Evaluation of Loma Linda University Health Physicians’ Attitude and Beliefs Regarding Pain Management

Background Effective pain management and safe opioid prescribing remain major challenges in healthcare delivery. Prior research demonstrates that primary care clinicians often manage chronic pain with little or no formal training in pain management, contributing to low confidence and apprehension when prescribing opioids. Surveys also show that insufficient knowledge and inadequate preparation are among the most common barriers to adopting evidence-based opioid-prescribing practices. This study examined physicians’ knowledge, attitudes, and perceptions regarding pain management and opioid prescribing at a large academic health system. Methods A cross-sectional survey was administered to physicians across multiple specialties at Loma Linda University Health (LLUH). A 54-item survey instrument developed primarily from existing medical and pharmacy education literature was used to assess physicians’ beliefs, knowledge, and experiences related to pain management. Descriptive statistics summarized demographic and clinical characteristics. Independent t-tests and correlation analyses evaluated associations between training, experience, and attitudes toward pain management and opioid prescribing. Results Of 262 surveys returned, 255 complete responses were included. Respondents averaged 8.3 years in clinical practice and worked approximately 48 hours weekly. Only 34.6% reported receiving formal pain-management training. Most clinicians (76.1%) believed opioid misuse is a major community problem, and 71.4% agreed that medical education devotes insufficient time to pain-management topics. Confidence in opioid-related counseling was moderate; however, fewer than half felt adequately trained or knowledgeable to manage chronic pain safely. Physicians with formal training reported significantly higher confidence in counseling about pain, opioid use, and opioid misuse (p < 0.001). Residents were more likely than attending physicians to view their institution’s pain-management resources positively, while attendings rated their own knowledge and training more favorably. Years of clinical experience correlated positively with perceived adequacy of training and knowledge, but negatively with perceived need for more education on opioid misuse. Conclusions Physicians reported limited formal training in pain management, modest confidence in opioid prescribing, and concern about the adequacy of pain-management education. These findings mirror national evidence showing that primary care clinicians frequently feel underprepared and apprehensive about opioid prescribing. Enhancing institutional support, expanding access to structured pain-management curricula, and integrating standardized opioid-education strategies may strengthen clinician preparedness and improve the quality and safety of pain care within academic health systems.