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Anesthesiologists & Pain Treatment 

  Summary - How Many Are In Pain Management?

The American Society of Anesthesiologists' manpower committee reported that 4% of 21,525 active anesthesiologists in 1989 were active in "pain therapy", up from 3% of 17,741 in 1985. This equaled 860 practitioners nationwide in 1989.  That was 14 years ago.  Today, the Society reports 24,326 active members (of a total membership of 38,707). The Society thinks that they may represent 87% of ALL the anesthesiologists in the United States. Marketdata estimates that there are now 27,500 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 1999.  Marketdata Enterprises estimates that 10.6%, or 2,915 are now involved in pain management.  The field of anesthesiology related to the operating room has become saturated, and salaries have fallen, due to managed care.  In response, many anesthesiologists are pursuing dual careers, splitting their time between the hospital and a pain clinic.

In 1993, the American Board of Anesthesiology began certifying anesthesiologists in pain management.  To date, 2,834 doctors have been certified in pain management by the ABA, versus 2,533 in 2001.

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 …

(% of patients)

Type of Pain

2003

 

 

Back

59.9

Myofascial

14.5

Neck

17.4

Neuropathic

20.8

Arthritis

16.8

Reflex sympathy dystrophy

7.0

Cancer

6.1

Headaches, migraines

6.4

Repetitive stress injuries

4.6

Abdominal

3.6

Pelvic (female only)

3.0

TMJ syndrome

1.7

Other **

5.3

* 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…

Treatment Method

2003

 

 

nerve blocks

100.0

trigger point injections

91.6

long term narcotic use

83.3

physical therapy

54.1

spinal cord stimulators

70.8

multidisciplinary

70.8

implanted intrathecal pumps, epidural

54.1

psychotherapy

33.3

neuromuscular electric stimulation (TENS)

8.3

acupuncture

25.0

botulinum toxin injections

45.8

massage

12.5

at-home pca

8.3

saline injections

8.3

magnetic therapy

0.0

herbal remedies

12.5

chiropractic

8.3

*other

8.3

* 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

 

-Arthritis Pain

-TMJ Pain

-Back Pain

-Joint Pain

-Knee Pain

-Neck Pain

-Pelvic Pain

-Cancer Pain

-Chronic Pain

-Shingles Pain

-Shoulder Pain

-Myofascial Pain

-Abdominal Pain

-Neuropathic Pain

-Athletes and Pain

-Fibromyalgia Pain

-Pinched Nerve Pain

-Repetitive Stress Pain

-Headaches & Migraines

-Irritable Bowel Syndrome

-Temporomandibular Joint

-Pain MD's & Specialists

-Pain Doctors CARF List

-About Painkillers Online

-Acupuncture

-At-Home PCA

-Biofeedback Services

-Botox Injections

-Brain Stimulation

-Herbal Remedies

-Magnetic Therapy

-Nerve Blocks

-Pain Clinics

-Pain Medications

-Physical Therapy

-Psychotherapy

-Saline Injections

-Spinal Cord Stimulation

-Trigger Point Injections

-Links and Resources





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