The Future of Evidence-Based Medicine in Pain Management: Q&A With Dr. Laxmaiah Manchikanti of the American Society of Interventional Pain Physicians

Laxmaiah Manchikanti, MD, is the chairman of the board and CEO of the American Society of Interventional Pain Physicians and the Society of Interventional Pain Management Surgery Centers; medical director of the Pain Management Center of Paducah (Ky.); and associate clinical professor of anesthesiology and perioperative medicine at the University of Louisville, Kentucky.
Q: What will 2012 bring for evidence-based medicine in pain management?

Dr. Laxmaiah Manchikanti: [ASIPP] is worried that evidence-based medicine will be converted into a witch hunt through overly empowered insurers. This is manifested by comparative effectiveness research and Patient Centered Outcomes Research Institute. PCORI and comparative effectiveness research may appear patient friendly and innocuous; however, once they make a draft determination, insurance companies will pick it up and start using and essentially denying the care.

There are protections against PCORI and comparative effectiveness research abuses with Medicare and Medicaid; however, these protections do not apply or extend to third-party payors. In fact, recent CMS evaluations have shown that essentially none of the treatments work — that is why it is extremely important that evidence be assessed appropriately.

Consequently, with the support of ASIPP and its members, Kentucky Rep. Brett Guthrie (R-2nd) introduced a long awaited bill to repeal PCORI and comparative effectiveness research funding. HR 3827 was introduced in the House Jan. 25, 2012 and if passed, would repeal PCORI and maintain patients' access to the appropriate care and treatments that they and their doctor chose. The bill has been referred to the House Energy and Commerce committee and is expected to gain strong bipartisan support.

Click here to read the full Becker's Orthopedic & Spine Review interview with Dr. Laxmaiah Manchikanti.

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