I guess ASPN really *is* the future of pain medicine. The dystopic one.

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Agast

Agast

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For $500 an NP can get the same hands on training as an MD who has to pay double.

I hope there is a good explanation for this nonsense.
 
drpainfree said:
why are they training NP/PA on interventional procedures? Ridiculous!

I'm going send a message to him on linkedin
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So apparently it’s Botox, trigger points, ultrasound guided injections and occipital nerve blocks. I really am not a fan of midlevels doing ultrasound guided injections and the occipital artery is easy to hit. My biggest question is “WHY.” This is not a void that needed to be filled. “I wish I had someone else to do these trigger points” is something I have said zero times. Why do midlevels need to be brought to the table? Is this what woke pain management is?
 
Agast said:
So apparently it’s Botox, trigger points, ultrasound guided injections and occipital nerve blocks. I really am not a fan of midlevels doing ultrasound guided injections and the occipital artery is easy to hit. My biggest question is “WHY.” This is not a void that needed to be filled. “I wish I had someone else to do these trigger points” is something I have said zero times. Why do midlevels need to be brought to the table? Is this what woke pain management is?
Click to expand...

How important is it to you that EVERY member of the health care team is treated EQUITABLY and functions at the top of their license realizing their fullest professional and human potential?

I think that ASPN wants to disrupt and dismantle systems that keep mid-levels down.
 
Agast said:
I think they’re a new pain society trying to drum up cash quick, and this is one of the ways to do it.
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I think that a fair question to address to ASPN's Chair of Diversity and Inclusion, Dr. Wesbein, is, "How does increase access to mid-level providers for pain care create benefit for patients with acute and chronic pain while disrupting institutional barriers and dismantling inequitable systems that create utilization disparities among providers of different levels of licensure?" #staywoke

1569513196943.png
 
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do we have any ASPN members among us? anyone who was at their first meeting and can give us some insight?

Membership fee of $100 is very reasonable and I'm not sure they're really trying to drum up cash.
 
Jigsaw said:
this is not true.

Can we seriously not jump to conclusions on this board and just post our feelings?
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When you destroy the specialty by training your replacement?
Can we seriously take you seriously?
Did gas passers not learn anything by seeking profits from CRNA supervision?
 
NJPAIN said:
There is no time for them to reply. Everyone is too busy implanting ProclaimXR so they came claim on social media to be the FIRST in the state, country, world, planet.
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I missed all of these posts today, until you brought them to my attention.

I am implanting 3 regular Proclaims tomorrow. They will have the XR warranty as there is nothing different about the two systems besides the XR programming governors to keep the device from dying in two years.

Only difference really is the roll mark.
 
The back story behind the break up of the NANS board and the creation of ASPN is a great one that was just a pissing contest. The social media stuff is just out of control, lots of people acting like ****** and losing integrity, not intentionally , just get sucked up into it. Most are good people and good doctors but are blinded by the BS of it.
 
*SMH*

ya know, ive always trusted my gut feeling. i really believe that nature has a way of telling you to 'stop/continue/be forceful/give it blessing' at any specific thing you are doing.

With that said, I have met some of these guys here and there during workshops, and came across them during training and conference etc, and i can tell you my gut weirdly wanted me to stay away from this and these people. it wasnt about me being "jealous" at their success (whatever it may be or potentially be - i actually want everyone to succeed the right way). Its just that their overall process, approach and demeanor was a little off. Something always felt disingenuous and snake oil salesman type...
 
lobelsteve said:
When you destroy the specialty by training your replacement?
Can we seriously take you seriously?
Did gas passers not learn anything by seeking profits from CRNA supervision?
Click to expand...
midlevel creep is in every specialty.
the quality of relationship with CRNAs is at an individual facility/practice and institutional level despite what is happening at a state level with CRNA seeking independence and the overall discourse nationally.
The reason being there are far too many surgeries and there has been an explosion in off site anesthesia procedures and it is just not cost effective to provide anesthesia by solo anesthesia doctor to one particular surgeon. it eats up time and resources that can be more efficiently utilized. now im not saying its not possible to do solo cases anymore. it is, and many practices do so and even with crna heavy practices, docs will often do solo cases - but gone are the days of MD only practices dominating the markets simply because of volume. check the OR schedules of any busy hospital...its packed. anesthesiologists are working hard.
the way to handle nurses is by displaying superior knowledge everyday, taking leadership roles and being a model of discipline and hard work. in short, make them respect you.
 
Paingas said:
The back story behind the break up of the NANS board and the creation of ASPN is a great one that was just a pissing contest. The social media stuff is just out of control, lots of people acting like ****** and losing integrity, not intentionally , just get sucked up into it. Most are good people and good doctors but are blinded by the BS of it.
Click to expand...

These issues need to be widely broadcast and openly debated. Moreover, the personalities behind the stories need to come out and own their words and deeds. Until and only then will there be redemption and forgiveness.
 
