I don’t want readers to miss the significance of Star reporter Stephanie Innes’ recent article on the closure of the Integrative Pain Center of Arizona. That story should have been the front-page lead article. Here is why:
The clinic that just closed was unique because they integrated behavioral and medical care for 15 years. No other primary care or pain clinic did this, providing daily contact among medical, alternative, physical therapy and behavioral health providers. The result was the next generation of health care. That was right here, in Tucson, under our noses — and we just lost it.
If others of you in pain medicine or primary care plan to write complaints to the Star that “I do integrated care too,” please put your pens down. You may have made a start, but you do not.
I considered myself at the cutting edge of pain medicine when I joined the IPCA team in 2012 to do the Pain ECHO telemedicine program. As I heard the way they analyzed case presentations from the primary care ECHO students and the advice they gave, I realized that their care model was advanced beyond what I had ever considered. This was immediately evident in the way the IPCA providers understood the mind-body connection (because they had worked side by side with behavioral health for so many years); the way they could help clinicians understand and engage their patients in taking better care of themselves in ways that had never occurred to the clinician.
The rest of us classically trained medical providers do not have these skills, this knowledge, or this approach and it is the ideal model for the next generation of health care in general — not just for pain medicine. I’ve seen it work now for obesity, smoking cessation and more.
Let’s look at health-care costs of the IPCA model versus usual care. The average usual care pain patient costs Arizona’s Medicaid program about $35,000 per year. IPCA’s program gets better results and costs less than $10,000 — one time, not yearly. IPCA’s approach stood to save Arizona tens of millions of dollars in pain care costs alone — and produce better results across the population of pain patients than what we are currently doing — including what I was doing before I retired. I used to hear Dr. Bennet Davis report excitedly to the ECHO pain expert teaching panel that he was working with health plans to make these cost savings a reality. We just lost all that.
The IPCA clinic was designated a Center of Excellence by the American Pain Society in 2010 for a reason. To this day, IPCA remains the only Arizona adult pain clinic to have achieved that status, as well as being one of only 18 non-university, non-VA affiliated pain programs in the entire country to attain this status.
The question I pose the community, from business leaders to politicians to my medical colleagues is this: If someone were to build an award-winning model for the next generation of health care right here in Tucson, why would we not get behind that effort? Answer that, and we have a clear picture of what is stopping progress in health-care reform.