title: Physician variability in the management of acute postoperative and cancer pain: a quantitative analysis of the Michigan experience.
abstract: BACKGROUND
  Little is known about physician attitudes, goals, or satisfaction regarding acute postoperative and cancer pain management.
  
  
  OBJECTIVE
  To provide quantitative data regarding the status of acute postoperative and cancer pain management by Michigan physicians. To measure physician confidence, preference, and satisfaction as well as identify their pain care goals for acute postoperative and cancer pain management. To evaluate variability in acute postoperative and cancer pain decision making based upon physician demographic characteristics, knowledge, and attitudes.
  
  
  METHODS
  A cross-sectional survey, which included two cancer and three acute postoperative pain vignettes.
  
  
  METHODS
  A randomly-selected sample of three hundred sixty-eight licensed Michigan physicians who provide clinical care for acute postoperative and cancer pain patients.
  
  
  RESULTS
  The majority of respondents (>50%) reported providing acute postoperative pain care frequently, while a minority (<20%) reported doing so for cancer pain. The majority of the physicians (>75%) reported goals of at least adequate pain relief without distress for both acute postoperative and cancer pain. Physicians more frequently chose the optimal pain management response for men following prostatectomy (56.2%) than for women following myomectomy (42%). They also chose the optimal response for metastatic prostate cancer more frequently (16.3%) than for metastatic breast cancer pain management (10.7%).
  
  
  CONCLUSIONS
  These data highlight physician variability in acute postoperative and cancer pain management decision making. Further study of the physician variable is necessary to improve the management of acute postoperative and cancer pain.
authors.affiliation: Department of Anesthesiology, University of Michigan Health System, Ann Arbor 48109, USA. carmeng@umich.edu
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Green
authors.forename: John R C
authors.initials: JR
authors.lastname: Wheeler
mesh_terms: D000208:Acute Disease; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008824:Michigan; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D059408:Pain Management; D010149:Postoperative Pain / Q000628:therapy*; D010166:Palliative Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires