how are these peeps getting board certified in pain?

[Piebaldi]

Scott J. Davidoff, MD - Main Line Spine

Scott J. Davidoff, MD is a physician at Main Line Spine who specializes in physical medicine, pain medicine, and sports medicine.

mainlinespine.com

i'm posting the bio of this physician simply for illustrative purposes. this group for example has a bunch of the docs there who have done a fellowship at a number of non accredited places yet they are all saying they are board certified and this person is even the president of american board of pain? how can someone be the president of the board when doing a non accredited fellowship?

someone edumacate me please.

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[DOctorJay]

I believe Dr. Davidoff trained under Dr. Furman at a time when the OSS fellowship had dual accreditation and those fellows were able to sit for both boards. I believe their Pain Management certification came through some type of arrangement with Sinai in Baltimore.


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[Piebaldi]

I believe Dr. Davidoff trained under Dr. Furman at a time when the OSS fellowship had dual accreditation and those fellows were able to sit for both boards. I believe their Pain Management certification came through some type of arrangement with Sinai in Baltimore.


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I believe OSS is no longer associated with Sinai and their fellowship is no longer accredited. He was just an example, many of the other docs also did non accredited fellowships and still say board certified in pain.

 

[DOctorJay]

You mentioned his specific case and for him at least I am fairly certain he is boarded in PMR, Pain, and Sports.

You’re correct that OSS is no longer an accredited fellowship for IPM.


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[RM38]

Some people trained back in the day when an equivalent training (non-acgme) fellowship would allow for someone to take pain boards through PM&R. That pathway has been shut down for awhile, but people have been grandfathered into keeping their status.

 

[Piebaldi]

Some people trained back in the day when an equivalent training (non-acgme) fellowship would allow for someone to take pain boards through PM&R. That pathway has been shut down for awhile, but people have been grandfathered into keeping their status.

That makes sense, thank you.

 

[RM38]

In some states ABIPP and ABPM are also considered equivalent and physicians with those are allowed to advertise as pain boarded. FL is one state that would allow this for example. Doesn’t mean hospitals or insurers have to respect that though.

 

[Aether2000]

Of course Furman's fellowship is extraordinary in its scope and the detail and anyone finishing that program is outstanding regardless of board certification status.

 

[Piebaldi]

Of course Furman's fellowship is extraordinary in its scope and the detail and anyone finishing that program is outstanding regardless of board certification status.

That might be the case, but as others have pointed out, no matter how good or outstanding a fellowship might be, it's best to do an ACGME accredited one - the board, insurnace companies, etc don't care how good Furman's fellowship is - if not accredited.

 

[Aether2000]

Insurance companies in some states do not block physicians from pain practice despite not having an ACGME pain fellowship. Consider the many surgeons trained by NASS to do injections and RF- they have no pain fellowship. Anesthesiologists or other specialties may use ABPM + experience as an alternative to ACGME fellowship plus ABMS additional qualifications route. Florida in particular permits this and many who never did a pain fellowship in the state become insurance company accepted.

 

[Ducttape]

i believe that this is a significant reason why the profession does not have the same cachet as neurosurgery or spine.

 

[NJPAIN]

i believe that this is a significant reason why the profession does not have the same cachet as neurosurgery or spine.

EXACTLY. Way way too many ways to call yourself a pain medicine specialist. Aside from creating a back door into the field for those non-ACGME fellowship trained, it’s a BIG money maker for those who run the “boards”, conferences and courses.


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[clubdeac]

I mean there are states where CRNAs are doing interventional pain. Why on earth do you need to be board certified when insurers, medicare and medicaid recognize interventional pain cpt codes submitted by CRNAs? This is the main problem. There are no checks and balances whatsoever when it comes to billing. If we could lobby to control this, all the nonsense would stop. I really don't understand why this hasn't been done yet, or at least attempted by ASIPP, AMA, ABA, ABPMR, AAPMR, ASRA and on and on

 

[gdub25]

Because every single one of those societies is open to anyone and everyone who wants to join as a member stating that “the bigger we are the more lobbying power they will have“.

 

[au bon pain]

I mean there are states where CRNAs are doing interventional pain. Why on earth do you need to be board certified when insurers, medicare and medicaid recognize interventional pain cpt codes submitted by CRNAs? This is the main problem.

