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treatment outcomes; and loyalty from your patients and referring physi- cians. Make effective use of ancillary staff time and the strengths these indi- viduals offer. Build external credibil- ity through promotional activities and educational public relations. Become a resource for others on pain management. Discuss new tech- niques and recent successes.

Words of Wisdom and a Warning You should be well versed in all types of pain management procedures. You don’t have to offer all of these proce- dures and should provide only those for which you are well trained. All staff must remain alert. Highly anxious, somatizing or angry patients are probably not good candidates for procedures in your ASC.

Bringing on New Physicians Conduct mandatory peer references and verify the information physicians provide in their application for privi- leges by looking up their state license and running primary and secondary verification sources such as the Na- tional Practitioners Data Bank (NPDB) and the American Medical Associa- tion. Don’t be shy about looking over a new physician’s work. Watch for warning signs of poor care, a failure to return calls or answer pages, frequent complaints and mishaps that could be avoided with precautions.

Office vs. ASC Health departments in 26 states and Washington, DC, have


over office-based surgery and require physicians’ offices where pain and oth- er outpatient procedures are performed to meet various thresholds based on the levels of anesthesia provided and the complexity of procedures performed. Often, a license, state registration or accreditation is required.

Accreditation for office-based sur- gery requires the same financial in-


Watch for warning signs of poor care, a failure to

return calls or answer pages, frequent complaints and mishaps that could be avoided with precautions.”

—Amy Mowles, Mowles Medical Practice Management LLC

vestment and the same investment of time and resources that an ASC needs to make to meet the standards and participate in ongoing surveys that evaluate compliance. Office-based accreditation on its own will not give a physician who performs pain man- agement procedures in his or her own office the right to collect facility fees. Local and state law and third-party


Visit to get your copy of Amy Mowles’ webinar “How to Keep Pain Management Cases in Your ASC.”

payer policies (commercial and work- ers’ compensation) typically require the facility to be licensed and certified before facility fees will be paid. “Doing pain management proce- dures in an ASC has many signifi- cant benefits,” says Jayen Patel, MD, owner of Tulsa Ambulatory Procedure Center in Tulsa, Oklahoma. “Patient safety is at the heart of this issue. That involves everything from the physical space and infection control to having the most qualified staff in the proce- dure room and recovery area. Having no regulation in the physician’s office entitles anyone to wear a white coat and give the public a sense of false safety. The cost compared to having a procedure in the hospital is also enor- mous. This is why I feel all insurances and states should mandate that pain management procedures be done in, at minimum, an ASC or accredited of- fice space.” Julien Vaisman, MD, president/med- ical director of New England Pain Care Inc. in Peabody, Massachusetts, agrees. “The ASC has created a new and fas- cinating model for the pain physician, affording the patient different new op- tions from what was available in the ‘good old days’ when spinal injections were done in the operating room of a hospital that was not ready to handle the short in-and-out pain procedures. Today patients can find a safe, intimate, pleas- ant, efficient and ‘customized’ environ- ment in a well-run ambulatory surgical center for pain procedures.”

Amy Mowles is the chief executive officer and president of Mowles Medical Practice Management LLC in Edgewater, Maryland,

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