"I think it's important for us to have all components under one roof. It becomes difficult when you're referring patients to procedures that you don't offer within your practice and within your healthcare system. Then, you kind of lose control over that; you lose your referral bases, you lose your follow-up. So that's something that concerns me."

Peter Passias, MD, orthopedic and spine surgeon, NYU Langone Health (New York City)

"Many of us know they will rely on Facebook or somewhere else to get their health news over their own provider. And so what I'm trying to focus on, what I'm challenging my team on, is consistency. There's still trust in the physicians but not the healthcare system,"

 Jonathan Davis, COO, Clearway Pain Solutions

Personalized Medicine: Personalized medicine is becoming increasingly prevalent in pain management and anesthesia. By leveraging genetic and biomarker information, healthcare providers can tailor treatments to individual patients, aiming to optimize efficacy and minimize adverse effects. This approach enhances precision in drug selection and dosage, fostering better outcomes and patient satisfaction.

In a panel discussion on big threats and opportunities in spine, orthopedics and ASCs, Peter Passias, MD, orthopedic and spine surgeon, NYU Langone Health (New York City), reiterated the importance of creating a holistic, personalized pain management journey to support greater patient retention.

"I think it's important for us to have all components under one roof," Dr. Passias said. "It becomes difficult when you're referring patients to procedures that you don't offer within your practice and within your healthcare system. Then, you kind of lose control over that; you lose your referral bases, you lose your follow-up. So that's something that concerns me. I like to keep it all under one roof where I can communicate with my pain providers and my physical therapy providers, and we can all be on the same page of what's a reasonable level of care." 

Minimally Invasive Techniques: There is a strong movement toward minimally invasive techniques in anesthesiology and pain management. Innovations such as nerve blocks and local anesthesia are reducing the need for general anesthesia, thereby decreasing recovery times, reducing hospital stays and minimizing risks associated with more invasive procedures.

In the same panel session, Dr. Passias of NYU Langone Health noted the variety of procedures his organization has added to accommodate patient needs and foster better outcomes — as well as fuel organizational growth.

"Maybe 10 years ago for a diagnosis of scoliosis or degenerative spondylolisthesis, we had one or two options surgically and we had operative or non-operative," he said. "Now, for those conditions, we have probably 10 pain management-based procedures. We have eight surgical options and we have five different protocols. So developing that, what your system can accommodate and what's best for particular types of diagnoses and patient profiles, I think helps your system grow and capture all levels of care."

Multimodal Analgesia: Multimodal analgesia, which involves the use of multiple medications and techniques to manage pain, is gaining traction. This approach diminishes reliance on opioid medications, mitigating the risk of addiction and side effects. By combining different pharmacological and non-pharmacological methods, healthcare providers can achieve more comprehensive and effective pain control.

Regenerative Medicine: Regenerative medicine, including stem cell therapy and platelet-rich plasma, is being explored as a revolutionary way to manage chronic pain. These techniques aim to repair and regenerate damaged tissues, offering a potential long-term solution to pain rather than merely masking symptoms.

Anesthesia Contracts: Anesthesiologists have seen lower reimbursements and pay in the last two years, and they're renegotiating contracts with hospitals and surgery centers as a result. Some ASCs are hiring anesthesiologists for the first time as they expand, while others are partnering with local anesthesiology groups to maximize coverage.

Some practices are even bringing anesthesia services in-house. In a session on threats and opportunities in spine, orthopedics and ASCs, Niko Jannetta, director of operations, National Spine and Pain Centers (Rockville, Md.), discussed the complex headwinds from changes in the anesthesia market and reduction in reimbursements, coupled with the scarcity of anesthesia providers. 

"Right now, it's very tough to have consistency of care," Mr. Jannetta said. "What we've done is bring anesthesia back in house with our own in-house team of MDAs and CRNAs. The cost is negligible and you're still paying similarly, depending on how you set it up for a pool of support providers or if you have a partnership with a group. But what we win at is consistency of care for our patients and our providers. Our doctors are comfortable who they're on the same team with, not a vendor partner. And with that we have consistency of care and paramount patient experience."