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West Virginia effort hits late obstacle; some DOs fear bias under a combined board
Tom Takubo, DO, an osteopathic physician and pulmonary critical care specialist, is exasperated and crestfallen.
Since 2017, the West Virginia state senator has questioned why his state has two separate agencies to license and discipline its osteopathic versus its allopathic physicians. Each board has its own rules and standards of practice that vary in at least a dozen perplexing ways. He said it's confusing to patients, it's strange, and constitutes a double standard.
"Why are we working under two separate rules, depending only on where we went to medical school?" Takubo asked during an interview with MedPage Today.
It's an important question.
After all, 37 states and the District of Columbia -- including large states like New York, Texas, Illinois, and Ohio -- license all their allopathic and osteopathic physicians under one board. That accounts for some 65% of the nation's doctors.
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Join the AMA or Renew your Membership Today!
As of now, ASIPP has two positions available in the House of Delegates and all of the other memberships where they are available, even for the other societies within AMA. The American Medical Association (AMA) requires all societies to requalify for membership in the AMA House of Delegates (HOD) every five years. To keep and hopefully increase ASIPP's membership in these committees, we have to keep at a minimum 20% AMA membership, otherwise, ASIPP will lose the AMA membership with all the available advantages.
We encourage you to join or renew your membership in the AMA. Joining the AMA will further strengthen our specialty’s representation at the national level through the AMA House of Delegates, the AMA’s policymaking body, and strengthen our ability to meet the challenges in health care today with thoughtful, well-organized responses.
As a member of the AMA, you become part of the organization that unites physicians nationwide to tackle the major issues we all face: 47 million uninsured Americans, looming Medicare payment cuts, and the need for medical liability reform. Membership also gives you access to a broad range of practice management resources and award-winning publications such as the Journal of the American Medical Association, AMNews, AMA Morning Rounds, and the Archives journals.
Please take this opportunity to support the critical activities of ASIPP by joining the AMA today. To join or renew the AMA, we encourage you to visit www.ama-assn.org or call (800) 262-3211.
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Physician practice ownership by corporations, including health insurers, private equity firms, and large pharmacy chains, reached 30.1% as of January for the first time surpassing ownership by hospitals and health systems (28.4%), according to a new report.
As a result, about three in five physician practices are now owned by nonphysicians.
In early 2020, corporations owned just about 17% of US medical practices, while hospitals and health systems owned about 25%, according to the report released Thursday by nonprofit Physician Advocacy Institute (PAI). But corporate ownership of medical groups surged during the pandemic.
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In late February, Emily Benson noticed something strange: her counseling practice was getting no checks from insurance claims.
It was the start of a grating month and a half. Since then, her clinic in Edina has been making around five percent of the revenue it usually brings in.
“It feels like COVID-19 all over again, but much, much worse,” Benson said.
Benson’s clinic, Beginnings and Beyond, took a hit after a cyberattack on a billing processing company called Change Healthcare.
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Registration is open for
ASIPP's 2025 Annual Meeting
We would love it if you would register and join us in Orlando!
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Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000 or more for easier access to their doctors.
It’s a trend that began decades ago with physician practices. Thousands of doctors have shifted to the concierge model, in which they can increase their income while decreasing their patient load.
Northwestern Medicine in Chicago, Penn Medicine in Philadelphia, University Hospitals in the Cleveland area, and Baptist Health in Miami are among the large hospital systems offering concierge physician services. The fees, which can exceed $4,000 a year, are in addition to copayments, deductibles, and other charges not paid by patients’ insurance plans.
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Virtual
April 27, May 25, June 29, & July 27
Click here for the complete list of upcoming exams.
ABIPP Part I; ABIPP Path - Combined DCCPM/CSM virtual exam;
ABIPP Competency Exam in IPM; ABIPP Competency Exam in Regenerative Medicine;
CSM Competency Exam; DCCPM Competency Exam
In Person
October 18, 2024
ABIPP Part II - Practical Examination
Lab Venue: MERI, 44 S. Cleveland Street, Memphis, TN 38104
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Nine people hospitalized across nine states after receiving the injections
The CDC is investigating harmful botulism-like reactions in 19 people who received counterfeit or mishandled botulinum toxin (Botox), according to a new report.
