" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

August 14, 2013




  1. Harvard Health Policy Review Publishes ACA Article
  2. Voluntary recall for another compounding facility
  3. Anti-oxidants offer great potential as a treatment for neuropathic pain
  4. Few Doctors Have Adequate Training to Effectively Treat Chronic Pain
  5. Dealers Now Being Charged in Drug Overdose Deaths
  6. 2014 Physician Fee Schedule: cuts and quality and data! Oh my!
  7. Some fear doctor shortage as Medicaid is set to expand
  8. Throbbing pain isn't a matter of the heart, UF researchers find
  9. Ohio State's Wexner Medical Center Implants One Of First MRI-Safe Spinal Cord Stimulators In US
  10. Medicare SGR reform bill passes key House committee
  11. Malpractice not cause of healthcare cost
  12. State Society News
  13.  Physician Wanted



harvardHarvard Health Policy Review Publishes ACA Article


Dr. Laxmaiah Manchikanti and Dr. Joshua A Hirsh recently published an article titled Regulatory Burdens of the AffordableCare Act in the Harvard Health Policy review.


Click HERE to read article.



recallVoluntary recall for another compounding facility


Fifteen patients have been hospitalized in Texas after getting calcium gluconate injections, according to the Food and Drug Administration.


The FDA has issued a national voluntary now for all sterile-use products produced by Specialty Compounding LLC, based in Cedar Park, Texas.




anti-oxiAnti-oxidants offer great potential as a treatment for neuropathic pain


Neuropathic pain - pain that results from a malfunction in the nervous system - is a daily reality for millions of Americans. Unlike normal pain, it doesn't go away after the stimulus that provoked it ends, and it also behaves in a variety of other unusual and disturbing ways. Someone suffering from neuropathic pain might experience intense discomfort from a light touch, for example, or feel as though he or she were freezing in response to a slight change in temperature.


A major part of the answer to the problem of neuropathic pain, scientists believe, is found in spinal nerve cells that release a signaling chemical known as GABA. These GABA neurons act as a sort of brake on pain impulses; it's thought that when they die or are disabled the pain system goes out of control. If GABA neurons could be kept alive and healthy after peripheral nerve or tissue injury, it's possible that neuropathic pain could be averted.


Medical News Today



fewFew Doctors Have Adequate Training to Effectively Treat Chronic Pain


Pain is the most common reason a patient sees a physician but few physicians have received adequate training to help their patients, according to a Henry Ford Hospital article published in the Journal of American Osteopathic Association. Pain management typically falls to primary care physicians, many of whom lack the skills to effectively treat pain.


A recent study of 117 U.S. and Canadian medical schools found that only four U.S. medical schools offered a required course on pain management. Dr. Raymond Hobbs, M.D., a Henry Ford Internal Medicine physician and senior author of the evidence-based clinical review article, offers these recommendations for physicians to help their patients with chronic pain: Work in collaboration with a team of specialists comprising primary care, physical or occupational medicine, pain management and mental health.


Patients being considered for oral opioid therapy like morphine, codeine and fentanyl should be screened for substance abuse using a five-point risk assessment tool. Set a threshold dose of 200 mg/d or less of oral morphine equivalents per day. Follow the so-called Universal Precaution model that calls for a complete medical evaluation and regular assessments of the four A's of pain medicine analgesia, activity, adverse effects and aberrant behavior.


Henry Ford Health System

dealersDealers Now Being Charged in Drug Overdose Deaths


With the number of heroin overdoses skyrocketing nationwide, a growing number of law enforcement agencies are dusting off strict, rarely used drug laws, changing investigatory techniques and relying on technology to prosecute drug dealers for causing overdose deaths.


The aggressive change in tactics comes as more people turn to heroin because of crackdowns on powerful prescription opiate painkillers that make them more expensive and inaccessible. The popular prescription drug OxyContin has also been reformulated to make it difficult to crush and snort, making it less desirable on the street, law enforcement officials said.


Nationwide, the number of people who said they have used heroin in the past year skyrocketed by 66 percent between 2007 and 2011, according to the Substance Abuse and Mental Health Services Administration. The number of people who died of overdoses and had heroin present in their system jumped 55 percent from 2000 to 2010, according to the Centers for Disease Control and Prevention.



ABC News


ohmy2014 Physician Fee Schedule: cuts and quality and data! Oh my!


The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule). The Proposed Rule highlights CMS's (and Congress's) continued focus on the principles of high-quality care, exceptional patient experience and affordability that has only increased since the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. In fact, almost all of the provisions of the Proposed Rule are directly or indirectly related to statutory provisions in the ACA.


