ASPN Newsletter Issue 14

Recently, I ran a tough 50-km. race, with more than half of it in loose sand. Subsequently, at the 20- km. point, I surged by my age group competitors, and once by them, I gave a smile and accelerated. I was in pain, and suffering, but I didn’t show it to my competitors because I wanted them to know that the race was over. I wanted to disrupt their mind and make them give up any hope and leave no doubt.

I went on to win my age group, finish 6 overall, and break the course age group record by more than an hour. Once I was in this potentially enviable position, I celebrated for a few hours and then went back to work for the next competition.

We can never rest on our laurels when there are more conflicts ahead, and I enjoy the battle. I enjoy being in “the arena” to quote Teddy Roosevelt.

Why do I bring up this potentially unrelated running story in the Chairman’s Corner this month? For those who practice interventional spine, we are in a complicated multistage race.

The race to have patient access for innovation that can be life changing. The race to make things less invasive, of lower risk, and with equal or better outcomes than the alternative larger surgeries, is a real struggle. The race to invent new options, establish a code, get through the RUC process, to win unfair local carrier determinations, and to grow and prosper as a field is a clear and present danger.

This is a call for my colleagues in our space to be disruptive. Disruption is defined as an act of interrupting or preventing something from continuing as normal. To put that in perspective, there are a lot of things that we need to disrupt. To name a few issues to consider:

1. The Opioid Crisis.
   We have already made a huge impact on this with earlier and more successful interventions to reduce the number of patients who ever need to be treated with addictive substances.

   In the next 12 months, I will work with colleagues to publish big data showing how neuromodulation devices significantly reduce opioid requirements over a 60-month outcome period.

   The use of big data to create nonbiased and indisputable evidence is a critical part of our journey. In addition, we must train young physicians and referring doctors to consider proper interventions before going down the road of oral medications and medical management. More and more outcome studies show that medical management equals ongoing reduction in function.

2. Minimally Invasive Spine (MIS) Procedures.
   When I performed the first non-surgeon based minimally invasive lumbar decompression 16 years ago, it was controversial and disruptive.

   Similarly, when Dr. Chris Kim and I joined the Vertiflex level one RCT, it was controversial and disruptive as we were the only group without a spine surgery background.

   Little did we know that we were in the beginning of a revolution. A revolution with new devices, indications, and patient selection requirements. In order to win this revolution, we need to continue to build data, improve education and mentoring, and be careful with our patient selection. We need to leave no doubt that in the correctly selected patient, MIS is the goal.

3. Career Mentoring.
   The mentoring model in the United States and the international community is broken. We see young physicians leave training and often enter the abyss. A zone of stagnation where skill advancement is rare and outcomes remain in a static zone. The goal of ASPN is to disrupt this model.

   Working with the best in both the USA and worldwide, we will introduce a new model of mentoring in July that breaks the mold and will include an umbrella of training for the post fellow or post resident that is unbeatable and really makes an impact. Whether you serve as an expert and mentor or are getting mentored by someone, this will be a major positive disruption.

4. Organized Medicine.
   Fixing the Broken Society Model. The society model is broken in pain medicine. We have too many societies, too many confusing agendas, and too many egos and personalities to ever fix our specialty.

   In addition, we have amazingly hypocritical society leaders who “have no conflicts” and do not like Industry in public. Privately, they ask Industry for large educational and meeting grants. And while they claim to have “no conflicts,” they stay in hotels funded by industry support, book travel paid for with industry money, and carry biases that last long after they’ve recused themselves from consulting.

   Our disruptive goals: ASPN will aspire to be the society of those who will partner with other physicians, APPs, neuroscientists, and Industry to help all of our members advance and succeed. This will be done in a transparent and open manner with bias towards none but enthusiasm toward all ethical and driven parties to move the field forward. This will be our disruptive mission.

   As for those societies who have lost their way or have lost the mission or become hypocritical in the process, Industry should vote with their support. Do not support those who do not want to make collaboration part of the culture.