Agreed. And insurers actually paying them is all the more curious as they otherwise do everything they can to deny coverage.

 

[Piebaldi]

I mean there are states where CRNAs are doing interventional pain. Why on earth do you need to be board certified when insurers, medicare and medicaid recognize interventional pain cpt codes submitted by CRNAs? This is the main problem. There are no checks and balances whatsoever when it comes to billing. If we could lobby to control this, all the nonsense would stop. I really don't understand why this hasn't been done yet, or at least attempted by ASIPP, AMA, ABA, ABPMR, AAPMR, ASRA and on and on

many jobs say "board certification required"
i guess perhaps the sentiment of my question is - in general how are peoeple who do non-acgme fellowships get accredited? yes i get that there is abipp, abpm, etc - but is that considered board eligible outside of certain states? it doesnt seem like all states recognize it?

 

[Ferrismonk]

many jobs say "board certification required"
i guess perhaps the sentiment of my question is - in general how are peoeple who do non-acgme fellowships get accredited? yes i get that there is abipp, abpm, etc - but is that considered board eligible outside of certain states? it doesnt seem like all states recognize it?

Many places only care if you are board certified in something, not necessarily pain management. They are then advertised as "Board certified, fellowship trained"

 

[NJPAIN]

I mean there are states where CRNAs are doing interventional pain. Why on earth do you need to be board certified when insurers, medicare and medicaid recognize interventional pain cpt codes submitted by CRNAs? This is the main problem. There are no checks and balances whatsoever when it comes to billing. If we could lobby to control this, all the nonsense would stop. I really don't understand why this hasn't been done yet, or at least attempted by ASIPP, AMA, ABA, ABPMR, AAPMR, ASRA and on and on

ASIPP is too busy training pain docs to be surgeons and alienate us from our surgical colleagues and running courses to make $$$$.
AMA - does that organization still exist???
ABA, AAPMR - too busy making money on MOC.

Stopping the threat from CRNA, NP and PA needs to be a top priority. I also think that plugging the holes to enter the field and get “board certification” needs to be a priority. However, some of these organizations make millions of dollars CREATING these opportunities and alternative paths to “board certification”.


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[Ferrismonk]

ASIPP is too busy training pain docs to be surgeons and alienate us from our surgical colleagues and running courses to make $$$$.
AMA - does that organization still exist???
ABA, AAPMR - too busy making money on MOC.

Stopping the threat from CRNA, NP and PA needs to be a top priority. I also think that plugging the holes to enter the field and get “board certification” needs to be a priority. However, some of these organizations make millions of dollars CREATING these opportunities and alternative paths to “board certification”.


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I thought the AMA was that insurance company? /s

 

[cowboydoc]

I thought the AMA was that insurance company? /s

All this time I thought it was a junk mail factory.

 

[olafa]

ASIPP is too busy training pain docs to be surgeons and alienate us from our surgical colleagues and running courses to make $$$$.
AMA - does that organization still exist???
ABA, AAPMR - too busy making money on MOC.

Stopping the threat from CRNA, NP and PA needs to be a top priority. I also think that plugging the holes to enter the field and get “board certification” needs to be a priority. However, some of these organizations make millions of dollars CREATING these opportunities and alternative paths to “board certification”.


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atleast start with eliminating mid levels, nurses, naturopaths (yes- have seen these guys doing or atleast charting that they have done US guided facet/SIJ injx) etc from doing these procedures

 

[Aether2000]

How does one eliminate any one from doing pain procedures? The nursing boards are not swayed by standard of care arguments nor scope of practice arguments. PAs can do anything under association with a physician, whether the physician themselves does procedures or not. NPs and CRNAs may have little training in these advanced procedures but who is there to stop them? State legislatures are beholden to the lobbying of these groups, state medical boards will not declare interventional pain procedures to be solely the purview of physicians, surgeons are usually interested in just getting the job done no matter who does the procedure even if it just the local hospital janitor since they are increasingly using independent PAs (out of network billing) to assist and close most cases, the courts will not intervene, and neither will governors. Insurance companies increasingly are paying for these procedures by CRNAs, NPs, and PAs yet will balk at some physicians (anesthesiologists without additional qualifications but not surgeons with no qualifications). Naturopaths can do whatever they chose in states where they have a board overseeing them, since it is not a board of medicine, but rather a self-serving naturopathic board that really doesn't care about silly archaic ideas like guidelines, scope of practice and standards of care. The whole field is a mess.

