THURSDAY | MARCH 5, 2020
Kevin Pho, MD
Founder and Editor, KevinMD.com , and Founder,  Physician Speaking by KevinMD .
Keynote Kevin Pho, MD Knows How to Establish, Manage, and Protect Your Online Reputation
Kevin Pho is a practicing, board-certifi ed internal medicine physician, a national media commentator, co-author of the book, Esta blishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices , and an acclaimed keynote speaker. Kevin built KevinMD.com platform from scratch in 2004. It now receives over 3 million monthly page views, and exceeds 250,000 followers on Facebook and Twitter. Kevin was named the web’s top social media influencer in health care and medicine.
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GENERAL SESSION
Friday, April 3 | 1:00pm – 2:00pm
Establishing, Managing, and Protecting Your Online Reputation:
A Social Media Guide for Physicians and Medical Practices 
Kevin Pho, MD Keynote
READ MORE | KevinMD.com |
Track the Coronavirus Outbreak on Johns Hopkins Live Dashboard

Realtime Infection and Death Data from Five Sources
This tracker from Johns Hopkins University provides realtime information and  counts cases of COVID-19 coronavirus  in China, as well as around the world, including numbers of deaths, recovered patients, and countries affected.

The World Health Organization has its own  coronavirus dashboard  as well, but includes only its own information, whereas the Hopkins team synthesizes data from WHO and four additional sources:  CDC European Centre for Disease Prevention and Control China's National Health Commission,  and  ncov.dxy.cn , an independent data source maintained by Chinese physicians.

Lauren Gardner , associate professor of civil and systems engineering and co-director of the  Center for Systems Science and Engineering (CSSE) , led the dashboard development effort. There's also a  mobile version  as well as  full size .
READ MORE | MEDPAGE TODAY |
BE PART OF THE CAREER FAIR | REGISTRATION FORM |
ABIPP Recognizes Your Knowledge and Expertise

The American Board of Interventional Pain Physicians ( ABIPP ) has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become ABIPP certified.

ABIPP now offers the only competency certification program for regenerative medicine.
 
For complete information about the examination requirements and to obtain an application packet, visit
www.abipp.org or call 270-554-9412 x4217 or by email at summer@asipp.org .
JUNE 27
ABIPP Part I  
  • Combined CSM/CCPM Exam for ABIPP Path
  • Competency Exam in Controlled Substance Management
  • Competency Exam in Coding, Compliance, and Practice Management
 
JUNE 27-28
ABIPP Part II  
  • ABIPP Competency Exam
  • Regenerative Medicine Competency Exam
  • Endoscopic Lumbar Decompression Competency Exam
 
939 Ridge Lake Blvd.,
Memphis, Tennessee 38120
JUNE 2020 ABIPP EXAMS AND COMPETENCY EXAMS
June 27 - June 28, 2020 | Hilton Memphis
LEARN MORE ABOUT ABIPP | EMAIL SUMMER WOODS |
More Addiction Treatment Docs Needed for Opioid Crisis, House Panel Told

"Having a trained workforce of addiction medicine and addiction psychiatrists is critical"
WASHINGTON -- The opioid crisis and growing addiction to methamphetamine and other stimulants won't be abated until the country trains more addiction medicine physicians, witnesses said at a House Energy & Commerce Health Subcommittee hearing.

"One of the things the opioid epidemic has laid bare is the lack of trained professionals we have to provide treatment, so we can put out all the funding dollars we want" but it won't do any good without a trained workforce, said Michael Botticelli, executive director of the Grayken Center for Addiction at Boston Medical Center. "I think it's really important for us to ensure that while we're doing other activities such as integrating addiction treatment into residency training, that having a trained workforce of addiction medicine and addiction psychiatrists is critical."
READ MORE | MEDPAGE TODAY |
Announcing A New ASIPP ® Partnership - Fedora Billing
And Revenue Cycle
Management Company 
After long discussions, in addition to our NorCal liability program for ASIPP ® members, now we are able to offer unique benefits for revenue cycle management with billing, etc.

Fedora ( https://www.ifedora.com ) is a company known to many of our board members and others. ASIPP ® has reached an agreement with Fedora to provide exclusive discounts on billing or revenue cycle management that will decrease practice costs and promote growth, or at least stop deterioration. It is not just a billing company; they streamline the billing and receivable process and constantly update payor regulations keeping your practice up to on date on a daily basis. 

