American Society of Interventional Pain Physicians | February 28, 2018
Tribute to Phulchand Prithvi Raj: The Man Who Transformed Interventional Pain Management
Most interventional pain physicians today assume that the way we currently think and practice interventional pain management or pain medicine has always been part of our profession. Many believe that we are evidence based and everything has already been written and published; however, the interventional pain management name did not even exist when ASIPP was formed in 1998. We face daily criticisms, abuses, overuses, and extinction. Forty years ago, pain management was dominated by story-telling, block clinics, and few people dominating the field without much evidence. There were few written documents and only two complicated texts. Studies were not well designed or executed.
One man made all the difference: Dr. Phulchand Prithvi Raj. Dr. Raj led the development of interventional pain management into the modern era. While we have many of our elders to thank, Raj is the foremost individual who envisioned the future with the publication of Practical Management of Pain , which was easy to understand, clinically based, yet with evidence available at the time.
His contributions to the specialty are enormous.
He passed away 2 years ago on February 27, 2016. We cherish his memories and ASIPP has honored him with the Lifetime Achievement Award, and continues to honor him with the Raj Excellence Award, the Raj/Racz Distinguished Service Lectures, and this year we will give him the highest award ever given in Pain Medicine: Giants in Pain Medicine. Dr. Raj, we miss you and your wisdom. You will always be in our hearts, minds, and practices. You have left us with a legacy of wisdom, of care, compassion, and continuing curiosity and exploration, analysis, and scrutiny of interventional pain management.
We look forward to seeing you at the annual meeting to watch the Giants in Pain Medicine Award be accepted by Susan Raj and the Raj Excellence Award presented to Craig Hartrick.
Raj-Racz Distinguished Lecture Series with:
●  Mesenchymal Stem Cells: Today, Tomorrow, and Future of Pain Management by Arnold Caplan, PhD
●  Evidence Synthesis in IPM: Evolution of EBM or Death of Expertise and Truth by Laxmaiah Manchikanti, MD.

CALL 407-938-9001

8601 Vineland Avenue
Orlando, Florida 32821 USA
Register Now and Receive ' Stop Physician Burnout: What to Do When Working Harder Isn't Working '
by Dike Drummond, MD
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.
This Book Give-away is sponsored by PREMIER MEDICAL BILLING SOLUTIONS .
Books will be distributed to all attendees at the meeting as long as supplies last.
Excludes sponsor and exhibitor registrations.

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.

  •   Multiple topics covering Interventional Pain Management
  • 70+ physician speakers discussing over 125 interventional pain management topics and conducting numerous panel discussions
  • 8 keynote speakers enlightening attendees
  • "Excellence in IPM: Education, Research, and Advocacy"
  • 100+ exhibitors showcasing new IPM products and services
  • A luxurious stay in the stylish rooms and many amenities of Marriott Orlando World Center

Thursday General Session:
Mesenchymal Stem Cells: Today, Tomorrow, and Future of Pain Management
Evidence Synthesis in IPM: Evolution of EBM or Death of Expertise and Truth

Friday General Session:
State of Health Care in the US: Past, Present, and Future
Health Care Advocacy: ASIPP Involvement with Grass Roots Advocacy Find everything you need for a successful stay.
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!
  • Comprehensive textbook of interventional techniques in managing chronic pain

  • Covers spinal interventional techniques, peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections and implantables

  • Step-by-step guidance backed up by the latest evidence

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
Some top opioid providers raise red flags
Family physicians, nurse practitioners and doctors whose health care focuses on non-narcotic therapies are some of the nation’s most prolific opioid prescription writers in recent years. 
Federal guidelines say they shouldn’t be. 
Medical professionals not specializing in oncology, surgery, emergency medicine or pain, accounted for more than half of the 1,000 highest opioid prescribers in the Medicare Part D, a government-sponsored drug benefit for the elderly and disabled, over a three-year span beginning in 2013, a Raycom Media national investigation has revealed. 
Pain doctors, whose use of opioids has come under increasing scrutiny by medical experts doubting the drugs’ effectiveness in curbing pain, represented nearly a third of the nation’s highest prescribers. They include three doctors at an Alabama clinic who wrote 33,084 opioid prescriptions during a three-year period. Compare that to 40,124 prescriptions written by 900 doctors at the Mayo Clinic in Rochester, Minnesota did during the same time. 

