I think there are pockets of excellence in the country where some of these approaches are employed, and where there's a multidisciplinary approach that truly has the patient at the centre and that has all the follow-up and supports in place. It's telling that it takes that kind of a resource-intensive, complicated enterprise to do it well. It reveals what a complex recalcitrant problem pain management is. The difficulties in Canada of course are in the rural and remote areas, and in certain demographic groups that have particular challenges by virtue of their socio-economic status and other demographic differences.
Many family doctors in remote areas—and Jamie will no doubt expand on this—will tell you they don't have any multidisciplinary team there. They're it, and opioids are all they have. There's no physiotherapist or occupational therapist there. So there's this inequity of resources available to patients that we really need to get at if we want a national approach. If we want to introduce some sort of uniform assessment and treatment of some of these patients, we can't do that by simply focusing on what we are going to do differently about prescribing, but on what we are going to do differently about treating these patients in pain.