Parameters of Pain Care: Mitigating Racial Disparities in Patients with Chronic Pain

This activity is part of a series


Monica E. Peek, MD, MPH, MSc
Ellen H. Block Professor of Health Justice in the Department of Medicine
Associate Director, Chicago Center for Diabetes Translation Research
Director of Research, MacLean Center for Clinical Medical Ethics
The University of Chicago
Chicago, IL
Monica E. Peek, MD, MPH, MSc

Monica Peek, MD, MPH, MSc is an Ellen H. Block Professor of Health Justice in the Department of Medicine. She is also the Associate Director, Chicago Center for Diabetes Translation Research, and Director of Research, MacLean Center for Clinical Medical Ethics. She is a practicing internist, medical educator, and clinician investigator. Her research pursues health equity and social justice, with a focus on promoting equitable doctor/patient relationships among racial minorities, integrating the medical and social needs of patients, and addressing health care discrimination and structural racism impacting health outcomes (e.g., diabetes, COVID-19). Dr. Peek has authored more than 200 peer-reviewed publications and abstracts on health care disparities, diversity, and bias; has been the principal investigator of multiple grants to address health disparities; and has been invited to speak at numerous local and national medical meetings.

Carmen Renee Green, MD
Professor of Anesthesiology, School of Medicine
Professor of Anesthesiology, School of Medicine
Professor of Obstetrics and Gynecology, School of Medicine
Professor of Health Management and Policy School of Public Health
Faculty Associate, Research Center for Group Dynamics Institute for Social Research
Faculty Associate, Institute for Health Policy and Innovation
Attending Pain Medicine Physician, Michigan Medicine
University of Michigan Ann Arbor, MI
Carmen Renee Green, MD
Professor of Anesthesiology, School of Medicine

Carmen R. Green received her MD from Michigan State University College of Human Medicine (MSU CHM) and was elected to Alpha Omega Alpha (AOA) National Honor Medical Society. She completed an Anesthesiology residency, subspecialty training in Ambulatory and Obstetrical Anesthesia, and a Pain Medicine fellowship at the University of Michigan Health System (UMHS) as well as the National Institutes of Health’s (NIH) National Institute on Aging Butler-Williams Scholar Program, Hedwig von Ameringen Executive Leadership in Academic Medicine (ELAM) Program fellowship, and Mayday Pain & Society fellowship. Dr. Green was a Robert Wood Johnson Health Policy Fellow at the National Academy of Medicine (NAM) of the National Academies. Working in the US Senate’s Health Education Labor and Pensions Committee and the Children and Families Subcommittee, she helped draft the National Pain Care Policy Act, incorporated in the Affordable Care Act, and was thanked in the Congressional Record by Senator Kennedy for contributions to the FDA reauthorization, i.e. including gender and race variables to assess outcomes.

Dr. Green is a tenured Professor of Anesthesiology, Obstetrics & Gynecology, and Health Management & Policy at the University of Michigan’s Schools of Medicine and Public Health, an attending physician in the Back and Pain Center, holds faculty appointments at the Institute for Social Research and Institute for Health Policy and Innovation, and is a faculty associate in the Program for Research on Black Americans, Depression Center, and Cancer Center, where she was elected to Phi Kappa Phi Honor Society. Green is also an elected fellow of the New York Academy of Medicine, Gerontological Society of America, and Association of University Anesthesiologists. She is a faculty associate in the Program for Research on Black Americans, Depression Center, and Cancer Center. The inaugural Associate Vice President and Associate Dean for Health Equity and Inclusion at the UMHS, she is the Executive Director of the Healthier Black Elders Center and Co-Director of the Community Core for the Michigan Center for Urban African American Aging Research. Dr. Green was the founding chair for the American Pain Society’s Special Interest Group on Pain and Disparities and chair of the Public Policy Committee.

At the nexus of public health and health care quality, equity, and policy, her health policy relevant and health services research agenda focuses on pain and the social determinants of health. She is the author of germinal and seminal papers that poignantly reveal unequal treatment, disparities, and variability in decision-making, and diminished health care quality, revealing suboptimal access to health and pain care across the life course for women, minorities, and low-income people. An innovator, she often uses narrative medicine and photo voice techniques to promote empathy and healing. Dr. Green published a selective review focusing on the unequal burden of pain in Pain Medicine, which remains the most cited article in the journal’s history and was the guest editor for its special issue on disparities. She was the first to identify hospital security errors.

