ASPN Newsletter Issue 7

Revelation and Revival
Those are the words on my mind for this newsletter. We as members of ASPN, ISPN, and the broader healthcare spine and nerve community are committed to alleviating suffering and improving quality of life in all those we encounter who need our help. Despite this empathy and giving nature that most of us possess, I feel, as I travel around the world, and around social media, that something is missing. There is an emptiness or longing in many of us that leaves our lives unfulfilled, even at moments when we should be elated. What causes this burnout, this dull view, this failure to emotionally thrive? I think I know.

Revelation
Recently a major United States newspaper criticized physicians for making too much money and being too focused on reimbursement. While everyone reading this newsletter would agree that after many years in school and training, much debt, and the application of special skill sets that are rare, doctors deserve to be compensated. We are missing the point. Happiness is not from the measurable, material, and economic bounty, but happiness is much deeper than that, and if you don’t seek it, you will not find it. As I traveled the Serengeti these past several weeks, and swam in the Indian Ocean off the coast of Zanzibar, I came to the realization and yes, the REVELATION, that we are, as modern medicine men and women, missing one of the most important points: you have to let inner peace find you, and this happens by opening your mind, body, and yes, your soul, to a new awakening. For me this was found in the experience of natural beauty and the interaction all things have in a way that impacts so many other parts of the ecosystem. As I watched the great migration, the hunt of the mother lioness, the river journey of the hippo and croc, I found myself thinking that maybe we could be more impactful if we focused on the natural instinct to lend a helping hand, stand by our friends, protect each other from harm, and when needed, bring together all of our strengths and alliances to win the battle when it arises. Inner peace doesn’t always mean harmony, just better self-awareness.

The exact RVU, or the new contract, or in some settings, the seriously complicated process of building a new office or ASC are issues that are so important and lead to many sleepless nights, bad attitudes, and a constant state of unrest. I urge each of you to try to search for the more important inner peace, since the outward things will constantly frustrate you and you will always be in a continuous loop of turmoil. This leads to my call in this newsletter for a revival.

Revival
A revival is a restoration of life, consciousness, vigor, strength, or other valuable inner emotions that lead to a new being. I know based on my experiences this summer and throughout the last few years, it is time for a revival amongst most of those in the Pain, Spine, and Nerve community. We are reviving the field by doing great research, making procedures less invasive, mentoring each other, and creating new standards. You will see this commitment in the NEURON projects, highlighted by David Lee in this newsletter, but I ask that you demand more of yourself and your friends.

Let’s set some revival goals.

1. Make yourself a better person by finding something that gives you a new mindset. That could be travel, exercise, meditation, or prayer. Find your “thing” and master it.
2. Make your fellow members of ASPN and ISPN better people by bringing a revival of support and inclusiveness that overcomes all hurdles. Commit to a revival of community and love for your friends, and yes, even for your enemies.
3. Make the world better for your patients, family, and those you encounter. That is why ISPN is such an important part of the makeup of ASPN, in that we need to improve access to care, quality of care, and have a resolve to help more people and colleagues as we go on our journey.

So I leave you with a hope to have a revelation to have a new inner peace, and do whatever it takes to get yourself to a better place. If you find that hard to achieve, lean on your friends at ASPN, and make our community even greater. The ASPN family is real; all you need to do is join it and make your mindset towards being a positive force.

Lastly, resolve to have revival to make everyone around you better, and remember that journey starts with love.

See Y’all in Dubai.

Tim Deer, MD

Friends and Colleagues,

As Immediate Past-President, I’d like to thank all our sponsors, meeting administrators, planning committee members, and especially our delegates for the execution of a wonderful and highly successful Annual Meeting this year in Miami. I continue to be impressed with the quality of the scientific program, the caliber of the membership, quality and diversity of our sponsorship, and the investment and attention of our registrants. We welcomed over 2,200 Health Care Professionals, with an impressive 75 sponsors, many of which supported our Best-in-Class Training Lab Experience. Our lab supported 150 fellows and 70 Master’s Class attendees, and nearly 70 APPs attended the dedicated Advanced Practice Provider tract. Our scientific program offered visibility on over 300 clinical and scientific abstracts, many of which received a research podium opportunity. This unparalleled growth and excitement are built on your active participation. We all have the responsibility to maintain our patient-centric stewardship of our space, focused on safety, efficacy, and patient access.

I look forward to next year with confidence that the ASPN Annual Meeting will continue to be THE PREMIER meeting in the WORLD to lead the science, network, and culture of our pain, spine, and neuroscience community. See you there.

The Pain Unfiltered podcast Season 1 kicked off on July 6th 2023. Tim Deer and I go indepth into the interventional pain and spine world with some of the top key opinion leaders and executives in the space. We have had some great discussions with some special guests in the first 3 episodes.

In Episode 1, Dr. Dawood Sayed talked about how ASPN was founded and named. We discussed how the society has grown so quickly in just 5 years and its plans for the future.

In Episode 2, ASPN president, Dr. Erika Petersen, discussed ASPN’s partnership with the NFL and the NFLPA. We also talked about why we’re focused on posttraumatic headaches and our reasons behind using CBD and non-invasive vagal nerve stimulation as treatment options.

In Episode 3, we announced our first sponsor, Mainstay Medical, for Season 1. Our guest, Painteq President, Michael Enxing, gave his advice to newcomers in both the medical device field and physicians looking to partner with industry. He talked about why he and his companies choose to partner with ASPN. Finally, he discussed his vision for Painteq and the interventional pain space moving forward.

