3 keys for coordinated, cost-effective spine care
At the 12th Annual Spine, Orthopedic and Pain Management Driven ASC Conference in Chicago on June 12, Scott E. Glaser, MB, DABIPP, president of Pain Specialists of Greater Chicago, shared opportunities for interventional pain management in a value-based healthcare environment.
In the current paradigm, pain patients are treated by multiple physicians without care coordination, which leads to confusion for both the patient and providers. Surgery for spinal pain is a “nuclear” option due to long-term risks of failure and mixed scientific evidence on the efficacy of certain spinal surgeries for pain. Treatment is fragmented and pain is treated, “but the source of the pain remains untreated,” explained Dr. Glaser.
Under the new paradigm, an interventional pain management physician manages the patient’s ongoing pain, just as a cardiologist would manage chronic heart-related problems. Ideally, the patient receives an early assessment by interventional pain management physician and then receives conservative treatment that is unique to each patient, based on their age, level of pain and any co-morbidities.
According to Dr. Glaser, the new paradigm of spine care is characterized with interventional pain management physicians serving as the “quarterback of care” and three key concepts:
1. Identification and treatment of the source of spinal pain through minimally invasive procedures, performed in a “step-wise” fashion, following an algorithm such as the one developed by the American Society for Interventional Pain Physicians.
2. Appropriate management of symptoms. Including anti-inflammatories, and narcotics, but only when absolutely necessary.
3. Educate the patient and encourage behavioral modification, if necessary. Help the patient better understand their pain, potential impact of various treatments (including the potential impacts of opioids) and manage expectations.
Referring pain patients to specialized pain management physicians who use conservative methods, rather than relying on primary care providers without deep pain expertise, can reduce the overall cost of treating pain and lead to more cost-effective, outpatient treatment for patients, said Dr. Glaser.