Building Bridges to Better Healthcare

The Do Nothings

Recently I had a post on LinkedIn that received a lot of attention. The photo was me and my friend, Pascal, at the swim start of the Ironman Puerto Rico. We were kicking off the race at the swim start and both went on to earn a spot in the Ironman World Championship. In the post, I quoted Nick Saban, an old West Virginian and famous Alabama football coach on the interaction of high achievers and mediocre people.

“Mediocre people don’t like high achievers, and high achievers don’t like mediocre people.” - Nick Saban

To cut to the chase, neither prefer the company of the other. I think we could analyze this negatively or positively. I chose to think of this as a challenge. How can we make more of our friends, colleagues, and even those who tend to be negative towards those whom they hold professional jealousy for, better?

I thought I would use this soap box to make a few recommendations.

• If you are a high achiever, never be satisfied. You are one bad move away from going backward. On the other hand, you should ask yourself: Can I raise even higher? And much like Michael Jordan, can you elevate those around you?

• If you are on the cusp of making a major impact, surround yourself with those who have the characteristics of those you want to emulate. Let’s push it to the next level.

• If you are mediocre and you are happy with the average success, be the best you can at the level you are currently, but don’t be negative towards those making an impact.

• A high achiever can make an impact at any level. The best in your town, a key policy maker in advocacy, a great researcher, a mentor to others, or a great skilled proceduralist. Don’t let someone else’s path determine what you should be or do. You be you.

• If we all give support, we can raise the water and raise all boats. We can improve your level of achievement no matter where you are currently if we work as a team. The key concept of ASPN is to find like-minded people who want to root for, encourage, and actively work to make those around them more successful.

• If you are a hater, please join some other society. Our tent is big, but there is no room for you. If you read this and want to change, of course, reach out to us. We are here to help you.

So, in summary, let’s go. We can make life better for patients in the United States and around the world, but we must work to help each other.

ASPN Advocacy & Policy Committee continues to advocate for its members. Here are some of the highlights we would like to share.

I. Cigna and eviCore expand coverage to Closed-Loop Spinal Cord Stimulation: Recently, we submitted comment letters to Cigna and eviCore regarding their Spinal Cord Stimulation medical policy. This letter requested expansion of their coverage for Closed-Loop Spinal Cord Stimulation. With our strong advocacy efforts, both Cigna & eviCore have expanded their coverage for Closed-Loop Spinal Cord Stimulation effective May 1, 2024. Evoke® SCS System is now covered by all major commercial payers and Medicare, providing broad patient access for this important therapy to over 200 million covered lives.

II. Palmetto and Noridian MAC’s proposed a non-coverage policy for minimally invasive approach of SI joint arthrodesis which does not use a transfixation device. ASPN led the charge on testifying during the live meetings and sent letters to both Medicare Administrative Contractors for reconsideration of the proposed language in LCD. The public comment period opened on March 28, 2024. Individual comments can be submitted electronically to Palmetto GBA at A.Policy@PalmettoGBA.com or B.Policy@PalmettoGBA.com no later than May 11, 2024. Palmetto & Noridian cover Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, and Northern Mariana Islands.

III. ASPN collaborated with key stakeholders to meet with members of Congress & Congressional Staff on emerging issue of Independent Review Organizations (IRO). As per healthcare.gov, the prior-auth denial rate ranges between 10–20% per year; there are additional cases where the insurance plan says “no prior auth required” or refuses to provide pre-determination and denies claim after the services are rendered. All such cases go to “Independent Review.” This industry is highly unregulated with no federal oversight. The quality of reviews is highly variable at inter- and intra-state level. This problem is currently in its metaplastic stage and needs urgent intervention to curtail its growth and spread.

IV. Unified voice in Advocacy: ASPN collaborated with Federation for Pain Care Access (FPCA) along with other national and state societies to meet with CMS on March 20, 2024. We advocated for SI joint ablation procedure reconsideration, Facet joint LCD reconsideration, stringent criteria on scope of practice of providers who can perform interventional spine and pain procedures and onerous documentation to meet medical necessity criteria leading to physician burnout.

MARK MALINOWSKI DO, DABPM, FIPP Advocacy and Policy Committee

Using AI and Digital Likeness Technology Can Help in Building Bridges to Better Healthcare

In the ever-evolving landscape of healthcare, the integration of artificial intelligence (AI) has emerged as a powerful tool to enhance patient care. One area where AI shows great promise is in the use of digital likeness technology to better educate and connect with patients.

Digital likeness technology, powered by AI algorithms, allows healthcare use to create realistic virtual representations of ourselves. By utilizing this technology, physicians can communicate complex medical information in a more visually engaging and approachable manner.

Educating patients about their conditions and treatment options is integral to their active participation in their own care. Traditional methods, such as pamphlets and brochures, often fail to effectively convey important information. However, digital likeness technology offers an innovative solution by creating interactive and personalized educational experiences.

By bridging the gaps in patient education and communication, AI and digital likeness technology have the potential to revolutionize healthcare delivery. Improved patient understanding and engagement empower individuals to make informed decisions about their health, leading to better adherence to treatment plans. As physicians treating chronic pain, we know that patient compliance can be just as important as the interventions themselves.

As with any emerging technology, there are ethical considerations that must be addressed. Patient privacy, data security, and the potential for AI bias require careful attention to ensure the responsible and equitable use of digital likeness technology. The Young Innovators should take the lead—as ASPN can help shepherd the safe and effective use of this technology in the specialty of interventional spine and pain medicine.

Diversity … the reason ASPN is ASPN. Bridging many physicians from every aspect of training together is why our interventional society leads all others.

Pain is a very complex symptom that really appreciates the diversity of understanding when it comes to interpreting what is actually producing pain. Having such diversity gives our society the ability to tap into the minds of our members and others, to help better construct medical understandings of what best treatments can be provided to patients.

ASPN is the leader in connecting equal opportunities to its members and fellows, thereby providing the best platform to excel in our industry.

As a member of our society, I can attest to the importance of why diversity means so much. Each committee is carefully selected to give our members the best possible opportunity to create equality in its panel.

We’ve learned along the way that having this diversity gives us a more meaningful understanding of how our patients deal and live with such conditions. Our members tap into their patients’ experiences to better provide treatments to all others

Diversity…is ASPN. I am proud to be a member of our society