 

[Wkrdoc]

How does one eliminate any one from doing pain procedures? The nursing boards are not swayed by standard of care arguments nor scope of practice arguments. PAs can do anything under association with a physician, whether the physician themselves does procedures or not. NPs and CRNAs may have little training in these advanced procedures but who is there to stop them? State legislatures are beholden to the lobbying of these groups, state medical boards will not declare interventional pain procedures to be solely the purview of physicians, surgeons are usually interested in just getting the job done no matter who does the procedure even if it just the local hospital janitor since they are increasingly using independent PAs (out of network billing) to assist and close most cases, the courts will not intervene, and neither will governors. Insurance companies increasingly are paying for these procedures by CRNAs, NPs, and PAs yet will balk at some physicians (anesthesiologists without additional qualifications but not surgeons with no qualifications). Naturopaths can do whatever they chose in states where they have a board overseeing them, since it is not a board of medicine, but rather a self-serving naturopathic board that really doesn't care about silly archaic ideas like guidelines, scope of practice and standards of care. The whole field is a mess.

CRNAs are doing everything outside of implants all over Texas

 

[drusso]

How does one eliminate any one from doing pain procedures? The nursing boards are not swayed by standard of care arguments nor scope of practice arguments. PAs can do anything under association with a physician, whether the physician themselves does procedures or not. NPs and CRNAs may have little training in these advanced procedures but who is there to stop them? State legislatures are beholden to the lobbying of these groups, state medical boards will not declare interventional pain procedures to be solely the purview of physicians, surgeons are usually interested in just getting the job done no matter who does the procedure even if it just the local hospital janitor since they are increasingly using independent PAs (out of network billing) to assist and close most cases, the courts will not intervene, and neither will governors. Insurance companies increasingly are paying for these procedures by CRNAs, NPs, and PAs yet will balk at some physicians (anesthesiologists without additional qualifications but not surgeons with no qualifications). Naturopaths can do whatever they chose in states where they have a board overseeing them, since it is not a board of medicine, but rather a self-serving naturopathic board that really doesn't care about silly archaic ideas like guidelines, scope of practice and standards of care. The whole field is a mess.

I predict within 15 years we'll have "shot robots" doing all the IPM for us. If you can teach a robot to draw blood, you can probably teach it to do a TFESI...

I'm coaching my daughter's AI/Lego Robotic's team this year and I'm impressed what middle school kids can assemble with just off the self components!

Deep learning robotic guidance for autonomous vascular access - Nature Machine Intelligence

Getting safe and fast access to blood vessels is vital to many methods of treatment and diagnosis in medicine. Robot-assisted or even fully autonomous methods can potentially do the task more reliably than humans, especially when veins are hard to detect. In this work, a method is tested that...

www.nature.com

 

[lobelsteve]

Robot laser msc’s.

 

[Aether2000]

I am working on creating an Alexa routine to do injections....

 

[Ducttape]

I'm coaching my daughter's AI/Lego Robotic's team this year and I'm impressed what middle school kids can assemble with just off the self components!

yes, they are amazing. I assume, middle school, that she is on an FTC team.

 

[Crybaby]

Soooo, reviving this thread

My area's newest and finest CRNA Pain specialist. Is there anything I can do about this or should I just bend over and take it. From procedure notes she uses another CRNA to do anesthesia... propofol for MBB. she actually works for a neurosurgeon that I used to really respect.

Jamie gained her Bachelor's of Science in Nursing from Northeastern State University and followed with a Master's of Science in Nursing from Newman University. She became a dedicated Certified Registered Nurse Anesthetist (CRNA) providing anesthesia in a variety of hospitals across the region. Jamie also completed the fellowship program in pain management from Texas Christian University. She is certified in advance cardiovascular life support as well as pediatric advanced life support and currently collaborates with doctors in multiple locations to perform the necessary pain management procedures for their patient population.

Jamie joined in 2019 and has devoted herself to ensuring that all of her patients receive excellent care. Her rapport with patients and excellent clinical skills, combined with the effective treatment options she provides have proven to be a great benefit to patients who are suffering from debilitating pain.