Rafael Miguel, M.D. Born July 1, 1955 in Havana, Cuba Passed February 25, 2018 in Miami, Florida

The President of FSIPP, Orlando Florete Jr., M.D. wrote a tribute on the passing of a dear friend and colleague, Dr. Raphael Miguel, on February 25th, 2018. Dr. Miguel was one of the founding members of FSIPP and a lifelong advocate for patients and the pain management specialty. 

It is with a heavy heart that I learned of the passing of Dr. Rafael Miguel on the morning of February 25, 2018. Dr. Miguel had been a giant among us… a colleague, teacher, mentor, scholar, leader as well as a friend. Throughout his career, he stood apart as somebody remarkable. He had trained many successful pain specialists all over the country when he headed the Pain Management Fellowship at the University of South Florida. He was exceptionally active in national, regional and state issues involving our specialty. Rafael had a charismatic personality and leadership qualities which were apparent when he represented us in national and state organizations. He committed himself to the advancement of Interventional Pain Management as a recognized subspecialty; in research, training and patient services. He was passionate in making sure that we practice legitimately and safely, spearheading and pushing for regulations both at the Florida Board of Medicine and the Department of Health to assure patient safety and the prevention of opioid abuse. He was instrumental in curbing the proliferation of pill mills and transformed the reputation of Florida from the “Wild West” of opioid prescribing to one of the most responsible states in the country in writing controlled substance prescriptions. His contributions to our specialty were powerful and everlasting. In spite of his sickness, he remained an active and dynamic force in our society up to the very end.  Additionally, he remained a devoted family man and friends to many.

He was buried February 27, 2018 T CHURCH OF THE LITTLE FLOWER in Coral Gables, Florida
Pain is soul destroying. As a Pain Medicine Physician, I have the distinct privilege of treating the most devastating of illnesses, chronic pain. No one should have to endure unrelenting pain that interferes with basic activities of daily life. There are many options that can help and while a cure is difficult, appropriate management can minimize its impact on daily life and interaction with others. Pills alone are not the answer and should be used as complements to other modalities.

Rafael Miguel 
SAVE THE DATE! 3 Exciting Meeting Options: Phoenix May 4-5, 2018
Almost all cannabis on Britain's streets 'super strength' and could be driving mental health problems
Nearly all cannabis on Britain's streets is now super-strength skunk that could be fuelling the rise in mental health problems, scientists have warned.
Researchers at King’s College London tested almost 1,000 police seizures from Kent, Derbyshire, Merseyside, Sussex and the capital in 2016 and found 94 per cent were of a dangerously high potency.
In 2005 just 51 per cent of cannabis sold on the street was sinsemilla, also known as skunk.

Azar Backs New MATs for Opioid Addiction
Soon-to-be released FDA guidance documents aim to help
WASHINGTON -- Stigma is a barrier to crushing the opioid crisis, and strong leadership is needed to tackle it, said Alex Azar, JD, Secretary of Health and Human Services, speaking during the National Governors Association's winter meeting on Saturday, here.
Specifically, Azar noted that only one-third of treatment programs across the country provide medication-assisted treatment (MAT), and one reason is that such therapy is stigmatized.
Critics view it, in simplest terms, as replacing one drug with another.
Azar announced that the FDA would soon be releasing two new draft guidances intended to speed the development of new MATs.

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:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives

Click HERE to submit
Mexican cartels pushing more heroin after U.S. states relax marijuana laws
CHIHUAHUA, Mexico — As more U.S. states legalize the use of marijuana, Mexico's violent drug cartels are turning to the basic law of supply and demand.
That means small farmers, or campesinos, in this border state's rugged Sierra Madre who long planted marijuana to be smuggled into the United States are switching to opium poppies, which bring a higher price. The opium gum harvested is processed into heroin to feed the ravaging U.S. opioid crisis.
“Marijuana isn’t as valuable, so they switched to a more profitable product,” said Javier Ávila, a Jesuit priest in this region rife with drug cartel activities.

