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FIRST, The Pain is the PITS Program will offer the first ever nationally recognized universal educational assessment and treatment pain management program for a best practice approach to the management of all types of pain, targeted for the public - the pain patients of America - and the pain management healthcare providers - the doctors, nurses, physical therapists, chiropractors, psychologists, and so forth - in this new era of using more multidisciplinary integrative pain management strategies and less opioid narcotic escalation for therapy.


     The Pain the PITS Program will provide a universal guideline for the assessment and management of acute and chronic pain, so that all those who suffer with pain and those that take care of pain sufferers, will have access to an easy-to-understand-and-follow integrative pain care program, with multiple P-I-T-S acronym assessment and treatment choices focused around a multidisciplinary model that can be used for as long as a patient needs - or even for a lifetime.  The PITS Program does not tell patients and doctors what to do, but rather, offers a pathway approach for different pain assessment and treatment avenues, so that patients and pain providers can talk about all possible options for optimizing ongoing care toward the goals of comfort, function, and overall quality-of-life; all based on the individual patient’s clinical pain circumstances.  With better coordinated integrative treatment options as outlined by the PITS Program guidelines, patients will receive better progressive care, avoiding previously attempted non-successful pain treatments, and ultimately require less high-dose opioid treatment.


SECOND, The Pain is the PITS Program will offer a PITS Pain & Quality-of-Life Score (the PITS Score) that can be used to continuously assess a patient’s pain treatment outcomes as documentation toward progressive pain management improvement.


     As the PITS Score improves - ranging from 0 to 120, the higher the score the better - so will a patient’s pain and quality of life; it is that easy!  The PITS Score assessment includes sections on physical function, intensity of pain, thoughts and behaviors, and social interactions; all aspects of concern that lead to the complexities in the development of chronic pain.  America loves to keep “score”, so hopefully following a PITS Score for pain and wellness will lead to better collaborative pain care and communication among all those involved; including the pain specialist, the primary care physician and nurse practitioner, the sub-specialists involved (orthopedics, neurology, rheumatology, and so forth), the physical therapist and chiropractor, the psychologist, all the complementary care professionals (massage, acupuncture, yoga, and so forth), and of course the patient.  All of this will ultimately lead to improved patient compliance and patient treatment satisfaction, two critically important factors in today’s healthcare climate.


THIRD, The Pain is the PITS Program will offer two other very important answers to the questions of, “How to keep opioid narcotic usage safe and balanced in chronic pain patients in America in light of the opioid crisis”, and “How to keep overall costs for chronic pain care down in America to sustain pain care maintenance”, for patients who continue to struggle with the ups-and-downs of long-term chronic pain management.


     The answer to the first question is “putting an upper limit on opioid narcotic daily usage individualized to the patient” by continuously pushing for additional integrative pain care options in the PITS Program.  Opioid narcotic medications are both good and bad for us; good that they can help manage pain as a medication option, but bad that continued increase doses can hurt our body’s organs and functions, make us more-and-more physically and psychologically dependent, and lead to possible misuse, abuse, and addiction.  There will always be risks and benefits to opioid narcotic usage, so the PITS Program developed a PITS Opioid Risk Screening Score (PORS Score) to assess an individual pain patient’s risk for using long-term opioid narcotics for pain control.  There is a continuous balancing act with the upper limits of daily usage for a patient, matched with a PORS Score that reveals low, moderate, or high risk by patient assessment.  The PITS Program always teaches this risk and benefit analysis of chronic opioid narcotic and educates them to safer and balanced long-term levels; and nearly all chronic pain patients in America seem to understand and respect this delicate issue; again, especially in today’s healthcare climate with America’s current opioid crisis and pain epidemic.


     The answer to the second question of keeping overall chronic pain care costs down in America is to: “follow the multidisciplinary Pain is for the PITS Program treatment options for maintenance control of pain, minimizing what patients need from the overall healthcare system and maximizing what they can do on their own (mind and body care), once a patient’s acute pain cycle is broken with the expensive aggressive initial pain care assessment and treatments they receive”.  Once a patient reaches their acceptable PITS Pain & Quality-of-Life Score, then their future chronic pain care needs can be maintained by using the lowest effective pain medication amounts, spacing interventional pain injections more, encouraging patients to maintain their physical therapy gains with a home exercise and gym program and coping strategies, and minimizing surgical intervention procedures when possible.  For example, when it comes to chronic opioid narcotic usage, using the lowest effective level, with the least side effects, for the longest period of time will help to keep costs down tremendously, as a lot of opioid narcotics commonly used throughout America are very expensive, and are typically prescribed on a monthly basis for long-term pain care.  Likewise, over use of pain injections and surgical procedures drive costs up, so their needs to be a better balance of care with better defined endpoints for the progression of medical, interventional, and surgical care for chronic pain patients in America.

IN SUMMARY, the Pain is the PITS Program for America will help provide this much needed educational assessment and treatment program guidance for our country’s current opioid crisis and pain care epidemic!  Currently, there is no universally known national pain program to learn and follow for the millions of chronic pain sufferers in America - like there are for weight loss programs in America - and that is why I created the Pain is the PITS Program - a "pain loss" program!:  you do a PITS Assessment - obtain your PITS Score - to see your baseline starting point, you do the PITS Treatments to improve your needed areas of care, you follow your PITS Score until you reach an acceptable pain control and quality of life level, then you maintain your program on a monthly basis so you can feel better and get on with your life.  First, you do what you can on your own being proactive, and then you access the healthcare pain team when you need professional help.  You can do the PITS Program online or you can walk into a future Pain is the PITS Center and do the program.  As patients are treated in the PITS Program, improving patient access to the program, keeping quality of care at a premium, and keeping overall cost of care down, will always be the main healthcare principal focus that drives their clinical pain care moving forward.


After all, with 100 million pain sufferers in the United States and an annual cost of over 600 billion dollars - pain care costs, lost work days and wages, cost of disability, and so forth - and with the ongoing opioid crisis in America, we all need to look for answers for improvement - the government and health insurers, pain management societies, pain professors and hospital systems, pharmaceuticals and medical device companies - and especially the individual doctors and patients in the trenches battling with the war on pain.  With my now 30 years in medicine with training, teaching and clinical pain management experience, you can certainly count me in to do my part with the creation of Project PITS and what it has to offer America as a legacy pain management medical wellness program!

Peter A. Kechejian, MD, CPE

Pain Management Specialist

Certified Pain Educator


President and CEO

PITS Program, LLC

Dallas, Texas

CLICK to learn more by checking out the PITS Podcast on Chronic Pain in America

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