Primary Practice Practitioner Program
Chronic Pain

The 4 Tenets of 4PCP

Why 4PCP?

New Funding Provides Course at No Cost

The Agency for Healthcare Research and Quality (AHRQ) has funded a study on 4PCP. As a result, starting in 2023, this AHRQ-supported study provides the course at no cost; practitioners and their patients complete surveys to evaluate program outcomes.

Contact the 4PCP study team:

Contact the program director:


Thomas Chelimsky, MD - Neurology
Thomas Chelimsky, MD - NeurologyProgram Director
Dr. Thomas Chelimsky has devoted much of his career to helping doctors manage chronic pain. For a decade, he directed the successful Case Western University rehabilitative chronic pain center which helped patients find new life in the midst of severe chronic pain. The Center was cited as a national model for its interdisciplinary collaboration across multiple departments. When the Center closed in 2004 because insurers now preferred medications and injections to the rehabilitative management style, he brought these same concepts to primary care physicians through the Primary Practice Practitioner Program for Chronic Pain (4PCP). As a result, practitioner satisfaction with this work improved and patient pain intensity dropped enough that they could reduce their pain medications including their opioid doses. As CEO of PainSTakers LLC since 2018, Dr. Chelimsky now focuses on training primary care physicians in the biobehavioral model and skillset. Previously chairman of neurology at the Medical College of Wisconsin, Dr. Chelimsky is now a tenured professor. He is currently funded by NIH to study the interface between pelvic pain and autonomic function. Dr. Chelimsky completed a fellowship in autonomic neurology at Mayo Clinic, where he also completed residencies in internal medicine and neurology. A graduate of Harvard University (undergraduate) and Washington University in St Louis (medicine), Dr. Chelimsky joined the faculty at Case Western in 1990 and rose to the rank of Professor in 2007. Dr. Chelimsky has published many original articles and chapters. He has received board certifications in Internal Medicine, Neurology, Pain Management, Autonomic Disorders, and Neurophysiology.


  • PainStakers provide a variety of course offerings to best suit your practice or individual learning needs. We facilitate chronic pain education in a variety of formats and commitment levels.
  • The full 4PCP Curriculum includes all of the components below and provides 34 hours of CME**

**As of June 27, 2023, all DEA-registered practitioners must complete an 8-hour CME training on opioids & SUD management. 4PCP’s opioid focus fulfills this requirement!

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