A New PATH Forward for Chronic Pain
“For 20 years, we had a fairly one-dimensional approach to chronic pain,” says Dr. Jon Porter, founding medical director of the Partners Aligned in Transformative Healing (PATH) Program at UVM Medical Center’s Comprehensive Pain Program.
That approach was opiate prescriptions. In addition to the harm opioid addiction has caused across the state, Dr. Porter says the relief these medications can offer a person with complex pain over the long-term is limited.
“A pill can’t make this go away,” he says.
The PATH program takes a different approach. Rather than seeking to eliminate pain, PATH’s goal is to help participants develop sustainable strategies for living well with the pain that they have. The eight-week intensive outpatient program’s “whole person” approach melds conventional medical and mental health treatment with weekly group work and a full slate of evidence-based complementary and alternative therapies like yoga, acupuncture, massage, and culinary medicine.
“By the time a participant gets to us, they’re often at wits’ end,” says Laurel Audy, the program’s registered nurse, and Reiki practitioner.
“But by the time they leave,” Dr. Porter says, “the effect is profound. People are tearful; they use words like transformative and life-changing.”
Only a handful of comprehensive programs of this type currently exist in the U.S., and the cost, which can range from several thousand to tens of thousands of dollars, is generally not covered by insurance. The PATH program is unique in this regard: thanks to an innovative collaborative partnership between the UVM Medical Center and Blue Cross and Blue Shield of Vermont, participants are given access to the entire array of services for the cost of two primary care visits.
Over the course of the program, participants are encouraged to try as many treatment modalities as they wish with the goal of building a personal toolkit to help optimize function and maximize comfort. This approach provides Vermonters with lifelong strategies to manage their pain.
“Each person gets a really good look medically, but we don’t emphasize that with the participants. The idea is that nobody else can know what works best for you,” says Dr. Porter. “You get to decide.”
Blue Cross helps vision become reality
The program was four years in the planning, including the creation of a custom medical suite designed to look as “soothing and un-medical” as possible for those who have seen the inside of one too many clinical buildings in their pursuit of a cure for their pain. In 2018, Dr. Porter was brought on to design the program and hire the transdisciplinary staff.
“Then the issue of how people are going to pay for this comes up,” he says. “Most of these integrative therapies, for most people are not covered. That was a huge issue. It’s truly thanks to Blue Cross Blue Shield—and the support of Chief Medical Officer Josh Plavin, in particular—that we were able to make it work.
"There was this alignment of the stars in terms of the health care community realizing that there are these other evidence-informed approaches that can help, and Blue Cross being willing to really think forward and take a leap.”