REQUIREMENT OF

Ethical

and Professional Standards

 

 


Please give this form to each recommending physician.

 

Two (2) letters of recommendation from practicing physicians must be submitted on behalf of each applicant for certification.

 

Both letters must be from physicians who can speak to the applicant’s practice in

Pain Medicine.  ONLY ONE (1) letter may be from a physician partner.  The second letter MUST be from another physician who can speak to the applicant’s practice in pain medicine.  Letters from relatives will not be considered. 

 

REQUIREMENTS

1.                           The letter must be TYPED on the letterhead of the recommending physician and

Should be mailed to:

Address Examination application and information request to

 

Monique Steegers, MD, PhD, FIPP

Registrar of Examination

World Institute of Pain

150 Kimel Park Drive, Suite 100A

Winston Salem, NC 27103-6984

Phone: 1.336.760.2939   -  Fax: 1.336.760.5770

E-mail: exam@worldinstituteofpain.org

 

 

2.                           The letter must be addressed:

 

Dear Credentials Committee,

 

3.                           ALL letters must contain the following information:

 

a.       Name of applicant.

 

b.      Number of years and in what capacity the recommending physician has known the applicant.

 

c.       A statement about the applicant’s competence in the field of Pain Medicine. 

 

d.      A statement concerning the applicant’s adherence to ethical and professional

standards.

 

e.       A description of the applicant’s scope of practice as it relates to Pain Medicine.

 

f.        The name, title, and signature of the recommending physician.


As the recommending physician, it is expected that your letter of recommendation will speak to the applicant’s practice in Pain Medicine, as well as serve as additional confirmation that the applicant has met the other WIP Certification Requirements.

 

Specifically, please include a summary of his or her overall practice, including information concerning specific evaluation, management and procedures in Pain Medicine.

 

For your information, the WIP-FIPP Board of Examination defines the field of Pain medicine as the following.

 

 

Definition of Pain Medicine

The specialty of Pain Medicine is the study evaluation, treatment, and rehabilitation of persons in pain.  Some conditions may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be conditions in which pain constitutes the primary problem, such as neuropathic pains or headaches.  The evaluation of painful syndromes includes interpretation of historical data; review of previous laboratory, imaging, and electrodiagnostic studies; assessment of behavioral, social, occupational, and avocational issues; and interview and examination of the patient by the pain specialist.  It may require specialized diagnostic procedures, including central and peripheral neural blockade or monitored drug infusions.  The special needs of the pediatric and geriatric populations, and patients’ cultural contexts, are considered when formulating a comprehensive treatment plan.

 

The pain physician serves as a consultant to other physicians but is often the principal treating physician and may provide care at various levels, such as direct treatment, prescribing medication, prescribing rehabilitative services, performing interventional procedures, directing a multidisciplinary team, coordinating care with other health care providers and providing consultative services to public and private agencies pursuant to optimal health care delivery to the patient suffering from pain.  The pain physician may work in a variety of settings and is competent to treat the entire range of pain conditions in all age groups.