I’m texting Sayed now as I sit here waiting to take my $2000 pain board recertification exam. definitely frustrating to say the least even if it is simple stuff. It won’t be long before they want to do epidurals, RFA and stim. It’s a slow fade
 
BobBarker said:
I missed all of these posts today, until you brought them to my attention.

I am implanting 3 regular Proclaims tomorrow. They will have the XR warranty as there is nothing different about the two systems besides the XR programming governors to keep the device from dying in two years.

Only difference really is the roll mark.
Click to expand...

Look at the **** Show taking place. The race to claim first place of a race to nowhere! A relabeling of the SAME DEVICE. LinkedIn is exploding with this nonsense. I don’t for a microsecond doubt that the timing of these implants was planned as early on Monday morning as possible in order to be first.
What have we become?

You need to have a sit down with your Abbott rep. You missed your social media three finger raised opportunity to claim first in your home state.
 
I do try to bring my APPs into the procedures with me when possible so they can understand the patient experience, the procedure, and the management pre/post. It's not a horrible idea for them.

Them actually performing stuff is a different issue all together, but there was a time when only neurosurgeons did stimulators right? This is the natural course of things as they get easier, simpler, safer, etc.
 
neutro said:
the way to handle nurses is by displaying superior knowledge everyday, taking leadership roles and being a model of discipline and hard work. in short, make them respect you.
Click to expand...

I'm sorry, In a just and moral world this would be true.

But we do not live in that world anymore since PC culture was instituted and "everybody is equal" in every fashion. Also, our forefathers sold out for greed and short term gain with midlevels.

This is the reason midlevel charlatans continue to proliferate.
 
Ligament said:
I'm sorry, In a just and moral world this would be true.

But we do not live in that world anymore since PC culture was instituted and "everybody is equal" in every fashion. Also, our forefathers sold out for greed and short term gain with midlevels.

This is the reason midlevel charlatans continue to proliferate.
Click to expand...
See the post above yours for example of an enabler
 
lonelobo said:
See the post above yours for example of an enabler
Click to expand...

The ONLY motivation one could have to allow the natural progression of giving up “easier and safer” things is $$$. In other words, so that you can make money off of your employees doing these things while you make more money doing more complex things with a higher price tag. I have no problem with you deciding to do that. However, don’t complain when they reach the level that they compete against you and the bank comes to take your Porsche because you can’t make the payments. Steve is correct, CRNAs are a perfect example and I can’t believe that young anesthesiologists have not learned from that example of shortsightedness.
 
Ligament said:
I'm sorry, In a just and moral world this would be true.

But we do not live in that world anymore since PC culture was instituted and "everybody is equal" in every fashion. Also, our forefathers sold out for greed and short term gain with midlevels.

This is the reason midlevel charlatans continue to proliferate.
Click to expand...
this has nothing to do with PC culture.

this has everything to do with financial reimbursement. this is not about your perceived political view.

your second sentence summarizes it all.
 
Ligament said:
I'm sorry, In a just and moral world this would be true.

But we do not live in that world anymore since PC culture was instituted and "everybody is equal" in every fashion. Also, our forefathers sold out for greed and short term gain with midlevels.

This is the reason midlevel charlatans continue to proliferate.
Click to expand...
You can’t control others, just yourself and your actions and live with your conscience. Do the right thing and be happy with it.
 
The American Academy of Ophthalmology does not allow optometrists to attend its annual meeting since 2004. The decision came about because they discovered optometrists were using attendance at the meeting and CME as the basis for surgical credibility. Now, optometrists are not midlevels by any means but their base training is not the same as doctor. New legislature has been passed in the last few years allowing them to expand their scope of practice. Don’t think for a moment we are not doing the same to ourselves.
 
Agast said:
The American Academy of Ophthalmology does not allow optometrists to attend its annual meeting since 2004. The decision came about because they discovered optometrists were using attendance at the meeting and CME as the basis for surgical credibility. Now, optometrists are not midlevels by any means but their base training is not the same as doctor. New legislature has been passed in the last few years allowing them to expand their scope of practice. Don’t think for a moment we are not doing the same to ourselves.
Click to expand...

EXACTLY. We need to wake up and do what is right for our field as a whole rather than for our individual pockets. We are the laughing stock of medicine. They see us as greedy, slimy, opioid prescribing surgeon wannabes.
 
drusso said:
How important is it to you that EVERY member of the health care team is treated EQUITABLY and functions at the top of their license realizing their fullest professional and human potential?

I think that ASPN wants to disrupt and dismantle systems that keep mid-levels down.
Click to expand...

The desire for PAs and NPs to practice "at the top of their license" is one of the most disingenuous and dangerous talking points utilized by midlevel interest groups, venture capitalists and private for-profit health corps, and hospital administrators. It's really a euphemism for "hey doctors, just let midlevels do stuff and if something goes wrong you'll be honorable enough to deal with their mistakes and shoulder responsibility." And unfortunately it sounds innocuous enough to patients who end up getting harmed.

