American chronic pain medicine has been in a state of crisis for many years, with the overall quality of care continuing to deteriorate. In a 3-part series published in 2008, Giordano and Schatman discussed this crisis,1–3 elucidating the notion that chronic pain care would not reach its potential if we failed to emphasize multidisciplinary care focused on the needs of patients. More than a decade later, it is quite apparent that our warnings were not heeded. Much of this failure has been related to the devolution of the “profession” of pain medicine to the “business” of pain medicine,4 which has been due to numerous factors. These have included, but not necessarily been limited to, the malevolent dominance of the health insurance industry, 5,6 progressive corporatization,7 fraudulent marketing,8 industry’s detrimental influence on medical education,9,10 a lack of undergraduate medical education in pain management,11 and, of course, the profound swing of the “opioid pendulum” from reckless opiophilia to its current zeitgeist of often cruel opiophobia,12–14 and last but not least, the demise of interdisciplinary pain care.
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