7 key challenges in pain management today & how to stay competitive

Written by Mackenzie Garrity | November 14, 2017 | Print  |

In the always-changing healthcare industry, it can be challenging for physicians, hospitals and health systems to remain competitive.

Kenneth Candido, MD, of Chicago Anesthesiology Pain Specialists, is a leader in pain management and discusses how pain management specialists can remain competitive through the next decade of challenges.


Dr. Candido will be speaking at the Becker's 16th Annual Future of Spine + The Orthopedic, Spine and Pain Management-Driven ASC Conference. To learn more and register, click here. Contact Maura Jodoin at mjodoin@beckershealthcare.com or Kristelle Khazzaka at Kkhazzaka@beckershealthcare.com for further information about sponsorship and exhibitor opportunities.


Question: What current challenges do pain management specialist face and what challenges will specialists face over the next decade?


Dr. Kenneth Candido: Some of the challenges include shrinking reimbursements for the same level of service provided and non-certification of interventional pain management procedures based upon flawed literature citations that are biased and skewed.


Other challenges include:


• Over-emphasis on reducing opioids across the board for all patients, based upon the reversal of thinking and a huge paradigm shift that we did not create, but which was thrust upon us by the Joint Commission and other regulators, who insisted that pain was a "vital sign" that needed to be chased.

• Increasing scrutiny by oversight agencies who continue to prosecute and harass legitimate pain practices as they 'weed out' the illegitimate.

• Ever punitive 'anonymous' patients who trash us on social media doctor-rating sites, largely without merit, and typically following our discontinuing their opioid prescriptions.

• Increasing the flow of patients per day, which necessitates that we spend considerably less 'face-to-face' time per patient to maximize productivity while reducing the personal touch they crave.

• Reliance upon the electronic medical record, which as several negative effects, among which are a reduction in the accuracy of reporting changing clinical scenarios in light of a "cut-and-paste-from-one-visit-to-another-to-save-time" mentality required to be efficient.

• Increasing costs as we scramble to hire additional office staff to navigate the increasingly complex landscape of the ICD-10 system.


Q: How can physicians, hospitals and health systems remain competitive in an ever-changing industry?

KC: Physicians and hospitals and healthcare systems are likely to only remain competitive by consolidating their services, hiring lower level and less skilled employees to act as surrogates, extensive use of physician-extenders at multiple levels and reduction in the volume of administrators who gobble up huge

salaries while not creating any revenue stream (biggest problem). Also. efficiently utilizing operating room time and reducing down time including case turnover times while providing incentives for productivity and being punitive for those below a certain benchmark or mean value allows physicians to remain



Limiting mandatory unnecessary "meetings" to discuss nebulous goals and objectives and recruiting quality practitioners who each have 'skin in the game' by tying salaries and compensation to overall quality measures and reimbursements are among other strategies. Also limiting the influx of under-insured or

Medicaid patients into the system, and instead seeking out clients who are younger, healthier and who routinely seek pre-emptive medical consultations and care can improve a health system's competitiveness.


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Trump nominates Alex Azar to lead HHS — 5 takeaways

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