ASPN Newsletter Issue 12

Introduction:
Reflecting on the significance of our recent election, I’m reminded of one of my favorite political figures, Theodore Roosevelt. Roosevelt had many accomplishments, but my favorite two things he did were the establishment of national parks, a place for us to enjoy the amazing natural world, and his ability to call out those who were always critics. He pointed out that if you are not in the arena, your criticism does not count. To quote this legendary figure:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

The highlight of my career has been helping patients. When I see someone have a life-changing therapy, I begin to reflect not only on how much we’ve impacted the individual’s life but also the family and friends they interact with daily. Let’s not forget the way this can impact their purpose in society. This is true when we offer an intervention but also on a larger note when we design or execute a study, teach a course, or give advice to our peers.

We are in a life-changing field, and that is our purpose. That is the primary reason the American Society of Pain and Neuroscience exists: to further promote the never-ending chain of people who help each other and, at the endpoint, help the patient and those who care about that person. To do this, we must foster new leaders and help grow those individuals who can guide opinion, research, and teaching. This doesn’t come without a cost. As early-career physicians, you must ask yourself if it is worth the price to build the type of life resume that makes you influential in the arena.

Dual Goals:
As noted above, the goal of a patient-centric focus is our mission, but we have a second high-value target for success. We strive to improve the success and impact of each of our members, whether you are a physician, advanced practice provider, scientist, fellow, resident, student, or a member of the industry. If I can help you be a better version of yourself, I have done a service to all humankind. What is in it for the person providing the support? Is it worth your time, effort, and extra work just to help someone else’s career? Only you know the answer to this.

The Return on Your Investment
Some may wonder why we spend many days traveling as volunteers to advance the field. The time investment can be overwhelming, and even when consulting, the fair market value rarely compensates for the “time lost” total cost. So, what is “the why”? Why should you go the extra mile, travel the extra flight connection, or miss important personal events? You need to check yourself and your mission to life balance.

Here are some questions you should ponder if you want to be a society leader or a key opinion leader in the field of Interventional Spine:

1. Do I have a genuine goal to make life better for patients and their inner circle?
2. Do I have a genuine goal to make society better from the standpoint of more functional and productive people?
3. Do I have a partner or significant other who will support me emotionally as I travel and spend endless hours working on my mission?
4. Do I have a mission that drives me to impact the lives of the many people I will meet, as well as the thousands of individuals who I will never personally interact with but who benefit from my broader work?
5. Are you willing to give up many family and social events because you are “teaching that weekend”?
6. When you look back years later, will you find satisfaction that your work has been impactful, or will you resent the time away from your family?
7. Are you willing to spend many nights away from home, write many chapters and articles without payment, and mentor people you may never see again?
8. Do you possess a certain set of skills that make you unique and valuable to advance the field?
9. Do you possess a desire to make all your colleagues better and take pride in seeing your friends succeed?
10. Can you handle criticism for your work, even when it comes from those with little accomplishment or contribution themselves?

We need many new young leaders to carry the banner of our field as it continues to grow, evolve, improve, and become a force in advancing human function. If you’re equipped to stand up, put in the work, and demand more every day from your skills, reach out to me and the leadership of ASPN.

We are here to help you in your growth and development. We are a community committed to the mission of improving patient safety and efficacy while creating more impactful people to help us lead the way of innovation and development of new medical technology. Much like Teddy Roosevelt, we are the disruptive and early to adapt to change.

I am grateful to share my journey in an Interventional Spine and Pain Management fellowship, where I’ve had the invaluable opportunity to learn and practice what I truly love.

The first 100 days of my fellowship at the Cantor Spine Center under the mentorship of Dr. Anthony Giuffrida have been nothing short of transformative. Immersed in an environment rich with clinical variety and advanced procedural techniques, I’ve quickly recognized the depth and complexity of this specialty.

Each day brings new challenges, offering an invaluable opportunity to deepen my understanding and refine my clinical approach. This exposure has expanded my procedural skill set and instilled a sense of confidence and precision that I carry forward with each patient encounter.

The work is undeniably challenging, yet every day reinforces how fortunate I am to be at this point in my career. It is truly a privilege to wake up each day, knowing I am actively engaged in what I am passionate about and surrounded by a supportive team that shares my commitment to excellence in patient care.

These first 100 days have reinforced my gratitude for the path I’ve chosen and my eagerness to continue learning and growing in this field.

The ASPN Young Innovators Committee is a dynamic group of dedicated early-career ASPN members focused on supporting professional development and creating networking opportunities. They foster mentorship, provide educational resources, and work to expand ASPN’s reach and diversity for the next generation of physicians in interventional spine, pain, and neuroscience.

We are excited to welcome the four new Young Innovators Co-Chairs: Vinny Francio, Anuj Shah, Yussr Ibrahim, and Kelsey Gustafson, along with our international Young Innovators Chair, Harry Soar. They will lead a leadership council of 22 early-career physicians on four major initiatives: research, mentorship, membership, and education.

Please join us at the upcoming Young Innovators’ Webinars:
Dec. 17, 8:30 pm, EST, Lumbar MRI: Understanding the Basics to Facilitate Interpretation
Jan. 14, 7:00 pm, EST, Journal Club: ASPN Peripheral Nerve Stimulation Guideline

We recently kicked off the 4th annual Poster to Podium program, which continues to be a world-class physician development program, thanks to Dr. Erika Peterson’s leadership and vision.