Jamie offers exceptional care for the following services:​

• Thoracic and Lumbar Epidural Steroid Injections
  
• Lumbar Facet Injections
  
• Peripheral Nerve Blockade
  
• Joint Injections
  
• Sacroiliac Steroid Injection
  
• Radiofrequency Ablations
  
• Intercostal Injections
  
• Lumbar Medial Branch Block
  
• Sympathetic Blocks including; Stellate Ganglion, Lumbar Sympathetic, Celiac
  
• Hypogastric Plexus Blocks
• Trigger Point Injections
  
• Occipital Nerve Blocks
  Selective Nerve Root Blocks
  
• Piriformis Injections
  
• Discography
  
• Glenohumeral Joint Injection
  
• Subdeltoid/Subacromial Bursa Injection
  
• Intra-Articular Knee Injection
  
• Suprapatellar Bursa Injection
  
• Genicular Knee Nerve Injection
  
• Intra-Articular Hip Injection
  
• Greater Trochanteric Bursa Injection
  
• Intra-Articular Elbow Injection
  
• Intra-Articular Ankle Injection
  
• Median Nerve Block
  
• Ilioinguinal/Iliohypogastric Nerve Block
  
• Transforaminal Epidural Steroid Injection
  

 

[Agast]

CRNA pain specialists exist because they have MDs willing to “supervise.” Aren’t they billing under the MDs information? Wait for the inevitable sentinel event, report the MD to the medical board.

 

[Crybaby]

It is just crazy.
From the looks of it this amazing fellowship appears to be 21 credit hours spread out over the course of a year and 2 cadaver courses.

 

[BobBarker]

Soooo, reviving this thread

My area's newest and finest CRNA Pain specialist. Is there anything I can do about this or should I just bend over and take it. From procedure notes she uses another CRNA to do anesthesia... propofol for MBB. she actually works for a neurosurgeon that I used to really respect.

Jamie gained her Bachelor's of Science in Nursing from Northeastern State University and followed with a Master's of Science in Nursing from Newman University. She became a dedicated Certified Registered Nurse Anesthetist (CRNA) providing anesthesia in a variety of hospitals across the region. Jamie also completed the fellowship program in pain management from Texas Christian University. She is certified in advance cardiovascular life support as well as pediatric advanced life support and currently collaborates with doctors in multiple locations to perform the necessary pain management procedures for their patient population.

Jamie joined in 2019 and has devoted herself to ensuring that all of her patients receive excellent care. Her rapport with patients and excellent clinical skills, combined with the effective treatment options she provides have proven to be a great benefit to patients who are suffering from debilitating pain.

Jamie offers exceptional care for the following services:​

• Thoracic and Lumbar Epidural Steroid Injections
  
• Lumbar Facet Injections
  
• Peripheral Nerve Blockade
  
• Joint Injections
  
• Sacroiliac Steroid Injection
  
• Radiofrequency Ablations
  
• Intercostal Injections
  
• Lumbar Medial Branch Block
  
• Sympathetic Blocks including; Stellate Ganglion, Lumbar Sympathetic, Celiac
  
• Hypogastric Plexus Blocks
• Trigger Point Injections
• Occipital Nerve Blocks
  Selective Nerve Root Blocks
  
• Piriformis Injections
  
• Discography
  
• Glenohumeral Joint Injection
  
• Subdeltoid/Subacromial Bursa Injection
  
• Intra-Articular Knee Injection
  
• Suprapatellar Bursa Injection
  
• Genicular Knee Nerve Injection
  
• Intra-Articular Hip Injection
  
• Greater Trochanteric Bursa Injection
  
• Intra-Articular Elbow Injection
  
• Intra-Articular Ankle Injection
  
• Median Nerve Block
  
• Ilioinguinal/Iliohypogastric Nerve Block
  
• Transforaminal Epidural Steroid Injection
  

That’s insane and we will take care of it.
@gdub25

 

[Agast]

Also if you see any of these patients after they have had their procedures done by a CRNA: always get a records request including all procedure images. Report any fraudulent activities by the CRNA for procedures done incorrectly and by extension the neurosurgeon has committed fraud as well.

