Dear Patients,

Last week, I wrote a blog about the new Medicare changes to pain management. Keep in mind that typically, private insurances follow Medicare’s lead, at least in part, when it comes to authorizations for treatment. After I wrote that blog, I did what we all should do whenever we write about subject that has us upset: set it aside for a day and show your work to someone else. I have taken the wise recommendations of my fellow board members, and so what follows is a very much revised version of that above-mentioned blog. Nonetheless, I’m still really upset. As your attending pain specialist, I am morally (and, to an extent, legally) responsible for your pain treatment, so when I’m told by someone who has never examined you what I can do and how I can do it, it is my nature to push back.

If you have Medicare in any form, or anticipate getting it soon, you need to speak with your MPC doctor about the pain treatment changes that he/she must make in order to be paid for the work, avoid penalties, etc. The changes are substantial,and were made without any input from MPC or from any other pain specialist colleague whom I know. I guess that my biggest gripe with the changes is that they do not make sense to me based upon my 27 years of practice. If there is one thing I’ve learned, it is that each chronic pain presentation is different, and as often as not, the success of treatment depends upon finding the correct combination of, as well as the correct schedule for, the individual patient. I’ve used this analogy before, and I’ll use it again because it has proven to me to be absolutely applicable: as in baseball, where every individual player has to find his pitches if he expects to consistently get on base, so too in pain management, subtle changes in treatment combinations and treatment timing make all the difference. There is no across-the- board formula, and unfortunately, in my hands at least, anything that impacts the ability to customize your treatment negatively impacts outcome.

My goal is to have every Medicare patient we see at MPC at least be aware of the changes and restrictions. As subspecialized physicians in private practice, my partners and I just don’t have much pull anymore (that’s another thing that is hard for me accept), and hence we rely upon YOU to contact your elected officials to at least make them aware of the situation. I can almost guarantee that they and their families are not much impacted by these new changes and restrictions, but if you are not so fortunate, now is the time to act. Go online to the Common Cause website, enter your home address, and you will receive contact info for all of your elected officials, state and federal.

Now is the time to act. Go online to the Common Cause website, enter your home address, and you will receive contact info for all of your elected officials, state and federal.

Thomas M Basch, MD