Medicare Extra for All - Center for American Progress
This proposal guarantees the right of all Americans to enroll in the same high-quality plan modeled after the Medicare program.
Introduction and summary
Health care is a right: No American should be left to suffer without the health care they need. The United States is alone among developed countries in not guaranteeing universal health coverage.
Over the past half century, there have been several expansions of health coverage in the United States; today, it is past time to ensure that all Americans have coverage they can rely on at all times.
January/February 2018 Journal Now Posted

January/February 2018 Issue Features
Health Policy Review
  • Buprenorphine Formulations
Systematic Reviews
  • Lumbar Spinal Stenosis
  • Middle Cervical Sympathetic Ganglion
  • Postherpetic Neuralgia Therapies
Randomized Trials
  • Pulsed Radiofrequency Improves Neuropathic Pain in Chronic Constriction Injury
  • Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis
  • Reducing Radiation Exposure in Lumbar Transforaminal Epidural Steroid
  • Cerebral Blood Flow and Heart Rate Variability in Chronic Fatigue Syndrome
  • Intradiscal Ozone-Oxygen Injection in Patients with Low Back Pain

Click view full article pdfs available only online at: 
Trump Administration works to give relief to Americans facing high premiums, fewer choices
Proposed rule to allow short-term, limited-duration insurance for longer periods providing increased choice at a lower cost
In direct response to President Trump’s October 2017 Executive Order, the Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) issued a proposed rule today that is intended to increase competition, choice, and access to lower-cost healthcare options for Americans. The rule proposes to expand the availability of short-term, limited-duration health insurance by allowing consumers to buy plans providing coverage for any period of less than 12 months, rather than the current maximum period of less than three months. The proposed rule, if finalized, will provide additional options to Americans who cannot afford to pay the costs of soaring healthcare premiums or do not have access to healthcare choices that meet their needs under current law.
“Americans need more choices in health insurance so they can find coverage that meets their needs,” said Health and Human Services Secretary Alex Azar. “The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices. The Trump Administration is taking action so individuals and families have access to quality, affordable healthcare that works for them.”
The opioid crisis is draining America's workforce
A pack of cigarettes sits on top of a Buffalo Wild Wings application on the kitchen table in front of Mike Harsanyi. After six years struggling with heroin addiction and two spells in prison, Harsanyi has been living in a sober house in Maryland for five months and he's looking for steady employment.
"The job search has not been going good," said Harsanyi, a baby-faced 27-year-old with tattoos poking out of his collar. "I think when you're a drug addict in sobriety with a felony on your record, they look at you different, like you're going to rob their store."
Jobs are plentiful in Maryland's Anne Arundel County, which boasts an unemployment rate of 3.1%. But after doing time for an armed robbery committed while he was high in 2015, Harsanyi has so far been turned down for jobs at Valvoline and Jiffy Lube, and is only able to pick up occasional work as a tile setter for another recovering addict he met through his 12-Step program.

States of Disgrace: A Flawed System Fails to Inform the Public
Every physician has heard the horror stories.
Stories about doctors who sexually harass patients, bungle surgeries, or ignore complications in patients who then die. And what's more, they can get away with it by taking advantage of lags and gaps in the medical licensing system. By hopping state lines, or having a fistful of licenses issued by different states, they can continue to practice wherever the grass is greenest.
Now, a  MedPage Today/Milwaukee Journal-Sentinel  investigation reveals the scope of the problem: between 2011 and 2016, at least 500 physicians were chastised by one state medical board and yet able to hang their shingles at a new address with a "clean" license.
They slipped through the cracks even though their actions resulted in suspensions, revocation, remedial classes or a portfolio of "letters of concern" that castigate them for misconduct.
Doctors who flood the country with opioids face little scrutiny, repercussions
Shortly after Dr. Mark A. Murphy, a top opioid prescriber in the U.S., started practicing here three days a week last year, the clinic owners asked a police detective to meet for dinner.
Lewisburg Police Lt. Tom Miller thought the request seemed like a preemptive strike to keep the cops away from the Specialty Associates clinic.
“They … wanted to stress with me they weren’t doing anything wrong,” said Miller, who served as a drug task force commander for 18 years before joining the Lewisburg force.
But Miller’s suspicions of the doctor were already amplified. He knew Murphy had been the No. 1 opioid prescriber in the federal Medicare program for years; that he closed his practices in Alabama when that state’s medical board accused him of writing excessive opioid prescriptions.