You may view the ASIPP ® billing program website at the following link:  https://www.asippbilling.com/  

Some of the ASIPP ® Billing Program highlights are below:
Up to 50% savings for ASIPP ® members for their billing or revenue cycle management for their offices and surgery centers:
 
  • Expertise in interventional pain management billing for all types of services
  • 99% Clearing House Rate
  • 95% First-Time Claim Passage
  • 23.4 Average Days in A/R
  • Eligibility and Benefits Verification 
  • Pre-Certification/Prior Authorization
  • Denials and A/R Management 
VIEW THE ASIPP ® BILLING PROGRAM | CLICK HERE |
New Vermont Bill Would Turn PRP into a Scarlet Letter
BLOG SUMMARY:

  • A Vermont bill has now incorrectly categorized PRP as “stem cell therapy”
  • It seeks to have physicians who use PRP be stigmatized
  • We need your help to stop this ridiculous bill
If you remember the Hawthorne novel “The Scarlet Letter” from High School English class, a young woman is made to wear a large red letter “A”. Now a new bill in Vermont wants to do the same thing for doctors who use PRP. Let’s dig in about why you should be VERY concerned about all of this and what you can do this weekend.
"THIS NOTICE MUST BE PROVIDED TO YOU UNDER VERMONT LAW. This health care practitioner administers one or more stem cell products that have not been approved by the
U.S. Food and Drug Administration. You are
encourage to consult with your primary care provider prior to having an unapproved stem
cell product administered to you."
READ MORE | REGENEXX |
Obtain A Waiver To
Prescribe Buprenorphine


ASAM Treatment of Opioid use Disorder - Buprenorphine Prescription Waiver Course
Course Includes 4 hours of online material at the conclusion of the course to provide the required 8 hours needed to obtain the waiver to prescribe buprenorphine in office-based treatment of opioid use disorders.

A $200 registration fee is in addition to the meeting registration fee.
ASAM course registrants must be registered attendees for the ASIPP ® 2020 Annual Meeting in Dallas. Onsite registration will be available as space allows or you may register in advance on your meeting registration form.

This course will only be offered Friday, April 3 and is open to Physicians, Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants who wish to obtain a waiver to prescribe buprenorphine in office-based treatment of opioid use disorder.
BUPRENORPHINE PRESCRIPTION WAIVER COURSE | REGISTER HERE |
Join The Group Purchasing Organization Today
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 the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today. While the cost of contrast media has skyrocketed due to the single dose vial issue, because we have partnered with Henry Schein, this could enable you to purchase Omnipaque 240mg/50mL for slightly above $4.50.

It will be easy for  ASIPP ® members in good standing to enroll today and begin to realize the savings this partnership can bring. Members can join or see sample prices by going to   http://pedspal.org/asipp/default.html   

Click on “view our discounted supplier prices” (Username:ASIPPmember and Password: Save) or click on the words "join for free now" and begin saving today!
LEARN MORE ABOUT GROUP PURCHASING | CLICK HERE |
Prescription Drug Prices Have Increased Three Times Faster than the Rate of Inflation Over the Last Decade, Even After Discounts
new  JAMA study shows that the net price  of  prescription drugs has increased more than three times faster than the rate of inflation over the course of a decade, even after manufacturer discounts.

“Previously, we were limited to studying list prices, which do not account for manufacturer discounts. List prices are very important, but they are not the full story,” said lead author Inmaculada Hernandez, Pharm.D., Ph.D., assistant professor of pharmacy at Pitt in a  press release.  “This is the first time we’ve been able to account for discounts and report trends in net prices for most brand name drugs in the U.S.”

In this retrospective descriptive study, researchers used pricing data from 2007-2018 to assess the US sales of 602 drugs as reported by publicly traded companies. They estimated net prices by collating company reported sales for each drug and the number of US units sold. The primary outcomes included list and net prices and discounts in Medicaid and other payers.
READ MORE | DOCWIRE |
Ransomware Damage To
U.S. Healthcare Industry Passes $150 Million In Four Years
In 1989 the first ransomware attack took place. It targeted a hospital network. 31 years later, ransomware remains a persistent menace to the health care industry.

Much has changed over the years. Today’s threats are far more sophisticated and, accordingly, the cost to recover from an infection is much higher.

According to a new  report from Comparitech , a total of 172 ransomware incidents have cost the U.S. health care industry more than $157 million since 2016.

Actual ransom demands only account for about 11% of that. Comparitech estimates that cybercriminals sought around $16.4 million from the attacks. The other 89% of the bill covers remediation costs and downtime.
READ MORE | FORBES |
ALWAYS RETWEET ASIPP | @ASIPP |
Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation
BMJ   2020 368  doi:  https://doi.org/10.1136/bmj.m283   (Published 04 March 2020) Cite this as: BMJ 2020;368:m283

Abstract

Objective  To examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration.

Design  Observational evaluation.

Setting  Veterans Health Administration.