 

[paindoc007]

Also if you see any of these patients after they have had their procedures done by a CRNA: always get a records request including all procedure images. Report any fraudulent activities by the CRNA for procedures done incorrectly and by extension the neurosurgeon has committed fraud as well.

Report them to who?

 

[Agast]

Report them to who?

Medicare, for one. State medical board also probably would not be pleased to find an MD/DO directing a midlevel to commit fraudulent procedures.

 

[ateria radicularis magna]

Soooo, reviving this thread

My area's newest and finest CRNA Pain specialist. Is there anything I can do about this or should I just bend over and take it. From procedure notes she uses another CRNA to do anesthesia... propofol for MBB. she actually works for a neurosurgeon that I used to really respect.

Jamie gained her Bachelor's of Science in Nursing from Northeastern State University and followed with a Master's of Science in Nursing from Newman University. She became a dedicated Certified Registered Nurse Anesthetist (CRNA) providing anesthesia in a variety of hospitals across the region. Jamie also completed the fellowship program in pain management from Texas Christian University. She is certified in advance cardiovascular life support as well as pediatric advanced life support and currently collaborates with doctors in multiple locations to perform the necessary pain management procedures for their patient population.

Jamie joined in 2019 and has devoted herself to ensuring that all of her patients receive excellent care. Her rapport with patients and excellent clinical skills, combined with the effective treatment options she provides have proven to be a great benefit to patients who are suffering from debilitating pain.

Jamie offers exceptional care for the following services:​

• Thoracic and Lumbar Epidural Steroid Injections
  
• Lumbar Facet Injections
  
• Peripheral Nerve Blockade
  
• Joint Injections
  
• Sacroiliac Steroid Injection
  
• Radiofrequency Ablations
  
• Intercostal Injections
  
• Lumbar Medial Branch Block
  
• Sympathetic Blocks including; Stellate Ganglion, Lumbar Sympathetic, Celiac
  
• Hypogastric Plexus Blocks
• Trigger Point Injections
  
• Occipital Nerve Blocks
  Selective Nerve Root Blocks
  
• Piriformis Injections
  
• Discography
  
• Glenohumeral Joint Injection
  
• Subdeltoid/Subacromial Bursa Injection
  
• Intra-Articular Knee Injection
  
• Suprapatellar Bursa Injection
  
• Genicular Knee Nerve Injection
  
• Intra-Articular Hip Injection
  
• Greater Trochanteric Bursa Injection
  
• Intra-Articular Elbow Injection
  
• Intra-Articular Ankle Injection
  
• Median Nerve Block
  
• Ilioinguinal/Iliohypogastric Nerve Block
  
• Transforaminal Epidural Steroid Injection
  

Incredible...
Jamie needs to lose her job.
Right now.

 

[gaseous_clay]

Soooo, reviving this thread

My area's newest and finest CRNA Pain specialist. Is there anything I can do about this or should I just bend over and take it. From procedure notes she uses another CRNA to do anesthesia... propofol for MBB. she actually works for a neurosurgeon that I used to really respect.

Jamie gained her Bachelor's of Science in Nursing from Northeastern State University and followed with a Master's of Science in Nursing from Newman University. She became a dedicated Certified Registered Nurse Anesthetist (CRNA) providing anesthesia in a variety of hospitals across the region. Jamie also completed the fellowship program in pain management from Texas Christian University. She is certified in advance cardiovascular life support as well as pediatric advanced life support and currently collaborates with doctors in multiple locations to perform the necessary pain management procedures for their patient population.

Jamie joined in 2019 and has devoted herself to ensuring that all of her patients receive excellent care. Her rapport with patients and excellent clinical skills, combined with the effective treatment options she provides have proven to be a great benefit to patients who are suffering from debilitating pain.