Season 1 will consist of 10-12 episodes being released every other week. Please tune in! We hope you enjoy!

NEURON is the next evolution for ASPN education and advancement. NEURON is an evidence-based published series which will be an international multispecialty collaborative effort. Topics will be germane to the fields of spine and pain management. The inaugural paper, “Pain Education and Knowledge (PEAK) Consensus Guidelines for Neuromodulation,” is led by Dr. Scott Priztlaff. PEAK was created from the need to establish a standard of competence for accredited, fellowship-trained physicians regarding the ever-growing field of neuromodulation.

Additionally, ASPN has been busy formulating a guidelines paper on the management of patients suffering from Painful Diabetic Neuropathy (PDN). The “SWEET” Guidelines will be the first of its kind—including evidence-based recommendations on pharmacological, interventional, topical, as well as alternative therapies.

Future NEURON publications will be available in late 2023 and early 2024 and will address topics such as non-surgical back treatment, closed-loop neurostimulation, minimally-invasive and surgical treatments for lumbar spinal stenosis, regenerative medicine, and endoscopic spinal procedures.

2023 has been an incredibly successful year for the Young Innovator Section with over a 100% increase in membership growth from the previous year.

It represents the fastest growing section at ASPN. Drs. Ryan Budwany and Nasir Khatri have been closely working with the YI board to broaden the reach of ASPN and will be hosting webinars on board preparation and early career education in partnership with Pain Exam as well as a webinar on ultrasound guided procedures in partnership with WAPMU in the last two quarters of the year.

We are looking forward to further involvement from all our members!

The ASPN Poster to Podium Program (P2P) is a signature 12-month program for young professionals interested in mentorship, research, and career growth.

The program consists of webinars, research project development, public speaking coaching, and mentorship pairing. The focus is to promote physicians to be the next generation of Key Opinion Leaders (KOLs) in our field and future faculty for ASPN.

The deadline for this year’s class is rapidly approaching. Submit your application by August 30th to have the opportunity to participate in this one-of-a-kind program. As part of this program, your research project will be presented as an oral presentation at the ASPN Annual Meeting in 2024.

We hope to welcome many previous participants as faculty to facilitate the continued growth of this program. If you have any questions, please contact Dr. Melissa Murphy or Dr. Ashley Bailey-Classen.

Updated Language for Category I PNS and SCS CPT Codes: Here is the summary table of updated Category I CPT codes for your review.

Posterior SI Joint arthrodesis CPT code updates: Effective January 1, 2024 Category III CPT code 0775T, aka posterior sacroiliac joint fusion, is converting to a Category I CPT code. CPT code 0775T is described as ‘percutaneous arthrodesis of the sacroiliac joint (SI) using placement of intra-articular implant(s) without placement of a transfixation.’ 2X000 is the placeholder for the new Category I CPT code being converted from 0775T with the actual number scheduled to be formalized in November when CMS promulgates their final 2024 Medicare rules.

In addition to CPT code 2X000 being able to be performed in the ASC or hospital outpatient department, CMS has proposed non-facility RVUs which will allow the procedure to be performed in the office (non-facility) place of service (POS) in 2024.

TRICARE to adopt Medicare reimbursement policy for ASCs: On April 4th, 2023, TRICARE published the Reimbursement of Ambulatory Surgery Centers and Outpatient Services rule.

Effective, October 1st, 2023, TRICARE is adopting the Medicare reimbursement methodology for Ambulatory Surgery Centers (ASCs). Adoption of Medicare’s ASC reimbursement system will bring TRICARE reimbursement for ambulatory surgery care into alignment with the statutory requirement that payment methods for institutional care be, to the extent practicable, in accordance with the same reimbursement rules used by Medicare. Reference Section 2, Ambulatory Surgical Center (ASC) Reimbursement for Service on or after October 1, 2023. This will improve access to evidenced based therapies for our veterans with significant cost-savings to the program.

We continue to work tirelessly for our members. Please feel free to reach out if you have any policy related questions in your region.

It is with gratitude and great humility that I write to you from this space. I commend Dr. Jason Pope for his leadership as he concludes his successful term as president. Under his watch, ASPN has continued to grow immensely. My goal is to maintain and grow the momentum that has built ASPN into the premier pain and neuroscience society. We will continue to promote new, unique programs that advocate for our patients and advance our knowledge as I serve ASPN and our membership.

A spirit of innovation and openness is part of ASPN’s DNA. Now is the time to get involved. Many of you have already connected with ASPN to contribute your talents, and there are numerous ways to participate. You can help with advocacy efforts, help organize and produce our new program of short educational videos for both patients and clinicians, help coordinate our research to webinar education options, and we are always developing new services and content to benefit our members. To find out how you can be involved, just reach out!

Congratulations to our scientific program and meeting planning committee volunteer members on the success of our 5th Annual Meeting last month. A record number of attendees and a new venue marked the weekend, which included hands-on lab sessions, panel discussions, and the now-infamous White Party with DJ Doc. With the Meeting slowly receding and our daily routine resuming, it is time to think forward. What next? Of course, both ISPN 2023 and ASPN 2024 meetings await, but our society has much more to offer throughout the year thanks to the rich expertise and energy of our members. I hope you will answer this call to action and find a way to contribute your skills to making ASPN better.