For me the biggest story of 2014 was the use of opioids for the treatment of non-cancer pain. In Pennsylvania, a broad coalition of professionals and state policy members have been working hard to try to address prescription drug abuse and the excessive reliance on opioids to treat chronic pain. Two new practice guidelines were released by the state, one for opioids to treat chronic non-cancer pain, the other for the treatment of pain in the ED. We are now working on a guideline related to the treatment of pain by dentists.

Recently the ANA released a position paper on the use of opioids to treat chronic pain, and this position paper expressed strong concern over what is essentially current practice. Hopefully initiatives such as these can indeed change practice.

I see 2015 as an opportunity to be innovative in developing and implementing new ways for integrated care. I think the push over the next several years will be to develop improved processes of care that improve patient outcomes while lowering costs. I’m one of the folks who believe that this is very much possible. However, it will require new thinking and innovation from physicians. Personally, I think that those physicians who see this as an opportunity can become leaders and active participants in change, and those that resist run the risk of being left behind.

Michael Ashburn, MD, MPH is Director of Pain Medicine at the Penn Pain Medicine Center, and Professor of Anesthesiology and Critical Care at the University of Pennsylvania.