5. Collaboration.
   In addition to industry collaboration, we strive to increase collaboration with other specialties. Recently, we have had some huge wins by partnering with like-minded people. Our partnership with our friends in radiology and like-minded progressive spine surgeons has led to major advancements. In 2025, you will see world leaders in both areas join the board of directors for ASPN. Collaboration will be our new and ongoing disruption.
6. International Outreach.
   We plan on disrupting the way education is done in the international community. Our work in Dubai last year was instrumental in meeting a new community of wonderful people.

   That goal continues in 2025 and beyond as we go to London, and then plan future meetings in Germany, Spain, the Netherlands, Middle East, and Latin America.

   ISPN will become an independent but aligned organization in 2026, and the revolution of disruption will continue in a worldwide way that will change spine and nerve care forever.

Reflecting on Two Years as Social Media Committee Chair

As the ASPN Social Media Committee Chair for the past two years, I have had the privilege of leading a dedicated team in expanding our society’s digital presence and engagement. Our committee has played a crucial role in keeping members informed, sharing the latest developments in our field, and fostering a sense of community through online platforms.

From promoting groundbreaking research to highlighting key moments from our annual meetings, we have worked tirelessly to ensure ASPN remains at the forefront of digital outreach. It has been incredibly rewarding to see our engagement grow and to witness the impact of our efforts in strengthening connections among members.

As I prepare to step down following the annual meeting in July, I am proud to pass the torch to an outstanding new leadership team. Nikhil Verma will take over as chair, joined by co-chairs John Gallagher and Andrew Goldblum. With their expertise and passion for outreach, I have no doubt that they will continue to elevate our social media presence and build upon the strong foundation we have established.

The role of the Social Media Committee is more important than ever, serving as a bridge between members, the public, and the broader medical community. I look forward to seeing how the committee continues to evolve and grow under their leadership.

While I will miss leading the Social Media Committee, I am excited to take on a new challenge as the Vice President of Communications and Outreach. This new role will allow me to further advance ASPN’s mission by overseeing a broader range of engagement strategies and communication initiatives. I am deeply grateful for the support and collaboration of my colleagues over the past two years, and I look forward to continuing to serve the society in this new capacity. Thank you to everyone who has contributed to our social media efforts—your enthusiasm and participation have made all the difference!

As a PGY-4 PM&R resident and incoming pain fellow, I am thrilled to begin my journey in pain medicine. However, stepping into such a vast and rapidly evolving field can be both exhilarating and daunting.

With the continuous advancements in interventional techniques, novel therapeutics, and groundbreaking research, the sheer breadth of knowledge can feel overwhelming. Fortunately, the American Society of Pain and Neuroscience (ASPN) has been instrumental in easing this transition.

ASPN fosters an environment of innovation, mentorship, and collaboration, making it an invaluable resource for trainees. One of its greatest strengths is its commitment to residents and fellows, including offering free membership that encourages early engagement in the field.

Through ASPN, I have built meaningful connections, participated in committees, and developed leadership skills that have expanded my knowledge and confidence.

ASPN has provided me with many tools to begin navigating the complexities of pain medicine, reinforcing my passion for the specialty and preparing me for the exciting road ahead.

The Advocacy & Policy Committee (APC) has made significant progress in representing our members and advancing patient care through timely and strategic advocacy. Below are highlights of recent accomplishments and summaries of key communications:

1. ASPN provided the first and most expeditious societal response to the most recently published BMJ article:

• ASPN was the first society to issue a rapid, detailed response condemning the BMJ guideline by Busse et al., citing critical statistical flaws, specialty bias, and misleading risk assessment.
• The letter called for retraction of the guideline, warning that its flawed methodology and recommendations could restrict access to evidence-based, non-opioid pain treatments and harm patients.
• ASPN emphasized the need for scientific integrity and accurate representation of interventional pain therapies in high-impact publications.

2. ASPN’s representation as Interested Party at AMA CPT:

• ASPN commented at the most recent AMA CPT special meeting discussing challenges with Peripheral Nerve Stimulation (PNS) coding and its impact on access to care for evidence-based, non-opioid treatment options for chronic pain management, as well as ongoing confusion around appropriate coding for “integrated” vs. “non-integrated” systems.
• We also commented on the ongoing challenges with SI Joint coding in relation to the work done in performing different approaches to SI joint arthrodesis and how interventionalists (interventional pain management, interventional radiologists, interventional spine, etc.) perform more of this procedure than orthopedic spine and neurosurgeons, making them critical stakeholders in providing appropriate guidance on coding scenarios.