DOJ News
Justice Department to File Statement of Interest in Opioid Case
The Department of Justice today announced it will be filing a Statement of Interest in a multi-district action regarding hundreds of lawsuits against opioid manufacturers and distributors.
The plaintiffs include numerous cities, municipalities, and medical institutions that have borne the costs of the prescription opioid crisis. The plaintiffs seek to recover the costs associated with providing treatment and public safety measures relating to the opioid epidemic from those who allegedly used false, deceptive, or unfair marketing practices for prescription opioid drugs.
The Justice Department will primarily argue that the federal government—through various federal health programs and law enforcement efforts—has borne substantial costs from the opioid epidemic and seeks reimbursement.

Attorney General Sessions Announces New Prescription Interdiction & Litigation Task Force
Attorney General Jeff Sessions today announced the creation of a new effort, the Department of Justice Prescription Interdiction & Litigation (PIL) Task Force, to fight the prescription opioid crisis. The PIL Task Force will aggressively deploy and coordinate all available criminal and civil law enforcement tools to reverse the tide of opioid overdoses in the United States, with a particular focus on opioid manufacturers and distributors.
The PIL Task Force will include senior officials from the offices of the Attorney General, the Deputy Attorney General, and the Associate Attorney General, as well as senior officials from the Executive Office for U.S. Attorneys, the Civil Division, the Criminal Division, and the Drug Enforcement Administration.  The Task Force will coordinate the Department’s many efforts and tools to combat the opioid epidemic. 
United States Files False Claims Act Complaint Against Compounding Pharmacy, Private Equity Firm, and Two Pharmacy Executives Alleging Payment of Kickbacks
The United States has filed a complaint in intervention against Diabetic Care Rx LLC d/b/a Patient Care America (PCA), a compounding pharmacy located in Pompano Beach, Florida, alleging that the pharmacy paid illegal kickbacks to induce prescriptions for compounded drugs reimbursed by TRICARE, the Department of Justice announced today. The government has also brought claims against Patrick Smith and Matthew Smith, two pharmacy executives, and Riordan, Lewis & Haden Inc. (RLH), a private equity firm based in Los Angeles, California, which manages both the pharmacy and the private equity fund that owns the pharmacy, for their involvement in the alleged kickback scheme. 
TRICARE is a federally-funded health care program for military personnel and their families. The government alleges that the Defendants paid kickbacks to marketing companies to target TRICARE beneficiaries for prescriptions for compounded pain creams, scar creams, and vitamins, without regard to the patients’ medical needs. According to the complaint, the compound formulas were manipulated by the Defendants and the marketers to ensure the highest possible reimbursement from TRICARE. The Defendants and marketers allegedly paid telemedicine doctors to prescribe the creams and vitamins without seeing the patients, and sometimes paid the patients themselves to accept the prescriptions. The scheme generated tens of millions of dollars in reimbursements from TRICARE in a matter of months, according to the complaint, which alleges that the Defendants and marketers split the profits from the scheme.
State Society News 
June 9-10, 2018
Midwest Societies of Interventional Pain Management Meeting
State Societies from Illinois, Indiana, Kentucky, Michigan, Missouri, Wisconsin, and Iowa .
Westin Michigan Avenue Chicago

April 18-22, 2018
GSIPP 2018 Annual Meeting
Georgia Society of Interventional Pain Physicians
The Ritz Carlton Reynolds, Lake Oconee

July 19-22, 2018
FSIPP 2018 Annual Meeting, Conference, and Trade Show
Florida Society of Interventional Pain Physicians
One South County Road, Palm Beach, FL 33480

Send in your state society meeting news to Holly Long,
ASIPP | Pain Physician Journal | Phone | Fax | Email