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Burnout, Poor Mental Health on the Rise for Healthcare Workers, CDC Says
"To label our current and long-standing challenge a 'crisis' is an understatement"
Healthcare workers reported increasing numbers of poor mental health days and increasing feelings of burnout from 2018 to 2022, although these issues were less common among those who trusted management and had help from their supervisor, a CDC study found.
"While usually health workers care diligently for others in time of need, it's now health workers who are suffering, and we must act," said Deborah Houry, MD, MPH, the CDC's chief medical officer, on a phone call with reporters Tuesday.
The Vital Signs report analyzed data from the General Social Survey Quality of Worklife Module. The module contains questions on working and mental health conditions and is administered to respondents aged ≥18 years who report having been employed during the preceding 2 weeks.
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Attention Residents & Fellows!
Take advantage of this complimentary webinar, focusing on interventional procedures for lumbar spinal stenosis with neurogenic claudication.
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Earn 1 AMA PRA Category 1 Credit | | |
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CMS published the 2024 Physician Fee Schedule, and the news is not good. If Congress does not act, a sequestration order will be issued within 15 days of the end of the congressional session, reducing Medicare reimbursements by 4%, beginning in 2024. Please take action to preserve our patients’ access to care.
Medicare payment cuts for physicians in 2024 include:
Medicare Physician Fee Schedule Cuts = -3.36%
- The Centers for Medicare and Medicaid Services are proposing a -3.36% decrease in payments in 2024 for services under the Medicare Physician Fee Schedule.
- Medicare physician payment has been reduced 26% adjusted for inflation from 2001–2023.
Medicare Sequestration = -2%
- Medicare sequestration of -2% has now been extended through 2032, because of a temporary delay for 1½ years.
PAYGO = -4%
- PAYGO cuts of -4% have never been enacted in the past; however, if Congress leaves without action, these will go into effect.
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 starting a letter campaign involving physicians, providers, nurses, staff and most importantly, the patients.
Click here to see the enclosed fact sheet.
If you choose to send your own letters, click here to view a sample physician letter you may want to use.
Click here to submit a physician letter through VoterVoice.
To get your patients involved, we have created a sample patient letter. You can ask your patients to sign the letter and then have them or your staff enter the letter into VoterVoice.
Click here to submit patient letters through VoterVoice.
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Early Bird Registration is open for ASIPP Members!
Register now for 10% off!
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Shady Medicare Advantage Plan Tactics Blasted at Senate Hearing
"It's a rip-off and it's got to stop," one Senator said
A dozen U.S. Senators and three witnesses sharply criticized Medicare Advantage (MA) marketing schemes during a Senate Finance Committee hearing yesterday.
Participants blasted the "unscrupulous," "deceptive," and "rip-off" tactics and high commissions that enroll seniors in plans that don't meet their healthcare needs.
With the 2024 Medicare re-enrollment window in its fourth day, committee chairman Sen. Ron Wyden (D-Ore.) pointed to federal investigators' findings that "marketing middlemen are the latest set of sleazy private-sector scoundrels targeting seniors on Medicare Advantage."
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Virtual
November 4, November 11
December 9 & December 16
ABIPP Part I; ABIPP Path - Combined DCCPM/CSM virtual exam; ABIPP Competency Exam in IPM; ABIPP Competency Exam in Regenerative Medicine
2024 Exam Dates Coming Soon!
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Telehealth Linked to Better Opioid Treatment Retention
TOPLINE
Starting treatment with buprenorphine for opioid use disorder (OUD) via telehealth is associated with longer retention in treatment compared with starting treatment in-person, new research suggests.
METHODOLOGY
- Researchers analyzed Medicaid claims data from November 2019 through the end of 2020 in Kentucky and Ohio to investigate the impact of a policy change implemented during the COVID-19 pandemic that allowed the use of telehealth to prescribe buprenorphine for OUD.
- The two main outcomes of interest were retention in treatment after initiation (telehealth vs traditional) and opioid-related nonfatal overdose after initiation.
