The Johns Hopkins multidisciplinary pediatric pain management service: a concept paper

Chronic pain in children poses a significant and under-addressed public health burden. This concept paper outlines the proposed design and implementation of a Multidisciplinary Pediatric Pain Management Service (MPPMS) at Johns Hopkins Medicine, addressing four key objectives. First, it presents a novel care delivery model grounded in the biopsychosocial framework, led by a multidisciplinary team and structured to deliver patient-centered care across escalating levels of clinical intensity. Second, it details the operationalization of the clinic in three phases, starting with a lean model and scaling toward a transdisciplinary team structure through enhanced clinic efficiency, technology integration, and strategic resource allocation. Third, it examines the financial implications of the model, including cost-per-encounter estimates, phased improvements in resource utilization, and strategies for achieving long-term sustainability through alternative revenue streams and workflow optimization. Fourth, it proposes a comprehensive outcomes framework encompassing clinical, operational, and financial metrics to guide continuous improvement and facilitate national benchmarking. Collectively, this paper provides a scalable blueprint for managing pediatric chronic pain that integrates care, optimizes operations, ensures fiscal responsibility, and delivers measurable patient benefit, positioning the MPPMS as a model that can be replicated at other institutions to address this growing clinical need.