Dr. Green received several honors, including UMHS Employee of the Year, U-M Woman of Color of the Year for Human Relations, Consumers’ Checkbook’s Top 100 Doctors, Top 1% of Pain Doctors by US News and World Reports, Who’s Who in America, U-M Harold R. Johnson Diversity Service Award, John Liebeskind Pain Management Research Award, Elizabeth Narcessian Award for Outstanding Educational Achievements, and MSU CHM Distinguished Alumni Award. Her federal and state board service includes NAM’s Health Care Services Board, Michigan Governor’s Pain and Symptom Advisory Committee, US Secretary of Health and Human Services (HHS) Interagency Pain Research Coordinating Committee, and HHS Oversight Committee for the National Pain Strategy (Disparities Committee Co-Chair) as well as NIH’s Advisory Committee for the Eunice Shriver National Institute of Child and Human Development, Advisory Committee for Research on Women’s Health, and National Center for Medical Rehabilitation Research. Dr. Green has made invited presentations across the globe, including the US Congress and Rockefeller Foundation Bellagio Center in Bellagio, Italy. She has worked across the health professional pipeline to achieve a critical mass of minorities and women in academic medicine, biomedical sciences, and higher education. Her former students lead, teach, and inspire others.

An avid swimmer and genealogist, Carmen enjoys travel, photography, college football, and time with friends and family. She began writing poetry, plays, and books as a teen. Carmen also enjoys the creative arts, attending operas and recitals, and recently appeared as the Narrator and Lincoln in Aaron Copeland’s Lincoln’s Portrait with the U-M Life Sciences Orchestra at the historic Hill Auditorium (Ann Arbor).

Statement of Need

Pain care disparities exist across medical specialties and settings, with Black and Hispanic patients receiving less analgesia for fractures and musculoskeletal pain in emergency rooms than White patients, and pregnant women from minority backgrounds receiving less optimal pain reduction during delivery. As undertreatment of pain contributes to medical mistrust, overuse of OTC medications, disease progression, worsening pain, and lower quality of life, it is imperative that clinicians are aware of the prevalence and impact of pain care disparities, and identify and address biases, discrimination, and stereotypes that lead to this form of structural violence against minority populations.

This CMEOCast episode will highlight the root causes of health disparities in pain care and identify best practices for addressing structural and interpersonal racism that cause inequitable pain management, to improve awareness of and address clinician biases in pain care for patients from racial minority backgrounds.

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Identify factors contributing to disparities in pain management.
  • Identify strategies to provide equitable pain management for all patients.

Financial Support

Supported by an educational grant from the Johnson & Johnson Institute and the Johnson & Johnson Family of Companies.

Target Audience

Physicians, dentists, nurse practitioners (NPs), physician associates (PAs), nurses, and pharmacists

Credit Information

Jointly Accredited Provider

In support of improving patient care, CME Outfitters, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Interprofessional (IPCE) 0.75

This activity was planned by and for the healthcare team, and learners will receive 0.75 Interprofessional Continuing Education (IPCE) Credit for learning and change.

Physicians (ACCME) 0.5

CME Outfitters, LLC, designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses (ANCC) 0.5

This activity is designated for 0.5 contact hours.

Note for California Nurses

This continuing nursing education activity was approved by the California Board of Registered Nursing. CME Outfitters, LLC’s provider number is CEP15510.

Pharmacists (ACPE) 0.5

This application-based activity is approved for 0.5 contact hours (0.05 CEUs) of continuing pharmacy credit.
Activity UAN: JA0007185-0000-21-065-H08-P

PAs (AAPA) 0.5

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Dentists (ADA CERP) 0.5

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Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.5 medical knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

MIPS Improvement Activity

Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Royal College MOC

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Peek has no disclosures to report.

Dr. Green has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report:

  • Michael Franks, APRN, AGACNP-BC, FNP-BC (peer reviewer) has no disclosures to report.
  • Noreen Iftikhar, MD (planning committee) has no disclosures to report.
  • Kathleen A. Blake, PhD (planning committee) has no disclosures to report.
  • Jan Perez (planning committee) has no disclosures to report.
  • Sharon Tordoff (planning committee) has no disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credits

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Parameters of Pain Care: Mitigating Racial Disparities in Patients with Chronic Pain
Event Date: 10/12/2021