparked your interest in working in your field? Briefly describe your career path.
After graduating from the Penn State–Jefferson 5-year premed/medicine program, I began a residency in general surgery. After 2 years, I transitioned into anesthesiology and then completed a fellowship in pain medicine at the Harvard Coordinated Pain Medicine program based at Brigham and Women's Hospital (BWH) in Boston. Since then, I have been a staff anesthesiologist and pain medicine physician at BWH and have been fellowship program director since 1995. My interest in pain medicine was sparked by the opportunity this practice has offered in terms of acute and chronic patient management, evaluative services and interventional approaches, and academics and clinical practice.
What has been a highlight of your work? Perhaps you and your staff are proud of a certain project or accomplishment.
I run a large academic pain medicine fellowship program and am interested in identifying methods that promote teaching excellence and preparing new pain medicine physicians for practice. Also, I teach a graduate level class on public policy and medicolegal issues as they relate to pain medicine. Lately, I've been involved in a large outcomes-related study on the effectiveness of epidural injections for elderly patients with spinal stenosis. I have been fortunate to have mentored a number of my pain medicine fellows who have been awarded grants for pain research from organizations such as the American Society of Regional Anesthesia and Pfizer. Winning the Clinical Centers of Excellence award from APS in 2007 and 2011 has certainly been a major accomplishment of which our entire team at BWH can be proud.
Is there a particular challenge that you've either overcome or hope to address soon?
There are many challenges. How do we stay innovative without sacrificing good existing methods of practice? How do we stimulate curiosity and scientific interest in new generations of pain medicine practitioners? How do we continue to foster collaborations both within and outside of our specialty that will help us move our field forward? How do we establish and prove to our patients, our referral sources, and the healthcare system in general that our services are valuable?
Who is your favorite role model and why?
I have been fortunate to have had many role models. Two of my uncles (Relja and Srecko Nedeljkovic) were physicians who taught me the philosophy that physicians need to have a sense of humanity. My first anesthesia chairman, Paul Levesque, helped all of his trainees understand the importance and value of our specialty. Dan Carr at Tufts, similarly, has inspired many to think of pain medicine in a more universal and global sense. And many of my colleagues at BWH, both in the Pain Center and in the anesthesia department, have been models of how to work in an environment that promotes teamwork and collaboration to achieve the best goals for our patients, department, and institution.
How has membership in APS been of value to you and your professional development?
APS is an organization whose goals and mission are to optimize the prevention, diagnosis, and treatment of pain. The advocacy efforts of APS to promote excellence in pain medicine by recognizing centers of pain medicine excellence have been recognized as an important aspect of the overall strategy of the organization. Through this program, APS has helped our pain center focus, define, and streamline our overall mission. Like APS, our pain medicine center strives to achieve excellence in innovation, clinical care, research and expanding scientific knowledge, teaching and education, and advocacy and promoting the public good when in comes to pain medicine.