Tag - pain

Surgery and Procedures During the COVID-19 Crisis

Reposted from the Texas Pain Society e-newsletter dated 3/26/2020

March 26, 2020

To assist our members in determining whether surgeries should be done during the period of the Governor’s Order and any extensions, we have put together this memo based on the CDC (Federal), Governor Abbott’s Executive Order, the Attorney General’s guidance, and guidance from the TMB (Texas).  There may also be county and city orders as well as facility requirements of which you should be aware.  These are not included in this memo, but should be researched in making your decisions.

Please keep in mind that we are doing our best to keep up with this fluid situation, and will revisit these issues as necessary.

Current CDC guidelines require rescheduling elective surgeries at inpatient facilities and rescheduling non-urgent outpatient visits to help limit the spread of COVID-19.

At the state level, on March 22 Governor Abbott issued Executive Order GA 09 ordering the following:

the surgery must be postponed unless it is immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician.

On March 23, Texas Attorney General Ken Paxton, issued a statement that Governor Abbott’s order applies throughout the State and to all surgeries and procedures that are not immediately medically necessary.

At the licensing level, the TMB has taken the position that the performance of a non-urgent elective procedure is a continuing threat to the public welfare, and will be prosecuted by the Board.

Further, the TMB has adopted a mandatory duty to report any physician scheduling to perform, preparing to perform, performing, or who has performed a non-urgent elective surgery or procedure to the TMB.   While this order is directed to physicians and other licensed healthcare professionals, in fact any human can report the physician to the TMB.

If a report is made to the TMB, the TMB may conduct a temporary suspension or restriction hearing with or without notice. This hearing will be judged by a panel of three board members (one of which must be a physician), at which the justification for both the necessity and urgency of the surgery or procedure at issue will be determined. This would include reviewing the medical records and utilizing applicable guidelines and literature.

If a temporary suspension or restriction hearing does not occur, the normal TMB process will occur, at which a panel of at least two physicians will determine:

  1.  whether or not the surgery was medically necessary given the Orders and guidelines provided above, and
  2. whether the standard of care was met.

The TMB has stated it intends to rely on  applicable guidelines such as the CDC, CMS, or other medical or specialty guidelines and literature in making these two determinations.

If you fail to comply with this Order, the consequences to you and your career are severe, and include:

  1. $1,000 fine;
  2. 180 days in jail;
  3. Temporary suspension or restriction by the TMB;
  4. Investigation by the TMB and possible loss of license;
  5. Mandatory report to the NPDB.

Therefore, we urge our members to apply the following standard in determining whether surgery should be performed at this time:

Is the medical act a surgery or procedure?

If No, and you are performing other medical acts, such as a history, physical exam, non-invasive diagnostics, or ordering/performing lab tests, you may proceed with the medical act.

If Yes, is this immediately medically necessary to correct a serious medical condition or to preserve the life of a patient and would this patient, without immediate performance of the surgery or procedure, be at risk for serious adverse medical consequences or death?

If Yes, you may perform the surgery. 

Given the severe consequences of these decisions, we urge our members to use caution in proceeding with surgery at this time.  In fact, before even scheduling the surgery, it may be wise to obtain a second opinion from a colleague in writing or a consensus within your community, as well as the approval of all medical professionals involved.

In short, the TPS advises you to be a good doctor, care for your patients and community, consider outcomes, and document.

We understand the gravity of this situation, and the consequences to you of postponing surgeries.  However, we urge you to think long term, and recognize that this is a temporary situation.  As a physician, your skills and talents will surely be necessary as this crisis evolves.

Sincerely,

Brian Bruel, MD
President, Texas Pain Society
On behalf of the Board of Directors

NOTICE: Texas Pain Society is providing this information as a service to its members.   Neither TPS nor its attorneys are engaged in providing legal advice to individual members with respect to their practices.  Neither TPS nor its attorneys assume legal responsibility for damages arising from the use of this information.  We encourage you to seek legal advice from your personal legal counsel.

Researchers at University of Maryland School of Medicine are testing ultrasound to treat neuropathic pain – Baltimore Sun

Steroid injections, nerve stimulators and spinal fusions were no match for the chronic pain in Tammy Durfee’s left side — never mind the “searing-hot poker” sensation that would jab her leg without warning. After a decade searching for relief, a four-hour procedure in Baltimore put her pain to rest.

Read more

Rome 2020: The 10th World Congress of The World Institute of Pain® (WIP)

WIP is delighted to invite you to its 10th world congress that will take place in Rome, Italy , May 20-23 2020.

The World Institute of Pain® (WIP), founded in 1993, is an international institute for global advancement and standardization of physician education, training, and certification of pain physicians.

The biennial WIP World Congress, the preeminent summit on pain management, is the mainstay of the educational mission of WIP. Thousands of physicians who dedicate themselves to the phenomena of acute and chronic pain syndromes come together as both teachers and learners to contribute to the advancement of pain education and collaboration on clinical practice standards of excellence worldwide. Together, with our educational supporters representing top clinicians & scientists, medical device and pharmacologic industries, WIP brings together the most recognized experts in the field of pain medicine to exchange medical science, practical experience, and evidence-based techniques in the field of interventional pain management.

As a professional society, WIP also publishes a high impact scholarly journal, PAIN Practice; certifies physicians who meet the qualifications and competency standards for certification as Fellow of Interventional Pain Practice® and Certified Interventional Pain Sonologist; administers a recognition program for pain centers of excellence; and organizes and endorses annually a broad spectrum of regional and international symposia and hands-on workshops that promote the highest standards and techniques of interventional pain practice.

Learn More

Pain School International

Pain School International was created by a group of highly regarded pain physicians from around the world who are passionate about pain management and teaching.  We pride ourselves in providing  unique training programs for specialists.

