Growing Pains

Clinical innovations and business trends in ASC pain management BY ROBERT KURTZ


ain management is ripe for signifi- cant growth in ASCs, says Ronnie

Pennell, executive vice president and chief operating officer for PhyBus in Brentwood, Tennessee. To support this belief, he points to the history of gas- troenterology (GI).

GI procedures used to be predomi- nantly performed at physician practices, Pennell says. “As gastroenterologists became more comfortable performing higher-acuity procedures—thanks, in part, to advancements in technology— and payers became more accepting of these procedures in ASCs, we saw a gradual movement out of the practice setting. Now, GI is synonymous with ASCs. I see a lot of correlation between GI and the future of pain management.” Amy Mowles, president and chief

executive officer of Edgewater, Mary- land-based Mowles Medical Practice

Management, shares that optimism for ASC pain management. “ASCs are where pain management belongs. If a physician is providing counseling, medication management and referrals to alternative care, those services are fine in an office. Invasive procedures do not belong in an unregulated envi- ronment. ASCs have the policies and procedures for infection control and safety that help ensure patients receive quality care.” Pain management physicians typi-

cally fall into two categories, Pennell says: those who see patients on an ongoing basis in their practices and often rely upon medications for treat- ment, and those who are increasingly making their way into ASCs to provide proven surgical procedures. “These are typically physicians who are looking for patients that are


seeking a procedure to help man- age or cure their problems,” he says. “If patients’ illnesses are managed or cured, they do not need to come back to see their physicians as often. ASC physicians are focusing on not just providing monthly medication to make a patient feel better for a little while, they [also] are pursuing treatments that can make patients feel better for much longer, even the rest of their lives.” The opportunity to provide such life-changing care motivated Michael Fujinaka, MD, a pain management specialist and surgeon, to open his own ASC with a physician partner. His single-specialty surgery center, Apex Ambulatory Surgery Center, is sched- uled to open in Foster City, California, by the end of 2018. “We have seen the evolving pres- sure in the pain marketplace to fight back against the overuse of opiates and offer viable alternatives,” Fujinaka says. “That is where services like those that will be offered in my ASC comes in. Instead of just giving patients an

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