Participants  1 394 102 patients in the Veterans Health Administration with an outpatient prescription for an opioid analgesic from fiscal year 2013 to the end of fiscal year 2014 (1 October 2012 to 30 September 2014).
Main outcome measures  A multivariable Cox non-proportional hazards regression model examined death from overdose or suicide, with the interaction of time varying opioid cessation by length of treatment (≤30, 31-90, 91-400, and >400 days) as the main covariates. Stopping treatment with opioids was measured as the time when a patient was estimated to have no prescription for opioids, up to the end of the next fiscal year (2014) or the patient’s death.

Results  2887 deaths from overdose or suicide were found. The incidence of stopping opioid treatment was 57.4% (n=799 668) overall, and based on length of opioid treatment was 32.0% (≤30 days), 8.7% (31-90 days), 22.7% (91-400 days), and 36.6% (>400 days). The interaction between stopping treatment with opioids and length of treatment was significant (P<0.001); stopping treatment was associated with an increased risk of death from overdose or suicide regardless of the length of treatment, with the risk increasing the longer patients were treated. Hazard ratios for patients who stopped opioid treatment (with reference values for all other covariates) were 1.67 (≤30 days), 2.80 (31-90 days), 3.95 (91-400 days), and 6.77 (>400 days). Descriptive life table data suggested that death rates for overdose or suicide increased immediately after starting or stopping treatment with opioids, with the incidence decreasing over about three to 12 months.

Conclusions  Patients were at greater risk of death from overdose or suicide after stopping opioid treatment, with an increase in the risk the longer patients had been treated before stopping. Descriptive data suggested that starting treatment with opioids was also a risk period. Strategies to mitigate the risk in these periods are not currently a focus of guidelines for long term use of opioids. The associations observed cannot be assumed to be causal; the context in which opioid prescriptions were started and stopped might contribute to risk and was not investigated. Safer prescribing of opioids should take a broader view on patient safety and mitigate the risk from the patient’s perspective. Factors to address are those that place patients at risk for overdose or suicide after beginning and stopping opioid treatment, especially in the first three months.
READ MORE | BMJ |
Essentials of Regenerative Medicine in Interventional
Pain Management
Essentials of Regenerative Medicine in Interventional Pain Management is a book to bring concise, collective, and comprehensive information to interventional pain physicians practicing regenerative medicine in managing chronic pain. Regenerative medicine is an integral part of interventional pain management within the definitions of interventional pain management and interventional techniques.

Each chapter contains an introduction of the subject, historical context,pathophysiology, applicability of regenerative medicine with its evidence base, indications, anatomy, technical aspects, complications, and precautions for each topic when available and applicable. This comprehensive book consists of 35 chapters, more than 350 figures, and 50 tables.
Essentials of Regenerative Medicine in Interventional Pain Management | ORDER |
Clinical Challenge:
Opioid Tapering
New trials look at ways to help chronic pain
patients take fewer drugs
 Too much focus on the pill and not enough on the whole person: that's a key piece missing in the movement to reduce opioids among chronic pain patients, said Beth Darnall, PhD, of Stanford University in Palo Alto, California.

After the CDC issued its 2016  guidelines for chronic pain opioid prescribing , there's been a big focus to reduce overprescribing, but little understanding of the best way to do so, Darnall noted. Some agencies and companies used the 2016 guideline to push hard dose limits and abrupt tapering, which the CDC later said was  inconsistent with its recommendations . Last year, the FDA issued a  safety announcement  about sudden opioid tapering, and in the fall, federal health officials released a  new guide  to try to bring a more balanced approach to the tapering process.
READ MORE | MEDPAGE TODAY |
Pain Physician January/February
2020 Articles Available Online Now
The January/February issue of Pain Physician features two surveys: one on prescription drugs in the workplace, and another on patient-reported outcome demographics. The issue also features randomized trials on pulsed radiofrequency on thoracic dorsal root ganglion, and the effects of intraoperative, low-dose ketamine on postsurgical pain after breast cancer.
Analysis/Survey
Prescription Drugs and the US Workforce: Results from a National Safety Council Survey
Alaa Abd-Elsayed, MD, Mathew Fischer, MD, Jonathan Dimbert, MS, and Kenneth James Fiala,BS

Demographic Factors Associated with Patient-Reported Outcome Measures in Pain Management
Jihad Abdelgadir, MD, Edmund W Ong, PhD, Salma M Abdalla, MD, John C Hunting, MPH, Mohamed Mustafa Diab, MD, Michael M Haglund, MD, PhD, C Rory Goodwin, MD, PhD, and Padma Gulur, MD

