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STOP PHYSICIAN BURNOUT – What to do when working harder … isn’t working

The first step-by-step manual for any physician in any specialty to stop physician burnout, build a more ideal practice and a more balanced life.

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The American Society of Interventional Pain Physicians will hold its 20th Annual Meeting March 15-17, 2018 in Orlando, Florida at Marriott Orlando World Center.

Thursday General Session:

RAJ-RACZ DISTINGUISHED LECTURE SERIES

ARNOLD CAPLAN, MD, PHD - KEYNOTE SPEAKER

Mesenchymal Stem Cells: Today, Tomorrow, and Future of Pain Management

LAXMAIAH MANCHIKANTI, MD - KEYNOTE SPEAKER

Evidence Synthesis in IPM: Evolution of EBM or Death of Expertise and Truth

Friday General Session:

MANCHIKANTI DISTINGUISHED LECTURE SERIES

ROBERT LASZEWSKI - KEYNOTE SPEAKER

State of Health Care in the US: Past, Present, and Future

REPRESENTATIVE ED WHITFIELD - KEYNOTE SPEAKER

Health Care Advocacy: ASIPP Involvement with Grass Roots Advocacy Find everything you need for a successful stay.

SENATOR TIM HUTCHINSON - KEYNOTE SPEAKER

Health Care Reform: A View from Washington

Multiple breakout sessions including: Abstract and Posters; Regenerative Medicine; Resident/Fellows; Compliance, Billing and Coding; and various sessions on interventional techniques

Essentials of Interventional Techniques in Managing Chronic Pain

Available for Order!

 

This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain. Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables. Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding. Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians.

Click HERE to order

JAMA Addresses Gabapentin Uses

Editorial: Gabapentin Approvals, Off-Label Use, and Lessons for Postmarketing Evaluation Efforts

Moore et al 1 summarize an updated Cochrane review on the use of gabapentin for neuropathic pain. The authors concluded that gabapentin is associated with reduction in acute pain associated with postherpetic neuralgia and peripheral diabetic neuropathy (the later indication is not approved by the FDA), and that there is limited evidence to support the use of gabapentin for other types of neuropathic pain and pain disorders.

Gabapentin for Chronic Neuropathic Pain

This Clinical Evidence Synopsis summarizes a 2017 Cochrane review on pain relief associated with use of gabapentin for patients with chronic neuropathic pain.

Findings: Oral gabapentin (1200-3600 mg/d for 4-12 weeks) for patients with moderate or severe neuropathic pain from postherpetic neuralgia (PHN) or painful diabetic neuropathy (PDN) is associated with pain reduction of at least 50% in 14% to 17% more patients than placebo.

Perspective: Friction in the Path to Use of Biosimilar Drugs

Enactment of the Biologics Price Competition and Innovation Act (BPCIA) in 2010 raised expectations that new competition would blunt price increases for biologic drugs. The BPCIA defined an expedited pathway for biosimilars — products that are similar to and have no clinically meaningful differences from a biologic product approved by the Food and Drug Administration (FDA) — to compete with biologics that no longer have patent or regulatory market exclusivity. The expectations for increased competition were based on the experiences in Europe and estimates made by the Congressional Budget Office and private analysts.

 NEJM

JAMA: Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain

In a study published in JAMA, 240 patients were randomized to determine the use of opioid vs nonopioid medication therapy. The study did not result in significantly better pain-related function over 12 months (3.4 vs 3.3 points on an 11-point scale at 12 months, respectively).

And the study does not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain

How Necessary Are Opioids for Chronic Pain?

The continued ravages of the opioid epidemic have prompted researchers to reconsider whether opioids are an appropriate treatment strategy for chronic non-cancer pain. In this 150-Second Analysis, F. Perry Wilson MD, MSCE, looks at a trial  appearing Tuesday in JAMA that compared opioid to non-opioid therapy in patients with chronic knee and back pain and found virtually no data to support using opioids in this setting.

When two treatment modalities are being compared, I can usually find something positive to say about both of them.

MedPage Today

SAVE THE DATE! 3 Exciting Meeting Options: Phoenix May 4-6, 2018

Brochure link for Interventional Techniques

Opioid overdose among children nearly doubles, study says

The number of children admitted to hospitals for opioid overdose has nearly doubled since 2004, according to a new study.

