FEATURE
fact that physicians own their own ASCs and would prefer keeping that revenue. They’re short procedures with minimal expenses and very good outcomes, and they are procedures hospitals would like to keep.”
In addition to sustaining such efforts on a political level, Thiel says ASCs and their physicians should always strive to advance the specialty on the basis of quality.
“I think the challenge for interven- tional pain is looking at how to care for the entire patient,” she says. “It’s not just performing procedures but actually try- ing to ferret out the root cause of the pain. Oftentimes, there are emotional factors or other things that influence the patient’s interest in getting well. “I believe the real win will be to iden- tify red flags that might indicate a patient
has a higher likelihood to move down the chronic pain path,” Thiel continues. “If we are able to identify those red flags and intervene early, we may then be able to educate the patient and set up a plan of care that avoids or minimizes opiate prescription, avoids unneeded surgery and uses imaging only when appropriate, rather than as a routine modality. “We would develop a plan of care
that focuses on identifying the root cause of pain and knocking it out before the patient’s pain advances to the chron- ic point. In my opinion, this is where interventional pain medicine will make its mark in the new health care environ- ment. The ultimate end goal is to do the right injection on the right patient at the right time. And we need evidence to support our work. If we don’t have evi- dence to show our work makes a differ-
ence, I think there will be people who will question the value of our work.” One of the critical steps to accom- plishing this end goal, adds Thiel, is to de- velop and agree upon algorithms of care. “We have several national societies
and there isn’t even agreement among them as to what is the correct algorithm of care,” Thiel says. “Unity among the societies is going to become important if we are going to prove the value of the work done in interventional pain management. There’s a lot of work being done following different algorithms of care, different approaches, different techniques and different data collection, and until we merge our thinking and come to a common agreed upon theme, we are not going to set the gold standard. Setting our gold standard needs to be our goal.”
ASC FOCUS MARCH 2013
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