This year we received 37 strong applications, and nine physicians were accepted into the program. Congratulations to Michael Appeadu, Jack Bulat, Roshan Chhatlani, Jason Crowther, John Gallagher, Benjamin Gill, Abhishek Gupta, Roshni Patel, and Boss Povieng!

The P2P physicians will participate in monthly education meetings in research, public speaking, career development, and personal branding. They will work with their mentors on a research project and present their research at the ASPN 2025 Annual Meeting.

ASPN Advocacy & Policy Committee continues to advocate for all its members and the subspeciality of interventional pain and neuroscience.

• Palmetto MAC proposes non-coverage of intradiscal biologics in their LCD – Intervertebral Disc Repair (DL39942) and Related Draft Billing and Coding Article (DA59866):

ASPN submitted a response letter opposing the non-coverage guidance from Palmetto Medicare Contractor for intradiscal biologics like Via Disc. It is imperative that we remain unhampered in our ability to collect valuable real-world data about utilization and clinical adoption of VIA Disc under code 0627T.

• CMS released its Physician Fee Schedule on Nov. 1, 2024. Some of the key aspects are summarized here.

1. 2025 CONVERSION FACTOR: The final 2025 conversion factor will be $32.34, a decrease of $0.94 from the current 2024 factor of $33.29. This decrease is due to a 0.05% positive budget neutrality adjustment and the removal of the temporary 2.93% payment increase for services provided from March 9 to December 31, 2024, as outlined in the Consolidated Appropriations Act of 2024.

2. TELEHEALTH: CMS will continue to support telehealth services in 2025 by extending several important waivers. These extensions include:

• Allowing healthcare providers to use their practice address when providing telehealth services from home.
• Enabling federally qualified health centers and rural health clinics to bill for telehealth services.
• Permitting remote supervision for residents in all teaching settings when providing virtual services.

3. DRUGS AND BIOLOGICAL PRODUCTS PAID UNDER MEDICARE PART B: CMS is finalizing a new rule requiring the use of the JW modifier for drugs billed under Part B when a portion of the drug is discarded during preparation but not administered to the patient. This is in addition to the existing rule that allows for refunds on discarded portions of single-dose or single-use drugs.

Senators Bill Cassidy, R-La., and Maggie Hassan, D-N.H., Nov. 1 released a policy framework detailing a plan to impose site-neutral payments on hospitals. Siteneutral payment policies would require Medicare to pay the same rate for services delivered regardless of the care site. Medicare payment rates currently recognize fundamental differences between patient care in hospital outpatient departments compared to other settings. This policy framework will level the playing field and lower the cost of healthcare. While this is vehemently opposed by American Hospital Association (AHA), ASPN supports this initiative and encourages its members to reach out to their respective representatives/congressman to seek support for this bipartisan herculean task.

International engagement remains our most significant growth area within the organization. Following the success of our inaugural ISPN meeting in Dubai in 2023, we are excited to build on this momentum with an even larger and more impactful gathering in London in 2025.

The theme for the 2025 Bi-Annual Meeting is “Uniting the Kingdom of Pain and Neuroscience.” This event will bring together international leaders from diverse specialties to advance patient care and scientific innovation.

The program will feature:

• An advanced hands-on cadaver lab.
• A dynamic three-day agenda highlighting groundbreaking topics in neuromodulation and minimally invasive spinal therapies.

Our goal is to foster collaboration within the global community as we continue to elevate the education of clinicians dedicated to treating patients with pain and neurological disorders. Save the date for this marquee international educational event in 2025. We look forward to welcoming you in London!

“Not for people like me.”

Several of our colleagues have shared stories of outsiderism, feeling isolated or overlooked at conferences. Having been a neurosurgeon in the midst of a clique of pain physicians, I can relate. It all starts somewhere, and at ASPN, we’re committed to creating a different kind of community—one that’s inclusive, open, and exciting.

We have worked hard to foster a welcoming, open environment with ASPN through creative programming and numerous opportunities to benefit from involvement with our society. We’re building a community where everyone feels valued, inspired, and empowered.

Our recent Collaboration Council meeting in Nashville was a powerful example of what we can achieve together. A diverse group of brilliant minds came together to spark innovation and drive progress in pain management. The energy was contagious as we explored groundbreaking ideas and forged new connections. Our panelists emphasized the importance of innovation, communication, and coordination among clinicians, industry, and regulatory stakeholders to improve patient outcomes.

Diversity is our superpower. By embracing different perspectives, we can unlock groundbreaking solutions that will transform patient care. We enrich our discourse by building a large, knowledgeable community. Diversity fuels innovation, and by bringing together varied perspectives, we can accelerate progress and make breakthroughs.

Our upcoming Annual Meeting in Miami, themed “Embracing Disruption, Driving Innovation,” is your chance to be part of this exciting journey. We have so many opportunities to improve how we diagnose and care for patients with pain conditions. Applications of big data, virtual reality, and artificial intelligence will allow us to innovate further.

What better venue for bringing these concepts to up-and-coming fellows and residents than through our panels and renowned lab experience at the Annual Meeting!

Join us as we push the boundaries of pain management and create a brighter future for our patients. Let’s inspire each other, collaborate fearlessly, and make a lasting impact.

Mark your calendars now to join us for a vibrant discourse in Miami. In the meantime, please share your thoughts and ideas for how else we can build and expand our impact for our patients, our service to our membership, and our welcome to our colleagues. Together, we can shape the future of pain management.