CMS has published the 2023 Physician Fee Schedule and it is worse than we expected. The conversion factor has been reduced by 4.4%. It will be reduced from $34.61 to $33.08, a decrease of $1.53. This will be added to the 2% sequester cut from ACA and 4% statutory PAYGO from the American Rescue Plan Act. This is equal to nearly a 20% cut when you combine this with inflation.
Unless Congress acts, the total expected cuts are 10.4% from 2022, and 9.75% from 2021, starting January 2023.
We encourage every ASIPP member to join us in the effort to contact every member of Congress. You can start by contacting the Senators and Representatives of your district. It is essential that we act soon and participate in meetings with members of our Congress, as well as start a letter campaign involving physicians, providers, nurses, staff, and most importantly, the patients.
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Historic rises in drug overdose deaths are disproportionately affecting Black and Indigenous people in the United States.
A new analysis from the Centers for Disease Control and Prevention using data from 25 states finds that fatal overdoses increased by 44% among Black people in 2020 compared with the year prior.
The jump in drug overdose deaths was almost as sharp for American Indian and Alaska Native people — groups that together saw a 39% increase over the previous year.
The steep rise in deaths among Black and Indigenous people far outpaced what was seen among white people during the same time period. That group had a 22% year-over-year increase in drug overdoses in 2020.
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Two days remaining to receive the
ASIPP Room
Block Discount
(July 22)
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Part 2 of our conversation with the former White House coronavirus response coordinator
In the second part of this exclusive video, Jeremy Faust, MD, editor-in-chief of MedPage Today, and Deborah Birx, MD, former White House Coronavirus Response Coordinator, have a candid discussion about her experience in that position and about Birx's new book, Silent Invasion: The Untold Story of the Trump Administration, Covid-19, and Preventing the Next Pandemic Before It's Too Late, which details the American pandemic response from within the White House.
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Unvaccinated are target population for two-dose, protein-based shot, ACIP member says
The CDC Advisory Committee on Immunization Practices (ACIP) voted unanimously to recommend Novavax's COVID-19 vaccine for individuals 18 and up.
With a vote of 12-0, the advisory panel endorsed a two-dose primary series of the adjuvanted, protein-based vaccine, which will be administered 3 weeks apart. The recommendation follows FDA's emergency use authorization last week.
Shortly after the meeting, ACIP's recommendation was endorsed by CDC Director Rochelle Walensky, MD, MPH.
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NEXT EXAM DATES:
Part I
July 30, August 27, September 17, October 22, November 19 & December 17
Part II
September 23
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Norwegian study suggests little impact by fifth grade, but generalizability to U.S. unclear
Prenatal exposure to opioid analgesics had no substantial impact on the scholastic skills of children by the time they reached fifth grade, findings from a nationwide Norwegian birth cohort suggested.
Compared to children of mothers whose only exposures to opioids were prior to pregnancy, children exposed in the first trimester and those exposed in two or three 4-week intervals during pregnancy scored lower on fifth grade tests in literacy (weighted β [wβ] -0.13, 95% CI -0.25 to -0.01; and wβ -0.19, 95% CI -0.35 to -0.04; respectively) and numeracy (wβ -0.14, 95% CI -0.25 to -0.04; and wβ -0.19, 95% CI -0.34 to -0.05), reported Johanne Naper Trønnes, MSc, Pharm, of the University of Oslo, and colleagues.
But "these differences were small and may not be clinically relevant," according to the researchers, writing in JAMA Network Open.
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Telling physicians to do more self-care is really "blaming the victim," says Jack Resneck Jr., MD
What is one of the biggest causes of physician burnout? Prior authorization and other "hassle factors," American Medical Association (AMA) president Jack Resneck Jr., MD, said Monday.
"We have learned a lot in the last decade about what causes burnout," Resneck, a dermatologist at the University of California San Francisco, said in a meeting with a small group of reporters at the association's Washington office. "They always are the things getting in the way of being able to provide the best care. That's why prior authorization is so high on our list."
The list Resneck referred to is the AMA's "Recovery Plan" for doctors, which includes fixing prior authorization -- the requirement by insurers that physicians get pre-approval before performing particular procedures or prescribing certain medications -- among its five pillars. "While resilience is important, and I'm all for yoga and an extra meal with hospital leadership, that is not the answer," he said. "It focuses blame on the victims, but it's not their fault they are burned out."
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Sharing gifts is a favorite way to sustain connection across peoples and cultures worldwide, but with bone marrow donation the gift-giving act is accompanied by uncomfortable side effects to the donor, making it a truly selfless expression of kindness. Recognizing this goodwill and wanting to improve the donor experience, Nicole McCoy, MD, an anesthesiologist at MUSC, started looking for a new way to manage pain during and after the harvesting procedure.
In a recent article published in Frontiers in Medicine, she and her colleagues describe a pain control method that has revolutionized the experience for donors and slashed the need for opioids.
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Please plan to join us at the
2023 ASIPP Annual Meeting
March 16-18 National Harbor, Maryland
Register Early
More details will be posted on our website at asipp.org.
Registration begins November 2022.
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For meeting or exhibitor/sponsor information:
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- ASIPP Members Only Site Information - |
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To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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| CASE REPORT |
Lindsay M. Milliken, MD, Amy E. Miloszewski, DPT, and Mohammed Jawaad Hussain, MD
Abstract
BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic pain syndrome characterized by sensory, motor, autonomic, bone, and skin changes. The onset of CRPS is most typically preceded by a traumatic event. Asthma is a chronic respiratory condition in which bronchial hyperresponsiveness and inflammation of pulmonary airways lead to symptoms of reversible lower airway obstruction, which may lead to musculoskeletal pain.