Randomized Trials
Pulsed Radiofrequency on Thoracic Dorsal Root Ganglion versus Thoracic Paravertebral Nerve for Chronic Postmastectomy Pain, A Randomized Trial: 6-Month Results
Diab Fuad Hetta, MD, Sahar Abdel Baky Mohamed, MD, Kawser Hofny Mohamed, MD, Taha Abd Elrazek Mahmoud, MD, and Hanan Ahmed Eltyb, MD

Effects of Intraoperative Low-Dose Ketamine on Persistent Postsurgical Pain after Breast Cancer Surgery: A Prospective, Randomized, Controlled, Double-Blind Study
Christine Kang MD, Ah-Reum Cho MD, PhD, Kyung-Hoon Kim MD, PhD, Eun-A Lee MD, Hyeon-Jeong Lee MD, PhD , Jae-Young Kwon MD, PhD, Haekyu Kim MD, PhD, Eunsoo Kim MD, PhD, Ji-Seok Baik MD, PhD, and Choongrak Kim MD, PhD
Court Rules Against Aetna For Refusing to Pay for Emergency Surgery Due to CPT Coding Error

AAPS sided with a Californian physician on problems he was having as an out-of-network spine surgeon. Insurers refused to pay him a reasonable amount for his services, despite his stellar record and how California (like many states) recognizes the right of physicians to sue insurance companies for out-of-network emergency services. This is an essential exception to the price controls being imposed on physicians under the guise of “surprise billing” laws.
In one of his cases, Aetna refused to pay him because it said he used the wrong CPT code for emergency services, even though his billing office clarified that the surgery was done on an emergency basis after the patient went to the ER in enormous pain. Insurance companies should not use CPT intricacies as an excuse for refusing to pay.
The physician performed emergency spine surgery on a patient from the ER who felt like she might otherwise die from the pain. She provided a sworn statement that she had “excruciating back pain … and the inability to walk.” The billing company indicated the surgery was performed on an emergency basis on the bills to the insurance company, Aetna. Yet the trial judge ruled completely for Aetna, as many trial judges do for insurance companies. It granted summary judgment based on Aetna’s argument that because an “incorrect” non-emergency CPT code was initially used, the physician had no right to payment. But an out-of-network physician should not be obligated to use particular CPT codes to get paid by an insurance company!
READ MORE | AAPS |
Blog: 3 Reasons Why Some Physicians Aren’t Burned Out
I have gotten to the stage where I take a more philosophical approach to the issue of physician burnout and job dissatisfaction. I see it all around me, and it’s impossible to miss some of the sobering statistics just browsing online any medical publication or social media feed.

There’s definitely a very real issue that’s been compounded by changes to health care delivery and the nature of the job itself (i.e., having to spend the vast bulk of the day glued to a screen). But something tells me too that there’s no such thing as a perfect job out there, especially whenever you are working for someone else. Every industry is facing massive changes in this new technological age. Google any profession and add the word “burnout” afterwards—from teachers to police—and you’ll be met with an avalanche of articles (even “CEO burnout” is a thing!). It’s not an issue that is unique to health care by any means, although every professional tends to fall into a trap of thinking it only affects their line of work. Given that we are where we are then, I can also guarantee you that there are experienced colleagues around you who are not burned out and do exactly the same job as you do. Can we learn from them? Here are three things they are probably doing:

1. They have found a niche that they are passionate about.  Professionals who are in a highly specialized area that they enjoy are always happier than those who aren’t. They see themselves as the go-to source of knowledge and take pride in staying on top of things. Whether they are already an “official” specialist, or a generalist with their own special interest, their area of expertise is on show to the world.

2. They are calm.  There are plenty of things to make one fly off the handle, from institutional politics, to a general feeling of being under-appreciated. Those happiest in their jobs know that being an employee, will always be a merry-go-round of new issues coming up and having the next new problem to fight. That bad boss, annoying colleague, or persistent roadblock to doing what you want to. These will always be there, and all you can do is just try your best to stay calm and measured as you fight your corner.

3. Well-rounded.  They have interests outside of work that take them away from the daily grind and are a great source of satisfaction. They are not working 24/7 and have a life away from the desk. This could be a hobby or an outside venture that they are passionate about and enjoy. They look forward to doing this, and it refreshes their mind.
READ MORE | KEVIN MD |
Control Your Waiting Room TV

Customized waiting room TV exclusively for ASIPP ® members. Create your own ad-free television broadcasts using our videos, custom informational slides and your own YouTube videos. Even add local weather reports, news and live messages.
GET YOUR OWN LOBBY TV CHANNEL | CLICK HERE FOR ASIPP-TV |
STATE SOCIETY MEETINGS
Send in your state society meeting news to Holly Long , hlong@asipp.org
ASIPP ® | Pain Physician Journal | Phone | Fax | Email