pizzo said we need new innovative therapies that we may not know about. i think is that pretty pro found. we need new innovative therapies that we may not know about. so how many people do not know about 45 years of practice and treating people and honining th to a fine dregree on how you treat people with chronic pain -- i should not practice medicine without a license, but without a physical basis. and i think that doctor serno mentioned, the first thing to do is look at that, do you that first. and then, if there's nothing there then you have to move to a different modeality, this is my own statement. i think there's too many people in our societies, some of us are equipped somehow, different people think different ways. different people can cope with things differently and assess things differently and this is my own judgment, i think there's just too many people in our country that think there's a pill, a drug or a surgery that will cure whatever you have. and i think maybe we have been brought up to think that. that there's something out there, of,

philip pizzo. i hope i correctly pronounced that who is the chair of the oim report that i just referenced here. dr. pizzo is joining us from stanford university where he is a professor in the pediatrics and microbiology and immunology department. dr. pizzo will focus on the oim report and target areas for future research. next we have dr. william maixner. will you please come up to the witness table, please. and same with ms. veasley and also dr. sarno. so dr. maixner, and then ms. veasley and dr. sarno down here on the end. there you go. we welcome dr. william maixner. dr. maixner is the director for the center of neurosensory disorders for the university of north carolina at chapel hill. dr. maixner comes to us today with specific experience in pain management research. he has developed an oral facial pain management program at chapel hill. kristen veasley the director of the national vulvodynia association. recently she was appointed to search on the pain research coordinating committee at nih.

pizzo? >> thank you. well, i certainly agree and appreciate that there is a broad array of contributing factors as has been stated, i think it is also important for us to be very sensitive to the words we use and the way that they're received. there is today a significant amount of perception felt by those suffering from chronic pain, and in fact those called to serve on behalf of patients that there is a significant amount of, quote, emotional contribution. and i think while there is no doubt that our emotions contribute to our physiology, i think that we have much work to do to look at our approach to pain, just as we do other neurological and psychiatric illnesses from a physiological perspective as well. this is a very complex, interrelated array of events. and i think one of the things that our committee certainly heard and the data describes, that one of the challenges that happens in medicine is that when we don't know an answer, we often ascribe it to something else. and those assignments are ofte

pizzo. did i pronounce that right? >> yes, you did. thank you. >> thanks, dr. pizzo. dr. maixner, welcome. please proceed. >> thank you, mr. chairman. let me just start by thanking the chairman for indulging these testimonies. it's truly an honor for me. i'm born in southeast iowa. and so to be testifying before an iowa senator is truly an honor for me. but more so for representing the pain research community and the patients who suffer from a hidden epidemic. so let me start my formal statement. it's truly a tribute to our political system that the voices of many as well as a few can be heard and acted upon. today i would like to further detail several of the points made in the imo report relieving pain in america, which provides clear and unequivocal evidence that more than 100 million of our fellow citizens are experiencing a silent, hidden, and poorly treated epidemic. an epidemic that is as real as a polio epidemic that visibly shackled hundreds of thousand of americans and caused individuals and families to suffer greatly. no less real is the suffering of millions o

pizzo and dr. maixner you all disgust doctor shopping and sometimes this is a barrier to properly treating patients with chronic pain. on average how many doctors does a person suffering from chronic pain sea before getting a proper diagnosis and you have estimations on the cost of, the numbers of different doctors that the patient might go to and what does that cost the health care system and is it because the patient does not get the response or they are still in pain that they feel they have to go to another doctor or are they also looking for more medication? >> senator i think that's an important question. i wonder if i could slightly broaden it if you would. clearly what we know today and as you have heard we are spending as a nation between 565 to $630 billion a year on pain and that over 116 million individuals are affected by it. many of those individuals don't have access to health care is we would like them to be able to and even though we have some wonderful centers and need more as dr.