CASE REPORT: Patient 1 is a teenage girl with poorly controlled asthma presenting with CRPS localized to her chest, upper abdomen, and upper back. Patient 2 is a teenage girl with well-controlled asthma but with a significant historical asthma exacerbation presenting with CRPS in her chest and upper back.
CONCLUSION: We suggest that a respiratory illness and associated asthma exacerbation served as the traumatic event for these patients’ CRPS presentations.
KEY WORDS: Complex regional pain syndrome, amplified musculoskeletal pain syndrome, asthma, pediatrics, rehabilitation
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New Edition Now Available |
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| RETROSPECTIVE STUDY |
Yitong Jia, MD, Ying Shen, MD, Lan Meng, MD, Tao Wang, MD, and Fang Luo, MD
Abstract
Background: The scarcity of an effective and safe therapy to relieve acute zoster-related trigeminal neuralgia (TN) and preventing it from developing into trigeminal postherpetic neuralgia is well known. Pulsed radiofrequency (PRF) is a novel and safe, minimally neuro-destructive technique for the treatment of acute zoster-related TN, which attains satisfactory pain relief. However, this result is only reported by a few single-center researches. In addition, no study has reported the predictive factors of the analgesic effect for PRF treatment on acute zoster-related TN patients.
Objectives: This study aimed to investigate the analgesic effect of computed tomography (CT)-guided PRF for acute zoster-related TN, and to explore determinants of the therapeutic efficacy of PRF based on clinical evidence at multiple centers.
Study design: Retrospective, multicenter, observational clinical study.
Settings: The study was conducted at pain management centers in Beijing Tiantan Hospital, Beijing Red Cross Peace Orthopedic Hospital, and Beijing Puhua International Hospital.
Methods: We retrospectively analyzed the effects of PRF on gasserian ganglion or its corresponding peripheral nerve as treatment for 85 patients with acute zoster-related TN under CT guidance between January 2008 to March 2021. The response criterion was a Numeric Rating Scale score reduction of > 50% at 12 weeks postoperatively. Univariable and multivariable analyses were performed to identify the predictive factors for a PRF positive response.
Results: The medical records of a total of 85 acute zoster-related TN patients undergoing PRF treatment were identified and analyzed. The effective rate was 62.4% at 12 weeks postprocedure. Univariate analysis indicated that disease duration (P = 0.023), diabetes mellitus (P = 0.024), and treatment location (P = 0.013) were exposure factors for the analgesic efficacy of PRF treatment. On multivariable analysis, independent predictor of PRF positive response was the treatment location of the gasserian ganglion (odds ratio = 3.032; 95% confidence interval = 1.153-7.927; P = 0.024).
Limitations: This was a retrospective study with a small sample size. Optimal PRF treatment parameters, as well as pain subtypes, need to be investigated in future studies.
Conclusions: CT-guided PRF is an effective and safe treatment for acute zoster-related TN patients. Compared to peripheral nerve PRF, gasserian ganglion treatment may be more effective for patients with acute zoster-related TN.
Keywords: efficacy; predictor; pulsed radiofrequency; retrospective study; Acute zoster-related trigeminal neuralgia.
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| REVIEW |
Chandni B. Patel, DO, Ankur A. Patel, DO, and Sudhir Diwan, MD
Abstract
Background: Chronic pelvic pain (CPP) is a complex, heterogeneous condition affecting both female and male patients with significant effects on quality of life. Chronic pelvic pain is a prevalent but often underdiagnosed condition due to the variation in patient presentation, a gap in communication among specialties, under-reporting of the syndrome, and lack of standardized diagnostic criteria with a subsequent delay in diagnosis. The mechanism of CPP is complex due to multifactorial etiologies of pain and its vast anatomy and innervation. Potential causes of pelvic pain include the nerves, muscles, bone, or organs of the reproductive, gastrointestinal, urological, musculoskeletal, vascular, neurological, and psychological systems.
Objectives: The objective of this article is to review the anatomy of the pelvis, share current lead placement locations, and discuss the current evidence for neuromodulation in the management of chronic pelvic pain.
Study design: This is a narrative review of current literature on neuromodulation for chronic pelvic pain.
Setting: A database review.
Methods: A PubMed search was performed to gather literature on neuromodulation for chronic pelvic pain.
Results: Traditionally, pelvic pain has been managed with conservative therapies such as physical therapy, pharmacological agents, trigger point injections, botulinum toxin injections, ganglion impar blocks, caudal epidural steroid injections, or superior and inferior hypogastric blocks, but with the evolution of the neuromodulation, there are new advances to incorporate this modality in the management of chronic pelvic pain.
Limitations: This review article possesses limitations and includes published data, excluding case reports. For this reason, some applications of neuromodulation for chronic pelvic pain may be missed.
Conclusions: Neuromodulation may include spinal cord stimulation, dorsal root ganglion stimulation, and peripheral nerve stimulation. Specifically, neuromodulation utilizes electrical stimulation or pharmacological agents to modulate a nerve and alter pain signals. Currently used locations for lead placement include intracranial, spinal cord, dorsal root ganglion, sacral nerve roots, or at a peripheral nerve. As the field of pelvic pain continues to evolve, continued evidence for neuromodulatory interventions is needed.
Keywords: dorsal root ganglion stimulation; neuromodulation; peripheral nerve stimulation; spinal cord stimulation; Chronic pelvic pain.
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Norcal Mutual is A-Rated by AM best and is licensed in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
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ASIPP® has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value-added services for independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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up-to-date news related to you, your practice, and your patients!
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