Put another way, the "top" of my medical license technically allows me to do all of the following in a single day: do brain surgery, counsel somebody on their high-risk pregnancy, replace somebody's hip, treat acute-angle glaucoma, do some well-child exams in the clinic, treat a few patients in thyroid storm, and then finish up the afternoon in the path lab reading slides.

The whole thing is a farce.
 
Agast said:
The American Academy of Ophthalmology does not allow optometrists to attend its annual meeting since 2004. The decision came about because they discovered optometrists were using attendance at the meeting and CME as the basis for surgical credibility. Now, optometrists are not midlevels by any means but their base training is not the same as doctor. New legislature has been passed in the last few years allowing them to expand their scope of practice. Don’t think for a moment we are not doing the same to ourselves.
Click to expand...

Someone should strike up a conversation with Dr. Wesbein, ASPN’s Director of Diversity and Inclusion and ask her to bring up the issue of training mid-levels at their next Board Meeting and using AAO’s prohibition policy as template/starting point for discussion and next steps.
 
NJPAIN said:
The ONLY motivation one could have to allow the natural progression of giving up “easier and safer” things is $$$. In other words, so that you can make money off of your employees doing these things while you make more money doing more complex things with a higher price tag. I have no problem with you deciding to do that. However, don’t complain when they reach the level that they compete against you and the bank comes to take your Porsche because you can’t make the payments. Steve is correct, CRNAs are a perfect example and I can’t believe that young anesthesiologists have not learned from that example of shortsightedness.
Click to expand...

My friend, I get bored easily. I'm happy to let the CRNAs manage ASA 1 - 3 patients.

If I was in it for the money, I would be stupid, as there's more money elsewhere.
 
I’m sorry there has been some confusion about my role at ASPN re: diversity and inclusion. The goal of that role is to help women, physicians of color, and those others who might feel marginalized from sexuality or other reasons find equality within the pain medicine field. With regards to research and teaching opportunities.
That being said, I think we can all appreciate the concern of our specialty being subverted by advanced practitioners. This is a widespread fear in many specialties, including Orthopaedics, derm, neurology and pain... where some of these advanced practitioners are being leveraged by their physicians or from their own desires to further themselves... and I don’t disagree that advanced practice providers should not be trained to perform stim or interventional injections. I’m sorry for the brevity of this note, but I’m at a fellows course, and I wanted to make sure you all didn’t think that people weren’t paying attention. And for what it’s worth, I don’t think tearing each other down is useful in creating unity or helpful for our specialty.
Have a wonderful evening 🙂
 
I just went to the website and looked at the agenda.

All this trolling/garbage for Trigger point injections, joint injections, botox, pump refills and patient selection? - if a mid level cant do that or you think thats going to take over your job you must not be in a relevant practice in 2019. Occipital nerve blocks - a stretch and shouldn't be on the curriculum.

Thinking about some other fields

Orthopedic PA - Joint injections, Assist in OR drilling into bone and inserting screws, suturing

Cardiac PA - Harvesting vein grafts for CABG

Dermatology PA/NP - Botox

NPs in and outpatient taking care of pain patients under physician supervision all the time.

Basic Home Infusion - RNs pump refills

ASPN didactic - all of the above.

Help me understand the outrage
 
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Needlejockeys said:
All this garbage for Trigger point injections, joint injections, botox, pump refills and patient selection? - if a mid level cant do that or you think thats going to take over your job you must not be in a relevant practice in 2019. Occipital nerve blocks - a stretch and shouldn't be on the curriculum.
Click to expand...

I don’t understand your point.
 
I would hope that the organizations that claim to represent us represent all of us and not just the best interests of those practices considered to be “relevant”. Representing a select group within our specialty at the expense of everyone else is far more divisive than any of us being critical of KOLs and their actions. This is nothing personal. It’s politics and those involved need to expect to be challenged because their opinions and actions affect ALL of us.
 
As long as these leaders disclose their COI that should be fine because you know it’s an ad. The challenge is those people who do not disclose. This is unfortunately rampant on LinkedIn
 
No Pain All gain said:
As long as these leaders disclose their COI that should be fine because you know it’s an ad. The challenge is those people who do not disclose. This is unfortunately rampant on LinkedIn
Click to expand...

Great point - but if its social media, does it count? Great topic of debate with varying opinions. And I agree with a lot of what is being discussed. I personally would never let a advanced practice NP or PA DNP DPA whatever they call themselves do a procedure outside of what was listed above - cant let crna anesthesia example cross over into pain. Have to protect the field and safety of patients.
 
I think that social media is a podium and if you don’t disclose your conflicts then you’re being disingenuous, especially if you are a society leader.
 
I’d argue it counts even more on social media where our patients are searching these things.
 
DOctorJay said:
I’d argue it counts even more on social media where our patients are searching these things.
Click to expand...

That’s a fantastic point. I think what bothers people the most is the lack of integrity and blatant hyping without credible data to support their hype.
 
Indeed. Clearly label it as an advertisement and if you get paid by the company indicate “Dr. X is a paid spokesperson for Company X”
 
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