Anesthesiology faculty and resident perspectives on evaluation and management of acute and chronic pain patients

Anesthesiology faculty and resident physicians often evaluate and treat acute and chronic pain very differently. Our study involved a one page questionnaire with 15 questions regarding evaluation and management of acute and chronic pain patients. Faculty and resident physicians from our Department of Anesthesiology were asked to fill out this questionnaire after written consent. The survey included questions grouped into sections regarding treatment of acute and chronic pain, reliability of specific patient complaints, and the decision for the clinician to refer to a Pain Physician. The answer choices for each question were all defined in the survey and included: postoperative pain, acute pain, chronic pain, and cancer pain. Each question was multiple choice and requested only one of the above answers per question. 67 surveys were returned and these were then separated into those that were in-training (residents and fellows) and faculty. Our study primarily focused upon similarities and differences in thought processes between Anesthesiology faculty and those that were in-training regarding acute and chronic pain patients. 16 of the 67 surveys were returned from faculty physicians, while the remaining 51 surveys were returned from residents and fellows. Based upon survey data analysis, most faculty and in-training physicians from our Department of Anesthesiology felt more comfortable treating postoperative and acute pain. Both groups felt that chronic pain patients were more difficult to interact with and treat. Faculty physicians tended to use more objective data such as vital signs and activity level for treating chronic pain patients when compared to residents and fellows. In summary, there were more similarities than differences in medical thought processes between faculty and in-training physicians regarding evaluation and management of acute and chronic pain patients. Improving education and maturation of medical decision-making for these patients may ultimately lead to better patient care and significant quality improvements.