The Proposed Rule would revise adjustments to the geographic practice cost indices to increase the weight of work expenses and reduce the weight of practice expenses and revisions to the calculation of the Medicare Economic Index, which is used to update physician payments for inflation in the same manner. As is customary, the Proposed Rule does not include revisions to the sustainable growth rate (SGR) formula because these calculations are statutory in nature. If Congress fails to take action on the SGR before the end of the year, physician reimbursement rates may be cut by nearly 25 percent.



fearSome fear doctor shortage as Medicaid is set to expand


As massive Medicaid expansion under nationalized health care looms, Virginia and other states could find a key group - doctors - shrinking from the demand, especially the red tape.


Medicaid rolls are expected to increase 42 percent under the federal Affordable Care Act. While many medical professionals welcome the expansion, they wonder whether there are enough doctors willing to take on new Medicaid patients.


Caring for that group adds burdens that extend beyond the examination room. Reimbursement rates typically lag behind Medicare. Nationwide, the Medicaid reimbursement rate is 58 percent of Medicare fees, according to an index compiled by the Kaiser Family Foundation. In Virginia, the rate is 73 percent. But it's still far behind private insurance rates.



The Daily Progess


throbThrobbing pain isn't a matter of the heart, UF researchers find


Throbbing pain may pound like a heartbeat, but University of Florida scientists have discovered the sensation is all in your head, or more precisely, in your brain waves.


The finding could drastically change how researchers look for therapies that can ease pain, said Dr. Andrew Ahn, a neurologist at the UF College of Medicine, a part of UF Health. Ahn and his colleagues reported their findings in the July issue of the journal Pain.


"Aristotle linked throbbing pain to heart rhythm 2,300 years ago," Ahn said. "It took two millennia to discover that his presumption was wrong."


People who have experienced a toothache or a migraine - or even just hit their shin on the coffee table - may have noted a throbbing quality to the pain that physicians have long associated with arterial pulsations at the location of the injury. Some medicines even constricted blood vessel walls in hopes of lessening the effect.



UF Health


ohioOhio State's Wexner Medical Center Implants One Of First MRI-Safe Spinal Cord Stimulators In US


COLUMBUS, Ohio - Neurosurgeons at The Ohio State University Wexner Medical Center are among the first in the United States to successfully implant an MRI-safe spinal cord stimulator to help patients suffering from chronic back or limb pain.


 Neurosurgeons Dr. Ali Rezai and Dr. Milind Deogaonkar performed the surgery Aug. 5 to help relieve intense foot pain due to a peripheral neuropathy that 78-year-old John Garvin of Worthington, Ohio, has suffered for more than 20 years. Garvin is among the estimated 100 million Americans living with chronic pain, according to the Institute of Medicine of the National Academies.


Ohio State University Exner Medical Center


sgrMedicare SGR reform bill passes key House committee


Washington Legislation to repeal the Medicare sustainable growth rate formula and revamp the physician payment system so it rewards high-quality care has garnered unanimous approval from a key House committee and constructive criticism from organized medicine groups.


The House Energy and Commerce Committee voted 51-0 on July 31 to approve its version of payment overhaul legislation. While eliminating the SGR would address the chief Medicare complaint many physicians have had for years, the American Medical Association and other organized medicine groups said they still will advocate for additional changes to improve the bill as other congressional committees take up their versions of reform legislation.



AMA news


malpracticeMalpractice not cause of healthcare cost


While healthcare costs continue to skyrocket, medical malpractice payments fell to a new low, undermining the argument that malpractice litigation costs contribute significantly to healthcare costs.


A newly released report from advocacy group Public Citizen shows the results of an analysis of data from the federal government's National Practitioner Data Bank, which has tracked malpractice payments since the fall of 1990.



Healthcare Finance News


State Society News



CASIPP Plans Fall Meeting
The California Society of Interventional Pain Physicians will hold its 4th Annual Meeting this September 20-22 at the Terranea Resort  in Rancho Palos Verdes, CA.
Interested physicians can register online at www.casipp.com



NY/NJ Societies of Interventional Pain Physicians Schedule Symposium


Registration is now open for the Pain Medicine Symposium, 2013, which is set for Thursday, November 7, 2013-Sunday, November 10, 2013 at the Hyatt Regency, Jersey City.


Following the great success of the 2012 program, this program again will be a joint effort between the New York and New Jersey Societies of Interventional Pain Physicians. The curriculum is presented by Course Directors: Sudhir Diwan, MD and Peter Staats, MD.


Speakers will be Sanjay Bakshi, MD, Sudhir Diwan, MD, and Peter Staats, MD.


Click here to register for the NYNJSIPP Pain Symposium.


Click HERE for more information.




* Please send in your State Society meeting news to:
 Holly Long at hlong@asipp.org





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American Society of Interventional Pain Physicians ®
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Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org