Publications
APS Bulletin • Volume 15, Number 3, Summer 2005
Past Presidents’ Perspectives
John L. Reeves II, PhD ABPP, Department Editor
An Interview with John D. Loeser, MD, APS President, 1986–1987
How did you get into the field of pain and who has influenced you the most?
I was in the right place at the right time. I trained in Neurological Surgery at the University of Washington from 1962–1967. John Bonica founded the Pain Clinic at the University of Washington in 1960 in association with Lowell E. White Jr, one of my attendings, and Dorothy Crowley, a nurse. Dr. White was interested in surgical approaches to pain management, and I saw a good deal of this when I was a resident. I joined the faculty in 1969 in part because Dr. White had departed, and someone was needed to do the pain surgery and interact with the Pain Clinic. That put me into a working relationship with Dr. Bonica, and he has certainly been one of the strongest influences on my clinical career. My undergraduate education in psychology also was an important factor in my interest in pain, as were my neurophysiology research activities as a resident and when I became a faculty member.
What are you doing now?
I am active in neurosurgery for pain, education of residents and fellows, clinical research, and as little administration as possible. I remain Professor of Neurological Surgery and Anesthesiology at the University of Washington, where I have spent my entire career.
What do you think has been the most significant contribution to the field of pain?
I think that the most significant contributions to the field of pain have been the Melzack-Wall Gate Hypothesis, cognitive and behavioral approaches to pain as pioneered by Bill Fordyce, and the leadership role played by John Bonica in launching the world of pain.
How do you view current U. S. pain research and treatment?
Pain research in the United States is rapidly expanding into new arenas and is an exciting field at this time. New experimental strategies are beginning to produce insights into the mechanisms underlying acute and chronic pain. Pain treatment is in chaos. We have not commonly agreed on certification or accreditation processes. Patients get the care offered by the provider to whom they happen to be referred. Economic incentives drive the provision of health care in the absence of meaningful data about the natural history and responses to treatments. Nonprocedural pain management, and especially cognitive-behavioral therapies, may fade away for lack of funding, even though they are cost effective and safe.
What is your forecast for the future?
The future has always been a time of great promise, and I see no reason to change that vista at present. Health care is in chaos in the United States, however, and pain management services are caught up in this. The relief of pain and suffering should be a basic human right, but we do not recognize this in U.S. health care today. I hope that health care can be available to everyone in this great, affluent country. That is the first step, for once that happens then pain management can be a universal feature of health care.
John D. Loeser, MD, is Professor of Neurological Surgery and Anesthesiology at the University of Washington, Seattle.
Please direct your comments or suggestions about this article or department to John L. Reeves II, PhD ABPP, Department Editor, at reeves@ucla.edu