The study, which published Monday in the journalPediatrics, looked at children between ages 1 and 17 who were admitted to hospitals and pediatric intensive care units with opioid-related diagnoses from 2004 to 2015. Researchers found that the number of children admitted to hospitals for opioid overdose nearly doubled to 1,504 patients between 2012 and 2015, from 797 patients between 2004 and 2007.

The researchers cautioned that many of these children likely overdosed after stumbling upon their parents' prescription medications.

 

CNN

Trump Administration Pushes Conservative Goals in Health-Care Market Changes

 

The Trump administration wants any congressional plan to shore up the Affordable Care Act markets to include conservative goals, such as letting insurers charge higher premiums to older people, according to a memo reviewed by The Wall Street Journal.

The memo encourages lawmakers to pass measures including allowing insurers to charge older people five times as much as younger people, expanding access to health savings accounts and increasing the amount of money that people can contribute to them, as well as supporting a permanent congressional appropriation for subsidies to insurance companies who decrease deductibles and copays for lower-income consumers in exchange for explicit exclusions on abortion coverage by those insurers.

The Affordable Care Act currently restricts insurers to charging older buyers three times as much as younger ones, which has checked premiums for 50-somethings and 60-somethings compared with what they might have been otherwise, but which some insurers contend have increased premiums for healthier 20-somethings and 30-somethings to the point that they don’t want to buy coverage, forcing premiums up across the board.

Wall Street Journal

Access to this article may be limited.

Click HERE to view February issue of IPM Reports

Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. 

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician . Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.  

The benefits of publishing in an open access journal that has a corresponding

print edition journal are:  

So submit today your:

Click HERE to submit

ABIPP Board of Directors Named

Below are the individuals voted to serve on the ABIPP Board of Directors:

Treasurer

Sudhir Diwan, MD

Board Member - 3 Year Term

Ramsin Benyamin, MD

Standiford Helm, MD

Kenneth Candido, MD

Board Member - 4 Year Term

Frank Falco, MD

Hans Hansen, MD

Devi Nampiaparampil, MD

Board Member - 5 Year Term

Miles Day, MD

Alan Kaye, MD PhD

Vikram Patel, MD

The below positions are serving out remaining terms:

Executive Director

Mark Boswell, MD

Secretary

Laxmaiah Manchikanti, MD

Report: All of U.S. saw opioid overdose rises

NOWHERE IN THE U.S. WAS  immune to increases in opioid overdoses between 2016 and 2017, according to the Centers for Disease Control and Prevention's  latest 'Vital Signs' report .

The report gathered data on opioid overdoses treated in emergency departments across the United States between July 2016 and September 2017. Of the data gathered, 52 jurisdictions in 45 states saw an average increase of 30 percent in opioid-related overdose rates, according to the CDC"s National Syndromic Surveillance Program.

 

US News and World Report

Increasing Number of Benzodiazepine Prescriptions a Growing Threat in US

Opioids are not the only class of drugs that constitute a danger to human health; overprescription, overuse, and addiction to benzodiazepines is a growing threat, according to an opinion piece published the  New England Journal of Medicine .

Anna Lembke, MD, of the department of psychiatry and behavioral sciences at Stanford University School of Medicine in Stanford, California, and colleagues note that between 1996 and 2013, the number of benzodiazepine prescriptions filled by adults increased by 67%. Similarly, the quantity of benzodiazepines in each prescription more than tripled, from 1.1 kg to 3.6 kg lorazepam-equivalents per 100,000 adults.

Medical Bag

January/February 2018 Journal Now Posted

January/February 2018 Issue Features

 

Health Policy Review

Systematic Reviews

Randomized Trials

Click view full article pdfs available only online at:  www.painphysicianjournal.com 

White House Plans to Sue Opioid Makers

WASHINGTON -- To stop the opioid crisis, President Trump said on Thursday, the country needs to be tougher on drug dealers and on drug manufacturers.

"We have pushers and we have drug dealers ... I mean they kill hundreds and hundreds of people, and most of them don't even go to jail ... We need strength with respect to the pushers and to the drug dealers. If we don't do that you're never going to solve the problem," he said during the  White House Opioid Summit .

 

MedPage Today

Single Payer Here We Come?

ACP's Bob Doherty lists the important questions

Single payer healthcare is enjoying a boomlet in public opinion.