The FDA also issued its own alert today, with information for healthcare providers on how to identify the counterfeit products.
As of April 12, nine people have been hospitalized after receiving the botulinum toxin injections, primarily for cosmetic purposes.
The people who received the injections were all women, and ranged in age from 25 to 59 years. All affected people reported that they received the injections in non-healthcare settings, such as homes or spas, or from unlicensed or untrained individuals, the CDC said. The injections appear to be counterfeit products or products with unverified sources, the report said, and investigation into the sources of these products is ongoing.
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ASIPP State Society Meetings | |
Agenda and Exhibitor Prospectus coming soon! | |
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A true public health success would be preventing the virus from further adapting to humans
The outbreak of highly pathogenic avian influenza A (HPAI) (H5N1) in dairy herds across the U.S. appears to be expanding, with over two dozen farms being affected in eight states. Although only one mild human case in a dairy farmer in Texas has been reported during the current outbreak, the situation is raising concerns for several reasons: it's happening against a steady, worrisome background of viral evolution and it sets up the potential for increased exposure among humans as well as a possible impact on our food sources.
A Worrying Trend of H5N1 in Mammals
This outbreak marks the first documented instance of H5N1 infection in dairy cows, highlighting a worrying trend that has been occurring over the last 2 years where the virus has moved from infecting birds to a growing range of mammals. More than 40 new mammalian species have been affected, and more than 26 countries have reported infections in mammals during the current zoonotic wave (2021-2024) compared to 10 countries prior to 2019. This represents an increase in both the geographic and host range of the virus.
The individual outbreaks have also been deadly, affecting large numbers of birds and animals. For example, last spring the virus killed over 5,000 sea lions on the coast of Peru, along with more than 100,000 birds. The year prior to that, a smaller outbreak hit New England Harbor seals, where seal-to-seal transmission was suspected. The CDC reports that nearly 86 million wild aquatic birds, commercial poultry, and backyard or hobbyist flocks in 48 states have been infected in the U.S. beginning in January 2022. The increased infections in birds have created more opportunities for spillover events -- instances where the virus jumps from a bird host to a mammal.
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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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Skylar Remick , Woo Jun Shim , and Chong Kim, MD
Abstract
BACKGROUND: Post-COVID-19 syndrome (PCS) symptoms are common after COVID-19 infections and despite recent efforts to study and treat, limited progress has been made. The most common of the symptoms, fatigue, can be debilitating and lack effective treatment options, and as a result, the need for potential management options is paramount.
CASE REPORT: We present a case report of a patient with refractory PCS fatigue. Following intravenous ketamine infusion, the patient noted significant improvement in his energy and fatigue symptoms.
CONCLUSIONS: We report the successful use of ketamine infusion for PCS fatigue symptoms.
KEY WORDS: Long COVID, post-COVID, ketamine, infusion, fatigue, case report
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Dolores Rufolo, MD, Carmelo Attilio Costa, MD, Giulia Bravo, PhD, and Paola Nosella, MD
Abstract
BACKGROUND: Applying pulsed radiofrequency (PRF) to the dorsal root ganglion (DRG) is an electrical neuromodulation technique, a valid complementary therapeutic treatment for failed back surgery syndrome (FBBS). Peridurolysis, when applied to vertebral canal adhesions, can be performed with dedicated catheters, providing patients with the benefits of mechanical, electrical, and pharmacological techniques.
OBJECTIVES: The aim of this study was to evaluate PRF’s effects on the DRG as part of FBSS treatment at different follow-up times, comparing 2 groups of patients exposed to distinct levels of voltage (100 V vs. 45 V) from a PRF generator.
STUDY DESIGN: A retrospective observational study was performed.
SETTING: The study was conducted on a sample of patients from an Italian hospital.
METHODS: PRF’s effects on the DRG as part of FBSS treatment were evaluated through the Numeric Rating Scale (NRS) and the monitoring of 155 patients’ opioid consumption at 3, 6, and 9 months. A Cosman® G4 model PRF generator was used. During follow-up periods, the Friedman test was applied to detect differences in outcomes between the 2 groups of patients, who were treated with different levels of voltage.
