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John Bonica (February 16, 1917–August 15, 1994) was an anesthesiologist and is recognized as the founding father of pain management, a field that has now evolved into the well-recognized medical specialty called Pain Medicine. After completing residency in 1944, Bonica joined the Unites States Army and was appointed Chief of Anesthesiology at Madigan Army Medical Center in Fort Lewis, Washington. For the next three years, he gained firsthand experience while treating painful injuries in World War II veterans. As an anesthesiologist, Bonica found that the tools at his disposal, opioid analgesics and peripheral nerve blocks using local anesthetics, were just a small part of what was needed to adequately diagnose and treat patients with complex, chronic painful disorders. He went on to pioneer the concept of bringing multiple medical specialists together to evaluate patients and construct a comprehensive treatment plan for each patient. Thus, the multidisciplinary approach to pain management was born. The original approach was to have each patient evaluated by a number of different specialists, usually an anesthesiologist or other physician would act as the team leader, often a surgical specialist would be involved, and the team always had a psychiatrist or psychologist and a physical therapist. Programs emerged around the world, many of which were based at rehabilitation facilities and they admitted patients for treatment during lengthy inpatient hospitalizations. Research about the effectiveness of this comprehensive approach emerged, demonstrating sustainable improvements in pain and function: Yes, the multidisciplinary rehabilitation approach really works. But there was a problem. Getting so many specialists together and coordinating care in this comprehensive fashion takes a lot of time and requires many different specialists, so it is expensive. Insurance providers began to deny coverage for comprehensive pain care and the approach fell out of favor in the 1980s.
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