How ASCs are Changing the Landscape of Pain Management: A Discussion with Pain Specialist, Michael Stanton, D.O., F.A.O.C.A.

Affecting more than a quarter of all Americans, pain can be chronic or persistent lasting months and even years, or it can be acute, finite pain often related to an injury or illness.  If left untreated, pain can be incapacitating, interfering with a person’s daily life.

Pain sufferers often face an uphill battle in finding a team of specialized medical professionals who understand their condition and know how to properly manage and treat it. To address this need, there nearly 500 Medicare-certified ambulatory surgery centers (ASCs)  in communities throughout the U.S. that focus on pain management, offering pain patients a convenient and highly specialized setting for care.

Michael Stanton, D.O., F.A.O.C.A, Medical Director and Chief of Staff at Baylor Surgicare Center, an ASC in Bedford, TX and a pain specialist at Metroplex Pain Management discusses his role in effectively diagnosing and treating chronic and acute pain in the outpatient setting.

Question: How did you develop your expertise in pain management?

My background and expertise is in anesthesiology, a specialty in which modern pain management has its roots. As my career progressed, it was a natural sequence for me to migrate from anesthesiology to a pain management practice, and I’ve dedicated the last 29 years of my professional life to helping people with pain improve the quality of their lives.

Question: Who is the typical pain patient?

In a typical day, I often see a combination of acute and chronic pain patients suffering from an illness and/or injury. I split my time between providing in-office consults, where I diagnose pain patients and develop an effective treatment protocol, and performing outpatient surgical procedures to help alleviate some cases of pain. About 60 percent of the patients I see experience chronic pain and 40 percent experience acute pain. I see a significant number of chronic pain case associated with tertiary illness, such as cancer and herpes zoster, as well as many acute cases, caused by an undertreated injury which, over time, can become chronic, long-term pain.

Question: As a leader in pain management, what are the most significant innovations you have seen in diagnosing and treating pain in the ASC setting over the past few years?

There has been a lot of progress over the past 15 years in treating pain and its causes. As innovation and technology in health care continues to advance, many of the pain management procedures once solely performed in a hospital setting are now able to be performed as an outpatient procedure in an ASC. Some of the most common procedures I perform to effectively treat pain are nerve blocks, pain pump installation, neurostimulation device implants and spinal cord stimulation.

Technological advances, such as the use of rechargeable batteries in equipment and sophisticated computer programs used in surgical devices, such as pain pumps or surgical equipment, have made many of the treatments and surgical procedures possible in an outpatient setting. Surgical procedures such as spinal cord stimulation and spinal decompression therapy have become more accurate, efficient and easier to perform in an outpatient setting. Additionally, until a few years ago neurostimulation device implants were strictly performed as an in-patient procedure, but as the product’s design and the procedure for implantation has advanced, we are now able to successfully perform this procedure in the outpatient setting.

The overall efficiency of ASCs coupled with innovation and these advances in medical technology have led to successful treatment of an increasing number of people living with pain which has translated into a tremendous value for the patient in terms of cost, time and convenience.

Question: Often there is a stigma related to prescription drug abuse associated with chronic and/or acute pain which hinders appropriate diagnosis and treatment; do you see this in your practice?  How can we start to break down these barriers?

I’ve been in practice for the past 29 years and one of the most significant barriers to appropriately treating pain starts with the preconceived notions of physicians and nurses, and even families and caretakers. With the rise in prescription drug abuse, many health care providers (HCPs) are cautious about prescribing pain medicines, which can be a liability, but it can also leave many patients who are legitimately in pain, un- or undertreated. There is a common fear that patients seeking pain relief are not experiencing pain, but rather in search of narcotics to achieve a ‘high.’

At an ASC as specialized as Baylor Surgicare Center, we are able to fully evaluate and monitor patients once we have developed a personalized and comprehensive treatment program to ensure that true pain sufferers are achieving what they came in for – relief from pain. The first step for any health care provider is to get to know a patient and make him/her feel comfortable. Next, it is important to fully understand any underlying conditions or injuries he or she has to help determine the root of their pain. To help break down these barriers and stigmas that may hinder appropriate management of pain, we must educate health care providers, family members and/or caretakers about pain as a condition, and sometimes a disease. I always remind my colleagues as well as a patient’s family members to put themselves in the patient’s shoes.

Question: What is the value for patients in going to an ASC for their pain care?

Some ASCs specialize in pain management, which means patients receive focused care and the latest thinking, therapy and technology for managing and treating pain from a staff of highly trained medical professionals. Additionally, every ASC is equipped with full operating rooms, so treatment programs can range from prescribing therapeutics (which would be done in the office setting) to performing cutting-edge surgical procedures that help patients live more comfortably.

ASCs are also known for greater convenience and an overall cost savings for patients. For example, on average, Medicare beneficiaries save over 50 percent on their coinsurance when having a procedure performed at an ASC.
Additionally, physicians often prefer working in the ASC setting because they have greater control over their scheduling, which translates directly into convenience for the patient. In my experience, the doctors and nurses at ASCs come to work to make a difference in every patient’s life.  The efficiency of the ASC allows me to spend more time with my patients who are living with an often debilitating condition. 

Question: What should people across the country know about pain management?

First, chronic and acute pain can be very serious conditions that often do require treatment by a specialized physician. Treating pain early on will result in a better outcome, so if you or someone you love is experiencing acute or chronic pain, seek professional medical attention from someone specialized in pain management.

Second, sometimes, pain can be so debilitating that it can be hard for a patient to see the light at the end of the tunnel, but pain can be successfully managed by a team of health care providers. Seeking the right medical team who can provide specialized and comprehensive care is critical to a patient wanting long-term relief from their pain.

Michael Stanton, D.O., F.A.O.C.A. completed his medical degree at Kansas City University of Medicine and Bioscience. He did his Residency in Anesthesiology at the University of North Texas Health Science Center and is a member of the American Osteopathic Association (AOA), American Society of Anesthesiologists(ASA), the American Osteopathic College of Anesthesiologists (AOCA) and the American Academy of Pain Management (AAPM). 

Media Contact:
Kay Tucker, ASCA
(703) 836-8808
ktucker@ascassociation.org