RESULTS: The most frequent diagnosis (61.29%) was FBBS in patients at a mean age of 64 (± 11.8) years old. All patients were treated with PRF on the dorsal ganglion, with the addition of a drug mixture. Most were treated with 100 V (62%). A statistically significant decrease (P < 0.001) in the NRS score emerged both as a whole and in the 2 distinct groups. Moreover, the group of 100 V patients showed a significant (P = 0.0360) reduction in the use of opioids.
LIMITATIONS: This observational retrospective study was based on a convenience sampling that involved a limited number of patients.
CONCLUSIONS: E-field technology is the only way to generate a constant 38°/42° PRF and 100 V level throughout surgical interventions (respecting the exposure times “set” by the operator). The patient will not feel any pain or electric current because the generated milliamperes will be greatly reduced.
KEY WORDS: Pulsed radiofrequency, dorsal root ganglion, different voltage, high voltage, Cosman G4 PRF generator, e-field, failed back surgery syndrome, neuromodulation, peridurolysis
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Suzanna Shermon, DO, John Maclean, BS, Richard Shim, BS, and Chong H. Kim , MD
Abstract
BACKGROUND: The central nervous system contains steroid receptors, particularly in the hypothalamic and limbic systems. These systems are responsible for driving certain emotions in humans, especially stress, anxiety, motivation, energy levels, and mood. Thus, corticosteroids may precipitate patients to experience these emotions. Most existing studies report neuropsychiatric side effects after oral or intravenous corticosteroids rather than epidural.
OBJECTIVES: This study examines the neuropsychiatric side effects after epidural steroid injections (ESIs), with a focus on whether certain factors in patients’ histories further exacerbate symptomatology.
STUDY DESIGN: Prospective observational cohort study.
SETTING: Fluoroscopy suite at an urban academic teaching hospital.
METHODS: Patients were called 24 hours and one week after their ESIs and asked if they experienced certain neuropsychiatric symptoms more than usual compared to baseline.
PATIENTS: Seventy-four patients undergoing a lumbosacral ESI (interlaminar (ILESI), caudal or transforaminal (TFESI)) were invited to take part in the study the day of his or her procedure.
INTERVENTION/MEASUREMENT: Assessed whether psychiatric history, gender, race, type of ESI, or the number of levels injected affected frequency and duration of neuropsychiatric symptoms at one day and one week after an ESI.
RESULTS: Significantly (P < 0.05) more patients with a psychiatric history experienced restlessness and irritability at day one than those without a psychiatric history. At week one, male gender (IRR 2.29, 95% CI 1.37, 3.83, P = 0.002), ILESI (IRR 7.75, 95% CI 1.03, 58.6, P = 0.047), and 2-level injections (IRR 2.14, 95% CI 1.13, 4.06, P = 0.019) were significantly associated to more total symptoms.
LIMITATIONS: Single center study, reliance on subjective responses from patients, lack of follow-up after one week post-ESI.
CONCLUSION(s): This study demonstrates that neuropsychiatric symptoms are rare overall after an ESI, though certain factors may influence patients experiencing these symptoms. Restlessness and irritability were more likely to occur one day after an ESI in those with a psychiatric history. Those who had a 2-level injection were more likely to keep experiencing most symptoms by week one, suggesting a possible correlation between corticosteroid dose and neuropsychiatric symptoms.
KEY WORDS: Epidural steroid injections, transforaminal epidural steroid injections, interlaminar epidural steroid injections, caudal epidural steroid injections, neuropsychiatric symptoms, restlessness, irritability, psychiatric history, anxiety, depression, dexamethasone, men, women, race, one-level epidural steroid injection, 2-level epidural steroid injection
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ASIPP is now in collaboration with Curi Medical Liability Program
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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.
Curi is a full-service advisory firm that serves physicians and their practices. Their valued advice is grounded in your priorities and elevated in your outcomes. They are driven by a deep understanding of your specific circumstances in medicine, business, and life. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary risk management CME activities, visit our website.
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Group Purchasing Organization Offer Better Pricing and Creates Added Value
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, Fedora Billing,
and Revenue Cycle Management Partnership
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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