HOW IT ALL STARTED…


EARLY DISCUSSIONS. Michael Gold and Jennifer Haythornthwaite started discussing the formation of a new US-based society for the study of pain during the summer of 2019.  Both had been reaching out to pain researchers around the country to get their thoughts on whether a new pain society was needed and if so, what it might look like. To broaden this discussion, they approached the organizers of the Midwest regional Pain Interest Group (Mr PIG) meeting (Drs. Julie Christianson and Doug Wright) held the first week of August, 2019 on the University of Kansas Medical Center campus to see if time could be devoted to a discussion of the future of a US based pain research association. Julie and Doug not only agreed to devote time, but enabled pain researchers from around the country who were not able to attend Mr PIG in person, to participate in the discussion virtually (who knew this would become the norm in a little over eight months!). The discussion focused on whether existing pain associations met the needs of the larger pain research community and therefore whether a new organization was needed. While a number of attendees felt it was important to work with the existing pain associations, the clear consensus was that there was a need for a new organization. 

FORMING AN ORGANIZING COMMITTEE. Drs. Gold and Haythornthwaite took the Mr PIG consensus as a mandate, and set about putting together an Organizing Committee for a US-based society for the study of pain. The goal was to make representation on this committee as broad as possible, and the strategy to achieve this goal was to reach out to any and all groups, specialties, disciplines with a link to pain research. These groups were charged with selecting representatives for the committee. Some, such as basic pain scientists, held an election. Others, such as the Eastern Pain Society had already voted to elect a president/president elect who were invited to join the Organizing Committee. The result was the creation of a group of 41 individuals from across the country, with varied career trajectories, specialty, and interests, all committed the promotion of interdisciplinary pain research.  

CREATING A NEEDS ASSESSMENT. This committee started its work in the fall of 2019 and chose to more formally address the same two questions Drs. Gold and Haythornthwaite had posed from the start: is there a need for a new US based pain research organization, particularly given the existence of multiple other pain societies in the US, and if so, what would it look like? To answer these questions the committee generated a Needs Assessment survey that was released in November of 2019 and closed in February of 2020. The survey was distributed as widely as possible via committee member contact lists, listservs linked to the committee member organizations, Twitter, Facebook, Instagram, as well as more traditional avenues including the US members of the International Association for the Study of Pain (IASP).  A total of 933 responses were received from many individuals interested in the US pain community and a longer report on the results of this assessment can be found below.  The answer to the first question was clear: 71% (n=617) of professionals and trainees residing in the US who responded to the survey (n=869) indicated that the available professional societies were not meeting their needs for their work in pain.  There was a broader range of opinions with respect to the answer to the second question with no clear consensus on the structure of the organization (Federation vs more traditional structure), how leadership and representation would be determined (by special interest group, discipline, etc), and whether the organization was run day to day by volunteers or a company. Nevertheless, the vast majority of respondents indicated that what they wanted most out of a society was a professional meeting, multidisciplinary membership, a journal, networking opportunities, and national advocacy. 

FUNDS TO PURCHASE THE JOURNAL OF PAIN. On just about the same day the Needs Assessment survey was heading out the door, the details of the auction of the Journal of Pain (JoP) were announced. An opening bid (of no less than $10,000) was due December 9, with the auction date set for December 12. Despite all the work that would still need to be done to form a society, let alone the awkward fact of putting the cart (a society journal) before the horse (the formation of a society), the possibility of purchasing JoP was just too good to pass up. Thus, the compressed time-line precipitated a scramble to not only raise the money needed for the purchase of the Journal, but to create a non-profit organization that would enable potential donors to make the needed contributions. A multi-pronged approach was employed to address the first issue, which included establishing a GoFundMe campaign (that raised almost $30,000) and a lot of direct contacts (spearheaded by Dr Gerald Gebhart, the first Editor in Chief of the JoP). The second issue was going to require a lot of quick decisions and more money to pay for expedited processing. The quick decision part was addressed by the Organizing Committee that elected Dr. Jessica Merlin to join Drs. Gold and Haythornthwaite in forming the United States Association for the Study of Pain (USASP), a registered 501(c)(3) corporation, for the purpose of purchasing the JoP. Fortunately, fundraising efforts were sufficient to cover the costs of expedited processing of the paperwork needed to form a non-profit organization. More importantly, there was enough money to cover the winning bid for the Journal at auction (although truth be told, the bid was made before all the funds needed had been secured).  Altogether, this campaign generated more than $170,000 (list of donors to be added when JoP editorial published), which not only covered the winning bid and purchase of the Journal on January 14, and the expedited processing of the USASP registration process, but what turned out to be a rapidly growing list of additional expenses. These included legal fees associated with the wording of the purchase agreement (Dr. Gebhart represented the USASP in court three times before the wording was finally approved), as well as support for the JoP editorial office that continued to process manuscripts in the publication pipeline through what proved to be a long process of finalizing an editorial agreement needed to resume publication of the journal. A final contract was signed with Elsevier on May 18 2020, and the Journal resumed accepting new manuscript submissions the next day.  Within 3 weeks, more than 100 submissions were made, demonstrating the important value JoP has for the pain community.

