US critical access hospitals' listings of pain medicine physicians and other clinicians performing interventional pain procedures

• Published in: Journal of clinical anesthesia Vol. 58; pp. 52 - 54
• Main Authors: Elhakim, Mohamed, Dexter, Franklin, Pearson, Amy C.S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2019; Elsevier Limited
• Subjects: Anesthesiology; Certification; Chronic Pain - therapy; Critical access hospitals; Hospitals; Hospitals, Rural - statistics & numerical data; Humans; Interventional pain procedures; Managerial epidemiology; Medicare; Medicine; Pain management; Pain medicine; Physicians; Physicians - standards; Rural areas; Rural health care; Rural medicine; Specialty Boards; Studies; United States; Web sites; United States; United States > US; Iowa; Rural medicine; Critical access hospitals; Interventional pain procedures; Managerial epidemiology; Pain medicine
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2019.05.005

There is little knowledge of rural hospitals' roles in the care of chronic pain patients nationwide in the United States of America. We hypothesized that very few (≅5%) critical access hospitals provide patients with interventional pain procedures performed by pain medicine physicians. Random sample of the 1346 critical access hospitals in USA. Public websites were used for collection of listed services. Nine pain medicine physicians were listed as performing interventional chronic pain procedures at 7 of the 110 randomly selected critical access hospitals nationwide (6.4%; P = 0.63 compared with 5.0%). All listed locations for the care provided by the pain medicine physicians were within a critical access hospital or a hospital building adjacent to the hospital. Seven of the 9 physicians were listed as having active American Board of Medical Specialties (ABMS) certification in pain medicine. The 7 physicians with ABMS certification were at 6 of the hospitals, giving a percentage of 5.5% (P = 0.95). The proportions of critical access hospitals reporting interventional pain procedures were homogeneously distributed among census bureau divisions (P = 0.38). Fewer than half of the clinicians listed as providing pain management were pain medicine physicians (26.5% [9/34]; P = 0.0090). A very small percentage of critical access hospitals list at their websites that they offer interventional pain services by pain medicine-trained physicians, and most clinicians listed as performing these procedures are not pain medicine certified. Increasing access to pain medicine physicians may present an opportunity for improved pain care in rural communities. •There is little prior knowledge of rural hospitals’ roles in the care of chronic pain patients nationwide in the USA.•Our survey showed that 7 of 110 randomly selected critical access hospitals nationwide (6.4%) had a pain medicine physician.•<1/2 clinicians providing pain management at critical access hospitals are pain medicine physicians (26.5%).