Roswell Park Physician Testifies Before Congressional Veterans Affairs Health Subcommittee

Mark Lema, MD, PhD, Chairman, Department of Anesthesiology & Pain Medicine, Roswell Park Cancer Institute and Chairman, Department of Anesthesiology, University at Buffalo's School of Medicine and Biomedical Sciences, testified on Thursday, October 4, 2007 before the US House of Representatives Committee on Veterans Affairs Health Subcommittee on behalf of the Pain Care Coalition. He also serves as current President of the American Society of Anesthesiologists.

On behalf of 50,000 physicians, clinicians, researchers and educators of the Coalition, Dr. Lema urged Congress to authorize and the Veterans Administration designate cooperative centers throughout the country for research and education on pain and to allow these newly created centers to compete on an equal basis with other priority research areas. Dr. Lema says, “We must ensure that the brave military men and women who serve or have served our country get the very best pain care possible.”

Dr. Lema's Five Minute Presentation

Mr. Chairman and members of the Subcommittee, my name is Dr. Mark Lema. I chair the Department of Anesthesiology, Critical Care and Pain Medicine at the University at Buffalo and at the Roswell Park Cancer Institute.

Today, I represent the Pain Care Coalition, a national advocacy effort of the American Academy of Pain Medicine, American Pain Society, American Headache Society and American Society of Anesthesiologists (ASA). I also currently serve as the President of ASA.

Collectively, the PCC represents over 50,000 physicians, clinicians, researchers, and educators who serve in leading clinical roles in the specialized field of pain management.

Some of these specialists work in the VA health system, and others are involved in collaborative relationships with research and clinical care programs throughout the VA system.

Briefly, I would like to discuss the complex problem of pain—especially for the men and women of our military. While we have made great advances, much more research needs to be done.

Mr. Chairman, pain is a very large public health problem in this country. Over 80% of patients seeing a doctor have pain as their primary complaint.

The pain problem is even more prevalent in our military and veteran populations: If miners, movers and construction workers suffer low back pain from heavy lifting, imagine the toll on the spine of those in active combat duty with full battle gear.

If truckers develop back pain from long hauls, imagine the toll of those soldiers inside armored vehicles going long distances on poor or non-existent roads.

If life’s daily stresses serve as triggers for those suffering migraine headaches, imagine the impact of battlefield conditions on the soldier’s stress.

Over 90% of the severely injured Veterans enrolled in the VA Polytrauma Centers are suffering from chronic pain, with most of these Veterans having pain at more than one site. 85% have traumatic brain injury.

As professionals in the pain care field, we must ensure that the brave military men and women who serve or have served our country get the very best pain care possible. However, many of these pain injuries have no cure.

We applaud the VA for its leadership in focusing resources on the assessment and treatment of pain. We are particularly supportive of the National Pain Management Strategy initiated in November 1998.

There is still much work to be done. The Pain Care Coalition believes VA’s pain research effort can and must be significantly enhanced.

We urge the Subcommittee to develop targeted legislation with three basic components.

First, Congress should require VA to establish a focused research and training program directed at acute and chronic pain within its Medical and Prosthetic Research program at VA headquarters.

Second, Congress should authorize and VA should designate cooperative centers throughout the country for research and education on pain.

Third, Congress should authorize these newly created pain research centers to compete on an equal basis with other priority research areas.

Mr. Chairman and members of the Subcommittee, pain is often characterized as the invisible disease. Unlike cancer, diabetes, and heart disease, there are no reliable tests to confirm the presence and severity of pain.

But that’s no excuse for letting research efforts lag behind those of other VA research priorities.

In closing, I would like to quote U.S. Army Deputy Surgeon General Joseph G. Webb, Jr. In October 2005, he said, “Wounded soldiers in Iraq and Afghanistan benefit from receiving some of the most advanced technologies and techniques in medicine today…The benefits of advanced pain management…are improved postoperative outcomes and the potential to eliminate chronic pain, particularly in amputees.”

Mr. Chairman and members of the Subcommittee, please help ensure adequate funding for pain management research. We must join together so that our brave men and women returning from combat continue to receive the best pain care possible by developing cures for traumatic painful conditions.

Thank you. I’d be glad to answer any questions.

For links to Dr. Lema's written and oral testimony as well as audio of the entire hearing, click here.