3. ASPN’s Letter to Medicare Administrative Contractors (SI Joint LCDs):

• ASPN formally objected to the finalized Local Coverage Determinations (LCDs) that deny coverage for minimally invasive SI joint arthrodesis without transfixation devices, citing procedural errors and outdated evidence.
• The letter detailed inaccuracies in the LCDs’ analysis, highlighted the comprehensive and up-to-date ASPN 2024 guidelines, and compared them favorably to other societal guidelines.
• ASPN requested immediate withdrawal of these LCDs and called for a collaborative conference to ensure policies reflect current evidence and best practices in SI joint care.

Thank you for your continued support and engagement as we work to ensure evidence-based, patient-centered policies for pain and neuroscience care.

Can AI and Automation Drive Revenue Growth in Pain Practices?
A New Study Takes a Closer Look

For pain clinics, growth depends not just on generating leads—but on how well systems follow up, engage, and convert them.

I’m a doctoral researcher studying how AI-personalized messaging, marketing automation, and workflow coordination affect conversion, reactivation, and early retention in interventional pain practices. I’m currently recruiting US-based clinics for a 90-day field study.

Participating clinics will use a customized tech stack designed for AI-driven communication, automation, and performance tracking. A comparison group will help establish a baseline for evaluating impact. I’ll also be interviewing clinic staff to better understand what supports or blocks adoption.

Preliminary patterns suggest that aligning marketing, messaging, and operations may be more important to revenue than reach alone.

I’m sharing this now to invite conversation. If your clinic is exploring automation, navigating followup challenges, or just wants to better understand what works, I’d love to hear what you’re seeing on the ground.

Contact at nicktryan@gmail.com

Contact: nicktryan@gmail.com

ASPN Diversity and Outreach Impact Expansion

ASPN is dedicated to leveraging its potential by embracing diversity. It is well-known that a diverse collaboration allows a well-rounded perspective that adequately captures the needs of the communities we serve.

We are excited to embark on a very important component called the Leadership Council to assist us in making this committee a more important section of ASPN. This will allow us to expand our impact to grow and enhance our membership.

With that being said, we would like to appoint some great colleagues to be part of this team. Please welcome our talented team!

• Diversity and Outreach Leadership Council Vice President: Dr. Jordan Tate
• Chair: Dr. Johnathan H. Goree
• Vice Chairs: Dr. Latrice Akuamoah and Dr. Eric Cornidez

We are excited to bring this group together to synergistically expand this committee’s impact on ASPN’s commitment to lead us to an age of scientific enlightenment.

As I reflect on our incredible profession, I am reminded that sometimes we must celebrate on where we have come over the course of the last decade to understand where we are going. Some compare our journey to where interventional cardiology truly became a force to be reckoned with in heart disease management.

We have seen incredible advances in minimally invasive therapy options, restorative neurostimulation, peripheral nerve stimulation, regenerative medicine, spinal cord stimulation, wearable therapies, to name just a few. With more therapy options, we are reminded that our definition of the pain management physician and their identity is evolving and changing. It’s not only critical to understand our role in pain, which affects one-sixth of the human population, but also our role in healthcare.

Today, we are in an unprecedented time where we are forced to re-establish our identity among our colleagues, insurance companies, industry, and other medical disciplines.

The next two years, we as a society have a unique chance to tackle and reshape where we wish to be. To me, that starts with a vision focused ultimately on patient access. Access requires better insurance coverage and policy, better educational guidance and rubric for pain management fellows, more focus on data standardization across newer therapy options.

The foundational three pillars of education, research, and policy are critical to moving key stakeholders that will eventually provide greater patient access. We must re-instill being proud of what we are doing and contributing to the movement of our specialty.

We must take this opportunity to shape our specialty, not as 55 national societies, but as one unified voice.

ASPN is ready to take that charge and its members should be proud of what it’s accomplished and what it’s going to continue to accomplish in the next two years.

I look forward to working with all our members and leadership team to drive that vision forward.