FORMING THE USASP. With the JoP related issues relatively clearly defined, the Organizing Committee turned its focus to addressing the clear mandate from the Needs Assessment to develop a US-based pain society that is multidisciplinary and brings together scientists, clinicians, health-care providers, and policymakers to support the study of pain in order to directly improve the lives of people in pain. Thus, subcommittees were established to address the nuts and bolts of turning the three member 501(c)(3) that was the USASP into a member-based society. This included laying the groundwork for a presence in the ether (website, twitter handle), plans for an annual meeting (to be virtual in the Fall of 2020), and most importantly, the structure of the organization in terms of bylaws and articles of incorporation. One of the few issues not covered in the Needs Assessment was whether the USASP could or should be established as a “sister” organization to another established society. Given the number of potential partners, the near unanimous Organizing Committee vote on this issue was that while the USASP should facilitate interactions across and between societies, it should be a stand-alone organization. Needs Assessment survey data were used to guide remaining decisions about the structure of the board, election process, and board composition. This last issue generated the most discussion, with the final decision being that board composition would be a dynamic process whereby board seats for each election would be defined by the “call for nominations” generated by a nominating committee, with the goal of generating a board reflecting the composition of the membership, including diversity, across the pain research committee. Finally, an implementation plan enabled the USASP to transition to a member-based society with a turnover of 1/3 of the board every year.

LEADERSHIP OF THE USASP. The initial board is composed of volunteers from the Organizing Committee who agreed to sit for terms ranging between ~one and ~three years and were elected by the Organizing Committee. This initial Board of Directors of the USASP will have a lot to accomplish in its first year, including a membership drive, the first annual meeting, and the application to be the US chapter of the IASP, all done in the face of an ongoing pandemic, opioid crisis, and long overdue cultural revolution. But with an established journal to our name, the USASP will be starting out with at least one solid block in the foundation upon which we will be building a new association. Thus, with a little luck and a lot of hard work, the new Board of Directors will establish an association that meets the needs of its membership, facilitating their struggle to achieve better and more effective pain management for all who need it.

 

ORGANIZING COMMITTEE

The Organizing Committee initially sought to answer two questions: Is there a need for a new US based pain research organization, particularly given the existence of multiple other pain societies in the US, and if so, what would it look like? The goal was to make representation on this committee as broad as possible, and the strategy to achieve this goal was to reach out to any and all groups, specialties, disciplines with a link to pain research. These groups were charged with selecting representatives for the committee. Some, such as basic pain scientists, held an election. Others, such as the Eastern Pain Society had already voted to elect a president/president elect who were invited to join the Organizing Committee. The result was the creation of a group of 41 individuals from across the country, with varied career trajectories, specialty, and interests, all committed the promotion of interdisciplinary pain research. A Needs Assessment was created and distributed among the pain science community and 933 responses were received. 71% of US-based professionals and trainees indicated that there was a need for a new US-based pain research organization. The Organizing Committee has now turned its focus to addressing the clear mandate from the Needs Assessment to develop a US- based pain society that is multidisciplinary and brings together scientists, clinicians, health- care providers, and policymakers to support the study of pain in order to directly improve the lives of people in pain.

