SIS tends to have educational offerings that are very conservative, with increasing scrutiny over what is being taught, forming a self consistent sphere of a procedural cookbook (that they term "Guidelines" or "Standards") and educational offerings. They have been politically active for many years, but their approach through the AMA and through cooperation with multiple societies has been under appreciated for the value. ASIPP tends to be less conservative, with educational offerings that vary in content and utility, but with a stellar journal that is one of the few free medical journals in the US. Politically, they usually "go at it alone" rather than cooperate with other pain societies in combatting threats to the profession. ASIPP may intervene in constraining the political activities of their state chapters who may wish to fight state or local battles. APS is primarily researchers and has many non-physician members with less political activity. They have a fascinating annual meeting due to the cutting edge rat research. The AAPM has been politically active, has a high quality journal that is not free, but has been hampered by the albatross of opioid advocacy in a time of opioid contraction.