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Excellent opportunities for Residents & Fellows
at ASIPP's 2024 Annual Meeting:
- Resident & Fellow Scholarship
- Abstract Session and Podium Presentation for Best Abstracts during General Session
- Half-Day Session dedicated to Young Physicians in Pain Management
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Frisco physician has medical license temporarily suspended after Wortham med spa death
Recently suspended Frisco doctor, Michael P. Gallagher, was chief anesthesiologist at Integrity Medical Center where Kimberly Ray was treated, per family attorney.
During an ongoing investigation into Dr. Michael Patrick Gallagher, the anesthesiologist whose license was suspended following the death of Jenifer Cleveland at a Wortham med spa, journalists uncovered an ongoing lawsuit from 2021 involving another alleged instance of medical negligence that led to a mother's death in Coppell, Texas.
According to the lawsuit, Ray from Arlington, Texas, died following a routine rhizotomy procedure at Integrity Wellness Center on April 19, 2023 that was performed by certified registered nurse anesthetist (CRNA) Joseph Scott Houghton, who misrepresented his qualifications to Ray.
The lawsuit further states that Houghton listed himself as a "surgeon," a "physician," and as "Dr. Scott Houghton" on documents Ray signed prior to the procedure.
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Abstract submissions are open for
ASIPP's 2024 Annual Meeting!
The submission deadline is January 22, 2024.
Don't miss your chance to be part of an exceptional event,
sharing insights and discoveries that shape the future of pain management.
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Hot Yoga May Help With Depression
Small trial suggests just one session per week could ease depressive symptoms
A hot yoga session at least once a week improved depressive symptoms in people with moderate-to-severe depression, researchers found.
In a small randomized controlled trial, hot yoga participants had a significantly greater reduction in Inventory of Depressive Symptomatology -- Clinician Rated (IDS-CR) scores over 8 weeks compared with those assigned to a waitlist (Cohen d = 1.04, P<0.001), according to Maren Nyer, PhD, of Massachusetts General Hospital in Boston, and colleagues.
In addition, more participants in the heated yoga arm responded to treatment as measured by at least a 50% reduction in symptoms than in the waitlist group (59.3% versus 6.3%), they reported in the Journal of Clinical Psychiatry. And more heated yoga participants achieved low enough IDS-CR scores to be considered in remission (44% versus 6.3%), they found.
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Common Fungus Might Fuel Alzheimer’s Onset
Researchers explored the link between the fungus Candida albicans and Alzheimer’s disease.
They found that C. albicans produces enzymes breaking down the blood-brain barrier, allowing it to access the brain and produce toxic amyloid beta-like peptides, typically associated with Alzheimer’s.
These peptides activate microglial brain cells to keep fungal load low but don’t clear the infection. The study suggests that the amyloid beta aggregates in Alzheimer’s could be generated both by the brain and by C. albicans.
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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 |
Effects of Novel Dual Peripheral Nerve Stimulator Therapy: A Case Report
Hall Wu, MD, and William Spalding, MD
Abstract
BACKGROUND: Peripheral nerve stimulators (PNS) are currently used for refractory cases of neuralgia, and are associated with single manufacturer use. This is the first case report describing the novel scenario where a patient received 2 neuromodulation devices from 2 different manufacturers.
CASE REPORT: We present a 32-year-old woman with spinal muscle atrophy type 2 who received a permanent PNS implant for chronic neuralgia. She experienced gradual treatment failure over 6 months, but continued to have pain relief with subsequent nerve blocks to the same nerves. She underwent semipermanent PNS placement to those same nerves. After the semipermanent PNS was removed, she experienced new, unexpected symptoms after trying to use her permanent PNS again.
CONCLUSION: Instances of multiple PNS treating the same area in patients is likely going to be a recurring scenario. More research will be needed to document the potential effects that dual neuromodulation therapy may have.
KEY WORDS: Case report, chronic pain, dual therapy, peripheral nerve stimulator
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| SYSTEMATIC REVIEW |
Application of Dexmedetomidine as an Opioid Substitute in Opioid-Free Anesthesia: A Systematic Review and Meta-analysis
Dan-hong Yu, MD, Xu Shen, MD, Lan Lai, MD, Yan-jun Chen, MD, Ke Liu, MD, and Qi-hong Shen, MD
Abstract
BACKGROUND: Opioid-based general anesthesia was previously used to alleviate perioperative pain; however, several complications associated with using anesthesia have raised several concerns. Various studies have investigated the application prospect of using opioid-free general anesthesia, such as dexmedetomidine, as an opioid substitute.
