Posted on ToxLaw.com by Sharon Kramer on 1/28/11
Experts Predict Harm to Patients
“Timothy Deer, MD, president of the Center for Pain Relief in Charleston, W.Va., and chair of the American Society of Anesthesiologists pain committee, said that if adopted in their current form, the ACOEM guidelines would adversely affect patients.
“We’ve gone to general quarters on this,” one society official told Pain Medicine News. “We’re talking litigation. We’re talking class action. We see this as pandering to the insurance companies,” said the clinician, who did not want to be identified. “The insurance companies will buy these guidelines and then cut and paste [the text] on their denials.”
“We don’t want this to be the de facto standard of care nationwide,” said B. Todd Sitzman, MD, MPH, president of the American Academy of Pain Medicine (AAPM).
ACOEM itself has come under recent scrutiny for its ties to business. The 5,000-member group, once called the Industrial Medical Association, was the subject of a January 2007 article in The Wall Street Journal that questioned the objectivity of an ACOEM report rejecting a link between mold and serious worker illness. The authors of the report, according to the newspaper, were researchers who frequently receive money to testify for companies named in mold suits—a fact not disclosed in the report or by ACOEM.
Similar accusations were raised in a recent article in the International Journal of Occupational and Environmental Health (2007;13:404-426), which labeled ACOEM “a professional association in service to industry” and said that corporate “money and influence permeate every aspect of occupational and environmental medicine.”
Proposed Guidelines for Workers’ Comp Patients Roil Pain Specialists
The nation’s pain groups have taken aim at proposed guidelines for the treatment of chronic pain that discount the utility of several staple interventional and noninterventional therapies, such as certain medications, epidural injections and spinal cord stimulation.
If approved, the guidelines, from the American College of Occupational and Environmental Medicine (ACOEM), could affect the willingness of health insurers to pay for the procedures in question, experts said. In the rationale sections of its recommendations, the document frequently comments on the cost-effectiveness of a given therapy. Although interventional pain medicine is a relatively new field, the growth of these procedures has been strong. Medicare spent roughly $2 billion in 2005 on interventional remedies.”
