Advanced Pain Management, based outside of Milwaukee, says it is the largest pain group in the United States, with 28 physicians and almost 300 employees working at 11 pain centers in Wisconsin and Minnesota. Vishal Lal, APM's CEO, describes how his organization is becoming a "brand," in a way like Starbucks, Target or Mercedes.
Q: How is your group different from other pain management organizations?
Vishal Lal: All of our physicians are employed and closely follow protocols that they helped develop. This is a very cost-effective model. Also, this is a closed system, meaning that outside physicians and other professionals cannot use our pain centers. And finally, we are branded. About 70 percent of our patients do not come here seeking a particular physician but are responding to the APM brand. They expect a certain level of care from every physician. Since the patient is willing to see any of our physicians, we can guarantee same-day care. If you call today, you will be seen today.
Q: What procedures do your physicians perform?
VL: We have a multidisciplinary model, with a focus on interventional pain management. Treatment runs the gamut from epidural to spinal cord stimulators. We have top physicians on staff, including people who were at Harvard, Johns Hopkins and Cleveland Clinic. Each of our sites has two to three interventional pain physicians and we run 11 ambulatory surgery centers accredited by Medicare and the Joint Commission.
Q: How do you handle your referral relationships?
VL: We get referrals from primary care physicians, chiropractors, physical therapists and orthopedic and spine surgeons. We have cordial relationships with all of them. Although we have a great track record, we recognize we can't fix everyone and that other modalities may work better. We want other caregivers to feel the same way about us. In many cases, by the time patients come to us, they have exhausted chiropractic, physical therapy and exercises. Also, 20 percent of our patients already had surgery, so we have a two-way relationship with the surgeons. We refer to them and take referrals from them.
Q: Have you considered hiring orthopedic surgeons?
VL: No, we haven't. It would be easy to hire one or two or them, but we would want to have a larger presence or none at all. If you just have one or two, you don't have an efficient operation and you end up making everyone your enemy. You are no longer a referral source; you are now a competitor.
Q: What is your relationship with hospitals?
VL: We want to have joint ventures with them, as we have done with St. Vincent Hospital in Green Bay. We provide the pain management for the hospital and we send our patients to the hospital for physical therapy. The hospital uses our protocols with them and then the patients come back to us. We also develop referral relationships with non-pain practices. In Mankato, Minn., our only site in Minnesota, we have a joint venture with the Mankato Clinic.
Q: Are you planning to continue expanding in the future?
VL: We will be looking for other sites in the next 2-3 years. We intend to be very selective because we want to do it well. We usually go where we've been invited. We'll continue to look for collaborations with hospital systems because it's a good arrangement. We provide inpatient pain care for the hospitals, which allows them to offer one-stop shopping.
Q: Do you have any advertising?
VL: Yes. We put ads on billboards and on TV. We also get the word out by hosting education seminars and community events. There is so much pain out there. Chronic pain affects 76.5 million Americans. Pain is the single biggest reason why patients walk into a primary care physician's office. We get the word out to primary care physicians, as well. For example, we provide courses on pain management for them. Knowledge should be shared.
Learn more about Advanced Pain Management.
Read more about pain management:
- 5 Points on Adding EMR to a Pain Practice
- 18 Statistics About Pain Management in Surgery Centers
- 70 of the Best Pain Management Physicians in America