A Pew Research Center poll released in June 2017 found that, "Overall, 33 percent of the public now favors such a 'single payer' approach to health insurance, up 5 percentage points since January and 12 points since 2014." Fifty-eight percent of those surveyed by Pew said that the government has a responsibility to ensure health for all, with a third saying it should be through a single national government program and 25% through a mix of government and private programs. Another 33% said the government is not responsible to ensure healthcare for all but agreed that Medicare and Medicaid should be continued, while 5% said the government should not be involved at all. The poll also showed that a majority of Democrats now favor single payer; support was also stronger among younger persons than older ones. However, most Republicans and older voters oppose single payer.

The Kaiser Family Foundation's June 2017 tracking poll found even

MedPage Today

Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Methylprednisolone Sodium Succinate for Injection, USP, 40mg, 125mg, and 1g Due to High Out of Specification Impurity Results

Sagent Pharmaceuticals, Inc. today announced the voluntary nationwide recall of ten lots of Methylprednisolone Sodium Succinate for Injection, USP, 40mg, 125mg, and 1g. A detailed listing of products and lots is listed below. These products were manufactured by Gland Pharma Ltd. and distributed by Sagent Pharmaceuticals. Sagent has initiated this voluntary recall of Methylprednisolone Sodium Succinate for Injection, USP to the user level due to the discovery of high out of specification impurity results detected during routine quality testing of stability samples for two lots. This impurity has not yet been identified. 

An elevated impurity has the potential to decrease effectiveness of the product in patients. To date, Sagent is not aware of any adverse patient events resulting from the use of the subject product lots.

USFDA

 

Gavin Awerbuch, MD of West Bloomfield headed to prison over drug crimes, fraud

A doctor from West Bloomfield who most recently worked at a medical marijuana clinic in Walled Lake is headed to prison for drug charges and health care fraud.

The charges against Gavin Awerbuch, MD, stem from his pain management office in Saginaw where from 2012-2014 he illegitimately wrote prescriptions for an opioid-based medication, Subsys, intended to curb pain in cancer patients, and then billed Medicare and private health insurers for it. According to prosecutors, for a time Awerbuch had written more Subsys prescriptions by far for Medicare patients than anyone else in the United States.

He was also charged with fraudulently billing for nerve-conduction tests and other diagnostic procedures that weren’t performed on patients.

The Oakland Press

DOJ News

Biloxi Physician Convicted for Role in $3 Million Compounding Pharmacy Fraud Scheme

A federal jury found a Biloxi, Mississippi physician guilty Friday for his role in an approximately $3 million compounding pharmacy fraud scheme.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division; U.S. Attorney D. Michael Hurst Jr. of the Southern District of Mississippi; Special Agent in Charge Christopher Freeze of the FBI’s Jackson, Mississippi, Field Division and Acting Special Agent in Charge Ted Magee of Internal Revenue Service Criminal Investigation’s (IRS-CI) New Orleans Field Office made the announcement.

Albert Diaz, M.D., 78, was convicted of one count of conspiracy to commit health care fraud and wire fraud, four counts of wire fraud, one count of conspiracy to distribute and dispense a controlled substance, four counts of distributing and dispensing a controlled substance, one count of conspiracy to falsify records in a federal investigation and five counts of falsification of records in a federal investigation following a five-day trial. Sentencing has been scheduled for May 22, 2018 before U.S. District Judge Keith Starrett of the Southern District of Mississippi, who presided over the trial. 

https://www.justice.gov/opa/pr/biloxi-physician-convicted-role-3-million-compounding-pharmacy-fraud-scheme

 

United States Files Civil Enforcement Action to Stop Arkansas Compounding Pharmacy and CEO from Manufacturing and Distributing Adulterated Drugs

The United States filed a civil complaint and a motion seeking a preliminary injunction against Cantrell Drug Company and its co-owner and Chief Executive Officer, James L. McCarley Jr., to stop the manufacturing and distribution of adulterated drugs, the Department of Justice announced today.

 

The complaint, filed in the U.S. District Court for the Eastern District of Arkansas at the request of the U.S. Food and Drug Administration (FDA), alleges, among other things, that defendants distribute adulterated drugs in interstate commerce. According to the complaint, defendants’ drugs are adulterated because they are prepared, packed, or held under insanitary conditions whereby they may have been contaminated or may have been rendered injurious to health. The complaint also alleges that defendants’ drugs are adulterated because defendants fail to comply with current good manufacturing practice regulations. 

https://www.justice.gov/opa/pr/united-states-files-civil-enforcement-action-stop-arkansas-compounding-pharmacy-and-ceo