 

NEEDS ASSESSMENT


 

Executive Summary: The Organizing Committee initiated this Needs Assessment to obtain opinions about the need for a new US-based pain society and to identify priorities for such a society. This report is based on the responses of 869 individuals who identified themselves as professionals or trainees currently residing in the US and interested in a US-based chapter of the International Association for the Study of Pain (IASP). The consensus indicate that a new pain society is needed at this time and should prioritize conducting a professional meeting, bringing together a multidisciplinary membership, provide networking opportunities, supporting national advocacy, publishing a journal, developing early career grants and programming, and developing Special Interest Groups. Although there was not a consensus on how best to represent membership in leadership of the new society, there was strong consensus that early career professionals should be involved.

 

The Needs Assessment was designed by the Organizing Committee to survey the pain community regarding the need for a new pain society and identify the priorities, structure and involvement of industry in such a society. The survey was released in November of 2019 and distributed as widely as possible via committee member contact lists, listservs linked to the committee member organizations, Twitter, Facebook, Instagram, as well as more traditional avenues including US members of the IASP. We closed the survey in February of 2020 and obtained a total of 933 responses that were complete or partially complete from many individuals interested in the US pain community. The largest group of respondents (n=869) were professionals or trainees who described themselves as currently residing in the US and interested in a US-based chapter of the IASP. The data from this group provide the basis for the following summary:

Is another pain society needed? 71% reported that professional societies are NOT meeting their needs related to their US-based work in pain and, of those reporting that their needs were met by professional societies (n=252), only 9% (n=21) indicated that there is not a need for another US-based pain society.

Conclusion: A new pain society is needed at this time.

What are the top needs for a new professional society? The majority of respondents (n=766) indicated that a professional meeting (86%), multidisciplinary membership (79%), networking opportunities (76%), national advocacy (75%), a journal (67%), early career research grants (64%) and programming (61%) and special interest groups (60%) were very important activities for a new US-based society for the study of pain. The professional meeting was ranked among the top 3 needs for 76% and more than half (51%) ranked a meeting as #1. This community indicated that hearing about the latest scientific work in the field, meeting and interacting with the leaders in the field, and interacting with other sub-specialties and disciplines were important activities not currently addressed by professional societies.

Conclusion: A professional meeting provides a critical need for the pain community.

What are the preferred logistics for professional meetings? The majority (81%) indicated a preference for small to medium venues for meetings (n=220) that last about 3 days. Continuing education (CE) credit is important to slightly less than half the respondents (45%), and content including clinical and translational research, cross-disciplinary, and basic science research were rated most highly.

Conclusion: Smaller, short meetings that provide CE are preferred.

What is the preferred structure for leadership? Respondents somewhat more favorably preferred a traditional (e.g., similar to IASP) leadership structure (41%) to a federation-style structure (e.g., similar to the European Pain Federation; 34%), although many did not have a preference (24%). Representation on the Board of Directors was equally distributed between those preferring a fixed structure (40%) and those preferring representation according to the characteristics of the membership (41%), although some did prefer representation proportional to discipline or Special Interest Group. There was a strong consensus that early career professionals should be involved in the leadership of a new pain society (82%).

Conclusion: The more familiar, traditional leadership structure is slightly preferred. Although there is not a consensus on how best to represent membership in leadership positions, the vast majority agree that early career professionals should be involved.

What is the role for industry? Opinions varied on the role for industry in the work of a new pain society, with the majority regarding it as acceptable that non-pharmaceutical companies (labs, publishers, etc) fund unrestricted educational grants (83%), exhibits at meetings (85%), or provide sponsorship of professional meeting expenses (73%). Sponsorship by pharma, a company that produces a commercial product marketed for the treatment of pain (e.g., drug or device), was more controversial, with a substantial minority indicating that unrestricted educational grants (33%), sponsorship of meeting expenses (46%), sponsorship of meeting lunches/activities (40%), and exhibits at meetings (25%) were unacceptable.

Conclusion: A substantial minority of the pain community regards pharma involvement in pain society activities and/or finances as unacceptable.

Nitty gritty of running the society? There was a clear preference for hiring staff (70%) over using volunteers (50%) or hiring a company (47%) in accomplishing the day to day operations of a new pain society. Most (71%) indicated that membership fees should be based on personal income and the majority preferred an annual membership fee of < $300/year (75%).

Conclusion: Staff should be hired and fees should be based on income.

Who responded to this survey? More than half of the respondents (57%) have a PhD, 17% a medical degree (MD or DO), 7% a nursing degree, and 3% a physical therapy degree. The distribution of time spent in various activities included: 25% clinical, 45% research, 15% teaching, 11% administration, and 4% other activities.