Jamie offers exceptional care for the following services:​

• Thoracic and Lumbar Epidural Steroid Injections
  
• Lumbar Facet Injections
  
• Peripheral Nerve Blockade
  
• Joint Injections
  
• Sacroiliac Steroid Injection
  
• Radiofrequency Ablations
  
• Intercostal Injections
  
• Lumbar Medial Branch Block
  
• Sympathetic Blocks including; Stellate Ganglion, Lumbar Sympathetic, Celiac
  
• Hypogastric Plexus Blocks
• Trigger Point Injections
• Occipital Nerve Blocks
  Selective Nerve Root Blocks
  
• Piriformis Injections
  
• Discography
  
• Glenohumeral Joint Injection
  
• Subdeltoid/Subacromial Bursa Injection
  
• Intra-Articular Knee Injection
  
• Suprapatellar Bursa Injection
  
• Genicular Knee Nerve Injection
  
• Intra-Articular Hip Injection
  
• Greater Trochanteric Bursa Injection
  
• Intra-Articular Elbow Injection
  
• Intra-Articular Ankle Injection
  
• Median Nerve Block
  
• Ilioinguinal/Iliohypogastric Nerve Block
  
• Transforaminal Epidural Steroid Injection
  

I used to practice pain in Tulsa. Wilson was part of OSH. I don’t remember him being that great. The Oklahoma medical board could care less about CRNAs practicing pain.

 

[DOctorJay]

Find out who her RFA vendor is

 

[Ferrismonk]

I used to practice pain in Tulsa. Wilson was part of OSH. I don’t remember him being that great. The Oklahoma medical board could care less about CRNAs practicing pain.

More to the point, the medical board would likely defer this to the nursing board who would give this CRNA a high-five.

 

[clubdeac]

Report for Medicare fraud and write letters to the state medical board and nursing board and call the overseeing surgeon who hired her and rip him a new one. This kind of crap has to be nipped in the bud otherwise our specialty will soon be gone. This kinda stuff gives me heartburn

 

[BobBarker]

It is against OK state law. We got this.

http://webserver1.lsb.state.ok.us/cf_pdf/2009-10 ENR/SB/SB479 ENR.PDF

 

[Agast]

More to the point, the medical board would likely defer this to the nursing board who would give this CRNA a high-five.

The surgeon gets reported to the medical board, she is likely billing under his license.

 

[Crybaby]

It is against OK state law. We got this.

http://webserver1.lsb.state.ok.us/cf_pdf/2009-10 ENR/SB/SB479 ENR.PDF

That’s great

 

[BobBarker]

The surgeon gets reported to the medical board, she is likely billing under his license.

Yes, I would assume they are using his NPI to bill for these procedures.

 

[Pain Applicant1]

Just out of curiosity, how do you report fraud to Medicare? I don't think it's that easy. I don't even think you can directly report it to them. It must be reported to an attorney who manages fraud and you must await their callback. If there isn't enough money in it, good luck getting that call.

 

[Agast]

Just out of curiosity, how do you report fraud to Medicare? I don't think it's that easy. I don't even think you can directly report it to them. It must be reported to an attorney who manages fraud and you must await their callback. If there isn't enough money in it, good luck getting that call.

I got a letter from Medicare advising me a patient accused me of fraud and I had to respond with a form and records. I don’t think it’s as difficult as we think.

 

[gdub25]

As Bob has pointed out what is happening in Tulsa is against OK state law and this should be easy to stop. It’s a good idea to find out who the vendor is for RFA. Every doc in the state should make it known to the rep/company that they are at fault as well. This surgeon had advocated for this CRNA as well as another who is also “pain certified” to be able to do procedures at one of the hospitals.

 

[Crybaby]

Bob, I am a little less hopeful after reading through the legislation in the link you supplied, Article D helps their case.

C. It shall be unlawful to practice or offer to practice interventional pain management in this state unless such person has been duly licensed under the provisions of the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act or the Oklahoma Osteopathic Medicine Act.

D. Nothing in this section shall be construed to forbid the administration of lumbar intra-laminar epidural steroid injections or peripheral nerve blocks by a certified registered nurse anesthetist when requested to do so by a physician and under the supervision of an allopathic or osteopathic physician licensed in this state and under conditions in which timely on-site consultation by such allopathic or osteopathic physician is available.

E. A certified registered nurse anesthetist shall not operate a freestanding pain management facility without direct supervision of a physician who is board-certified in interventional pain management or its equivalent.

 

[BobBarker]

But she is doing discograms and RFA’s also. So far outside that limited scope in article D.

 

[Ducttape]

I'm guessing that she "offers" such treatments, meaning that she will write an order for those procedures, not actually perform them herself.

it is a devious way of marketing herself and not be liable...

 

[BobBarker]

No, she is doing them. Confirmed by two physicians.