Anesthesia Spotlight: Yi Zhang, MD, PhD

When Yi Zhang, MD, PhD, first came to Massachusetts General Hospital for residency training in 2005, he knew almost immediately that it would be his home for years to come. 

“The amount of talent at Mass General is astonishing,” he says. “I cherish the opportunity to work alongside the greatest minds in our specialty and in the field of medicine.” 

Throughout his career, Dr. Zhang has followed his interests and explored different areas of study to broaden his background and expertise, including lab-based molecular neuroscience research, computational genomics, neuroimaging, and clinical research. Above all, he says his passion is caring for patients with various pain conditions, integrating everything he has learned and clinical innovation to improve their lives. 

Now, Dr. Zhang is set to embark on the next stage of his career as chief of the Pain Management Center at Mass General. He shares more about his vision for the future of pain care and research at Mass General and beyond. 

What will be your focus as the new chief of the Pain Management Center? 

I firmly believe that the collective success of our Center rests upon the individual achievements of our team members. My unwavering focus is on supporting each team member to thrive in their professional pursuits. 

What is unknown about chronic pain today? 

The field of chronic pain management is an exciting realm for the most intellectually curious minds, primarily because it is laden with a plethora of "unknowns" rather than "knowns." 

To name a few questions that we are eager to find an answer for:  

• What factors contribute to the transition of acute pain to chronic pain? 
• Why do individuals with identical injuries experience different outcomes, e.g., some heal while others develop chronic pain? 
• Can we establish objective measures to accurately quantify pain? 
• How can we develop innovative methods to visualize pain in real-time within living human beings, allowing us to precisely identify the source of pain and deliver more targeted and effective therapeutic interventions? 

When you reflect on your own research pursuits, what are you most proud of?

Looking back on my research, I find most satisfaction in the work I did in optimizing the use of buprenorphine, a unique opioid analgesic agent, in acute and chronic pain conditions. I am glad that my work has contributed to a nationwide change in the way we care for patients with opioid use disorders (OUD) and acute pain conditions, and the way we care for chronic pain patients for whom there is unfortunately no alternative to chronic opioid therapy. Clinicians are now moving away from the practice of suspending OUD treatment around surgery, and are incorporating buprenorphine more as part of safter regimen for patients who need chronic opioid therapy. 

How is pain research different at MGH vs. other institutions? 

The depth and breadth of pain research at Mass General is truly exceptional. Our dedicated team of pain researchers and physician-scientists have made groundbreaking discoveries across various domains, encompassing basic science, translational, and clinical research. 

Among many others, these discoveries include: 

• Elucidating the molecular mechanisms of pain 
• Developing innovative animal models to study pain 
• Exploring the influence of gut microbiota on pain 
• Identifying valuable pain biomarkers 
• Advancing the diagnosis and management of opioid-induced hyperalgesia  

Their tireless efforts have significantly enriched our understanding of pain and opened new avenues for improving pain management and patient care. 

How is pain care different at MGH vs. other institutions? 

At Mass General, we strive to stay at the forefront of pain medicine. We pride ourselves in providing comprehensive services to our patients, including state-of-art image-guided minimally invasive procedures, neurostimulation, management of complex medical regimen, psychological and psychiatric pain care, alternative medicine, etc. 

What does the future of pain care look like? 

I believe our subspecialty of pain management will continue to embrace an integrative approach. We will see expansion of the indications for minimally invasive therapies. Advances in neuromodulation, regenerative medicine, and emerging pharmacological therapies will provide new tools to alleviate chronic pain and minimize the need for medications with harmful long term side effects such as opioids. The recognition of the mind-body connection in pain management will lead to a greater emphasis on psychological and behavioral interventions, as essential components of comprehensive pain care. 

What advice would you give to others with similar career aspirations? 

Don’t let failure keep you down. In pain management, the source of pain can be evasive and the treatment options not as effective as we hope. We tend to see more challenges than success. Failure can dishearten you temporarily, but it only makes the ensuing success more rewarding for you and your patients.