A prospective one-year outcome study of interdisciplinary chronic pain management: Compromising its efficacy by managed care policies

Heather Robbins, Robert J. Gatchel, Carl Noe, Noor Gajraj, Peter Polatin, Martin Deschner, Akshay Vakharia, Laura Adams

Research output: Contribution to journalArticle

58 Scopus citations


Although interdisciplinary pain management programs are both therapeutically effective as well as cost-effective, they are currently being underutilized because of managed care policies. We used this pro-spective comparison trial, with 1-yr follow-up of chronic pain patients, to demonstrate the short- and long-term efficacy of an interdisciplinary pain management program, and evaluate the impact of managed care's physical therapy "carve out" practices on these treatment outcomes. Consecutive chronic pain patients (n = 201) were evaluated, some of whom had their physical therapy "carved out" from this integrated program. Results revealed that successful completion of interdisciplinary pain management was therapeutically effective. Most importantly, physical therapy "carved out" practices had a negative impact on both the short-term and 1-yr follow-up outcome measures. Thus, interdisciplinary pain management is effective in treating the major health problem of chronic pain. However, insurance carrier policies of contracting treatment "carve outs" significantly compromise the efficacy of this evidencebased, best standard of medical care treatment. This raises important medico-legal and ethical issues.

Original languageEnglish (US)
Pages (from-to)156-162
Number of pages7
JournalAnesthesia and analgesia
Issue number1
StatePublished - Jul 1 2003


ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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