OBJECTIVES: We performed a systematic review and meta-analysis to explore and highlight the safety and effectiveness of dexmedetomidine as an opioid substitute for opioid-free anesthesia.
STUDY DESIGN: A systematic review and meta-analysis.
SETTING: We screened for suitable clinical trials from electronic databases, including “PubMed,” “Cochrane Library,” “EMBASE,” and “Web of Science.” Eligible trials were included in this meta-analysis.
METHODS: The quality of the screened randomized controlled trials (RCTs) was determined using the risk of bias assessment criteria by the Cochrane Collaboration tool. We used the “Review Manager 5.3” and “Stata 10.0” software to perform the meta-analysis. We evaluated the quality of evidence using the “Grading of Recommendations Assessment, Development, and Evaluation” approach.
RESULTS: For the analysis, we included 32 RCTs encompassing 2,509 patients. In the opioid-free group, the 2-hour postoperative pain score of patients (mean difference = -0.53, 95% CI: -1.00, -0.07; P = 0.02, I2=78%) was significantly lower compared to those in the opioid-based group. In addition, several patients required rescue analgesia (risk ratio = 0.70, 95% CI: 0.58, 0.84, P < 0.05, I2 = 71%) and opioids postsurgery. However, the duration of extubation and postanesthesia care unit, as well as the incidences of bradycardia, were high in patients receiving dexmedetomidine as opioid-free general anesthesia.
LIMITATIONS: Subgroup analysis for different anesthesia-maintaining drugs had not been conducted. The heterogeneity did not reduce after subgroup analysis. Different doses of dexmedetomidine had not been evaluated.
CONCLUSIONS: These findings indicate that opioid-free general anesthesia based on dexmedetomidine could be effective; however, prolonged extubation time and cardiovascular complications are a few risks associated with dexmedetomidine.
KEY WORDS: Opioid-free anesthesia, dexmedetomidine, meta-analysis
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| RANDOMIZED TRIAL |
Ultrasound-guided Retroclavicular Approach Versus Costoclavicular Approach of Infraclavicular Brachial Plexus Block for Upper Limb Surgeries
Josef Zekry Attia, MD, Rowaida Nabil Gaber, MBBCh, and Shadwa Rabea Mohamed, MD
Abstract
BACKGROUND: Regional anesthesia for an upper limb provides many advantages over general anesthesia, especially in orthopedic surgery.
OBJECTIVES: This trial aimed to compare a retroclavicular approach to the infraclavicular brachial plexus with a costoclavicular approach in term of needle time, image time, and procedure time, and comparing both with the classic technique for upper limb surgeries guided by ultrasound.
STUDY DESIGN: Prospective, randomized, single-blinded controlled trial.
SETTING: Minia University, Faculty of Medicine, Anesthesia and Intensive Care Department.
METHODS: Sixty patients of both sees with an American Society of Anesthesiologists Classification of I and II, a BMI (kg/m2) of 20-35, aged from 18-60 years who were scheduled for a forearm or hand surgery under infraclavicular brachial plexus block were divided into 3 parallel equal groups. Group I (RC) received a retroclavicular approach. Group II (CC)received a costoclavicular approach. Group III (CT) received the classic technique. Procedure time, the sum of the imaging and needling times, was our primary outcome. Secondary outcomes were the motor and sensory block success rate 30 minutes postinjection of local anesthesia, duration of motor and sensory block, Visual Analog Score, first analgesic need, total analgesia requirements during the first postoperative 24 hours, and any complications.
RESULTS: The procedure and needle times were significantly decreased in the retroclavicular group due to better needle visibility. There was no significant difference regarding sensory and motor block data. The VAS score in the first postoperative 24 hours showed no statistical significance. Regarding analgesic data and patient satisfaction, there was no statistical significance among the 3 studied groups. There were no complications in any of the used approaches.
LIMITATION: Our trial did not include patients with a BMI > 35.
CONCLUSIONS: The retroclavicular approach is superior because of its decreased procedure time and needle time than both the costoclavicular approach and classic approach.
KEY WORDS: Retroclavicular, costoclavicular, infraclavicular brachial plexus block, upper limb surgery
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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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