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Anesthesiologists & Pain Treatment
Summary - How Many Are In Pain Management? From all indications, based on Marketdata’s phone interviews with the leading multidisciplinary programs, the leading pain associations and anesthesiology societies, it is very clear that more anesthesiologists have moved into the field of pain management since our last study in 2003. There is solid evidence that that trend will continue in the near future, as the tide seems to be toward using more drugs and “procedures” to treat chronic pain. Ample evidence to support this comes from Medicare statistics (see tables below), from insurers, and from pain program directors. In 2003, the American Society of Anesthesiologists' manpower committee reported that there were 24,326 active members (of a total membership of 38,707 – about 63%). Today, the Society has a total membership of 45,000. If that same 63% share are active and practicing, that would come to 28,350. The Society thinks that they may represent 87% of ALL the anesthesiologists in the United States. Based on that percentage, Marketdata estimates that there are 32,500 active and practicing anesthesiologists. Consequently, Pain101 analysts estimates that there are now 32,500 active anesthesiologists in the United States. Based on interviews with anesthesiologists and the trade groups and boards representing them, it appears that the percentage becoming involved in pain therapy or treatment has risen slightly since 2003. Marketdata estimated in 2003 that 10.6%, or 2,915 were involved in pain management. Today, that figure is estimated to be 12% of the active 32,500 practicing anesthesiologists, or 3,900. To date, 4,119 doctors have been certified in pain management by the ABA, versus 2,834 in 2003. This is up 45% from 2003. Typical Caseloads.... Some anesthesiologists spend little time on patient evaluations, concentrating mostly on performing nerve block procedures. At the high-volume end, the doctor may see 15-20 patients a day, several times per week. At the low-volume end of the scale, an anesthesiologist may see 3-5 patients a day. Most workweeks average 2-5 days. A typical epidural nerve block for lower back pain costs $350-400 for several visits. Costs vary, depending on the site of the block. Some patients only come for 3-4 visits, while others may be treated for 1-2 years, and some do not respond to treatment at all. Percent of anesthesiologists' time devoted to…-hospital emergency room/surgery 31.6 %
-your pain
program 68.4 Apparently, most anesthesiologists we surveyed devote the bulk of their time these days to their pain program rather than the hospital.
Percentage of anesthesiologist patients treated for …
* including. back and neck pain combined ** sickle cell anemia, PHN, shingles, stress. By far, the most common type of pain for which anesthesiologists treat patients continues to be back pain—nearly 60% of the typical anesthesiologists’ patients in 2003. When combining back and neck pain, this accounts for 77% of all patients’ conditions, very close to the 74.7% rate for anesthesiologists and multidisciplinary programs combined. Since 1997, the share for back and neck pain has risen—from 58% to 77%. A noteworthy trend is that of the increasing share of patients treated for neuropathic pain. Treatment methods used - Percent of Anesthesiologists Using…
* Includes: epidural steroids, cryoastatin, discography, IDET procedure, vertebroplasty, epiduroscopy, cryotherapy, neural ablation, radiofrequency, spinal injections, intra-discal turmal annulsplasty. What is the average cost of treatment to the patient? (per visit) The average cost derived from respondents PER VISIT by anesthesiologists is now $378.77. At an average of 9.7 visits during a patient’s treatment, this comes to a total treatment tab of $3,674. The cost of treatment by anesthesiologists was substantially lower than the cost of multidisciplinary programs. This is no surprise, since anesthesiologists do not operate any inpatient programs, nor do they have the size staff and number of ancillary specialists as part of their program. They are doing specific procedures such as nerve blocks, which are not as costly as many of the methods used by a comprehensive pain program. Outcome Data The majority of anesthesiologists treating chronic pain patients still cannot document outcome measures, and it is getting worse. In Marketdata’s last 2001 survey, we found that 47% could document outcome. Today it’s down to 40%. There’s still a long way to go when compared to multidisciplinary programs. Fully 84% of the latter group claims to be able to document outcome this year.
Source: Marketdata Enterprises, Inc., Chronic Pain Management Programs: A Market Analysis
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