WHY PAIN SCHOOL INTERNATIONAL

  • “Executive fellowship” style course covering a full pain curriculum
  • Live patient procedure demonstrations
  • Module 1 & 2: 18 CME credits, Module 2 & 3: 23 credits
  • Internationally renowned faculty
  • 1:4 teacher- participant ratio
  • Hands on cadaver sessions
  • Fluoroscopic and ultrasound guided procedures
  • Access to hundreds of pain articles and lectures

 

WHO SHOULD ATTEND

The courses are for physicians who have no formal pain education in their countries, and for those who wish to strengthen their skills in interventional pain management. The curriculum provides comprehensive training in the assessment and treatment of chronic pain from the basics to advanced pain treatment.

 

DATES

SESSION 4: 3 – 5 November, 2017

2018 Course Workshop Dates
SESSION 1: 23 – 25 February, 2018
SESSION 2: 18 – 20 May, 2018
SESSION 3: 13 – 15 July, 2018
SESSION 4: 24 – 26 August, 2018

 

LOCATION
Budapest, Hungary

Click here to register

34th Annual Pain Symposium at Texas Tech University Health Sciences Center

WHO:  Program Director, Miles Day, Professor of Anesthesiology at TTUHSC and Medical Director for The Pain Center at Grace Clinic

WHAT: 34th Annual Pain Symposium at Texas Tech University Health Sciences Center

WHEN: Thursday, October 26, 2017

WHERE: Texas Institute of Medical Education, Plano, TX

The dynamic faculty that is being assembled for this activity will feature some of the country’s best pain practitioners instructing in our cadaver workshops for an audience of anesthesiologists and interventional pain specialists from around the world.

We hope that you will be able to join us as we move into our third decade of providing the best in informative, cutting edge technology and instruction in pain management.

Please refer to the attached information and feel free to call or email us if you have questions. We look forward to hearing from you and thank you for your continued support of Texas Tech University Health Sciences Center.

Click here for Event Flyer

Southern Pain and Southern Headache Society Combined Annual Meeting in New Orleans

In 2017 the Southern Pain Society (SPS) will be partnering with the Southern Headache Society (SHS)  for our combined annual meeting in New Orleans.

From Head to Toe: A Combined Meeting of the Southern Pain and Southern Headache Societies

When: September 8 – 10, 2017
Where: Astor Crowne Plaza Hotel, New Orleans, Louisiana

Now in its 31st year, SPS is an association of physicians and healthcare practitioners whose mission is to serve people with pain by advancing research and treatment and to increase the knowledge and skill of the regional professional community.  SHS is I its 7th year and is dedicated to the treatment of headache, facial pain, and related disorders.

The decision to combine these two societies is the direct result of the recent calls to action from various scientific and public health agencies.  We understand that chronic pain is an interdisciplinary health issue that requires collaboration from multiple pain specialists.  We have an exciting lineup of speakers and breakout sessions for each discipline.  Please visit our website  www.southernpainsociety.org  for the brochure, hotel booking information and the prospectus.

Read Dr. Trescot’s New Book “Peripheral Nerve Entrapments”

Featured as a single volume, this is a comprehensive guide to possible nerve entrapment syndromes and their management. Each chapter covers a single nerve, or group of closely related nerves, and goes over the clinical presentation, anatomy, physical exam, differential diagnosis, contributing factors, injection techniques, neurolytic/surgical techniques, treatments of perpetuating factors, and complications.

  • This book features over 50 videos of examination and injection techniques, at least 2 per nerve
  • Contains “Pain Problems Index” to navigate by symptom
  • Includes anatomy, injection technique, and complications for each nerve

About the Author

Andrea M. Trescot, MD
Medical Director – Pain and Headache Center
Anchorage, AK, USA

Dr. Trescot is currently the Chair of the Education Committee of the World Institute of Pain. After 15 years of private practice, she joined academics as a professor and served as the Director of the pain fellowship programs for the University of Washington and the University of Florida/VA Pain Center, before she returned to private practice. She was President of the American Society of Interventional Pain Physicians (ASIPP) from June 2007 to June 2008.  She coauthored the book Pain-Wise: A Patient’s Guide to Pain Management (Hatherleigh Press, 2011), and co-edited the 3 volumes of Pain Medicine & Interventional Pain Management – A Comprehensive Review (American Society of Interventional Pain Physicians Publishing, 2011).

Click here for more information!

http://www.springer.com/us/book/9783319274805#aboutAuthors

TTUHSC 33rd Annual Pain Symposium

New Therapies, Internationally Recognized Faculty Hands-on Ultrasound and Cadaver Workshops

Who: Texas Tech University Health Sciences Center
What: 33rd Annual Pain Symposium
When: October 27, 2016
Where:  Texas Institute of Medical Education Plano, Texas

View the Brochure

https://www.ttuhsc.edu/som/cme/flyers/pain/Pain2016.pdf

 

Persistent Pain After a Knee Replacement?

Do you have patients who experience persistent pain after a knee replacement?

Dr. Timothy Lubenow, Anesthesiologist & Professor of Anesthesiology at Chicago’s Rush University Medical Center, faced that familiar problem with his patient, Barbara Ford and turned to COOLIEF* Cooled RF. “It was a pain management problem at that point, which is why I recommended the COOLIEF* procedure1,” explains Dr. Lubenow. “The COOLIEF* procedure is designed to destroy the nerve fibers that innervate the inner portion of the knee joint1.”

Barbara Ford talks about how she got “99% of pain relief within fifteen minutes of coming out of anesthesia1” and how it was the best day of her life! Listen to her emotional story!

Barbara Ford video SHORT