Editor's Column: Musings ... A.M. & AM

By William Sullivan posted 10-16-2017 11:43 AM

Many people start their day with a daily calendar or other quote to provide some introspection or musing as they start their day. Musing is defined as contemplation or meditation, or being deep in thought. I think the two quotes above are perfect to provide morning (a.m.) contemplation, but are also appropriate as we think about the other important AM in our spine care universe: the Annual Meeting.

The 32nd Annual Meeting of the North American Spine Society is sure to be a hit. The program chairs—Ted Dreisinger, PhD, Jonathan Grauer, MD, and Conor O’Neill, MD—and staff have been working diligently, and the preliminary program looks great.

While Orlando was not immune to the effects of Hurricane Irma, it appears they sustained minimal damage, and that the community has been working hard to ensure a successful recovery. My thoughts go out to those affected by Hurricanes Harvey, Irma and other natural disasters including Western US wildfires and Hurricane Maria, currently active at the time of this writing.

I expect that part of the recovery process is trying to get back to business as soon as possible. Word from the Orlando Convention Bureau is that the storms have not impacted our Annual Meeting—the Convention Center, hotels and theme parks resumed operations quickly—and we can look forward to enjoying and supporting the Orlando community and Florida. I know I'm looking forward to a postmeeting visit with a good friend in Tampa, who was hunkered down during Irma, Ridin' The Storm Out (nod to 70s rockers, REO Speedwagon).

The first quote above is about perspective, which I have written about in previous columns. It is certainly appropriate as we approach the Annual Meeting, as we each may view issues related to spine care from a different perspective. I am interested to hear the differences among presenters, even though we all may be looking at the exact same issues. Overall, the Annual Meeting provides an opportunity for all attendees to see things from a different perspective, and thereby elevate their knowledge and understanding.

The second quote is also pertinent as we consider whether to attend the Annual Meeting. For those with no plan, they will continue to muddle through without goals or ultimate control of their destination. Those who plant a seed (often through seeing things from a different perspective) will likely flourish. This is not to say that things can’t change. From John Lennon’s Beautiful Boy, “Life is what happens to you while you’re busy making other plans” (adapted from Allen Saunders).

As this is the Annual Meeting edition of SpineLine, I usually try to keep things short. But I can’t help saying how happy I am for Dr. Todd Wetzel on his outstanding presidential year, and how sorry I am this is his last column From the Desk of the President. His columns have been thoughtful, provoking and fodder for many morning musings on my drive to work. I am also looking forward to his address at the Annual Meeting. Incoming president Daniel Resnick, MD, will have big shoes to fill, but as we read in his introductory column last month, we can anticipate many good things to come.

Our CURRENT CONCEPTS section in this issue includes contributions from several committees in NASS.

From Ethics chair and long-standing board member, Jerome Schofferman, MD, we have an interesting review on the current state of the complex nature of pain and benefits of treatments, “Some Reasons Patients Feel Better.”

Values committee member, Matthew Smith, MD, provides an article on “The Value of Epidural Injections for Axial Low Back Pain.” Dr. Smith gives us a realistic look at what to do when something with “limited evidence” is an option, or even the only option. It reminds me of a statement I think I first heard from Denver orthopedic surgeon Courtney Brown, MD, which I'll paraphrase here: evidence-based medicine is not just randomized, double-blind, placebo-controlled trials—it is all levels of evidence, including experience.

Drs. Alison Stout, Michael Guo and Jerome Schofferman (busy guy!) provide a Literature Review Commentary critiquing a recent RCT published in JAMA on radiofrequency neurotomy. They take a close look at limitations of the study and the potential downstream affects.

The SOCIOECONOMIC & POLITICS section includes a helpful Coding piece on “Coding for Corpectomies” from Karin Swartz, MD. From Allison Waxler, we get specifics on the "2018 Proposed Rule for Medicare Outpatient/ASC Reimbursement" in her Regulatory Policy update. This issue's Advocacy column, "2017 Legislative Gridlock and What Lies Ahead," comes from new NASS Advocacy staff, Daniel Stanford and Advocacy Chair John Finkenberg, MD. You'll find relevant information, analysis and opinion in each of these timely contributions.

I will close with a special thank you to all of the contributors, section editors, and especially NASS Staff for their dedication in providing another edition of SpineLine. I also congratulate and thank those who plan to participate in the Annual Meeting. As always, we are receptive to any comments or suggestions that will help make a difference. And Please Come to Orlando! (...not quite the same ring as last year’s Dave Loggins reference, but you get the point.)

*This column initially appeared in the September/October 2017 issue of SpineLine. To read more from the issue, click here