Senate proposal to increase pain workforce by > 100%

[cluelessme7]

Opioid Workforce Act of 2021 Introduced in Senate

Sens. Maggie Hassan (D-N.H.) and Susan Collins (R-Maine) introduced the Opioid Workforce Act of 2021 in the Senate on April 27.

www.aamc.org

What are people's thoughts on this new Bill? In short, the bill will supposedly be active from 2024-2028, increasing the number of training spots in pain management (which fields this will include is unclear, whether its strictly pain management fellowships or other residencies that are involved in pain management such as PM&R, psych, etc). The planned number of spots to be increased is quite drastic, given that pain management is a small field.

My thoughts/opinion --> Seems that this will definitely have significant negative implications on the job market and saturation going forward. Currently each year there are ~ 350 spots for pain fellowships, unsure how a > 100% increase would be sustainable while also meeting all the case exposure requirements under ACGME. Also this was written as a way to combat opioid overdose events, which again not sure how increasing pain prescribers is going to address that.

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[TheLoneWolf]

They should put some of this into addictions fellowships and incentivize residents to enter that.

 

[sloh]

Not sure there is a pain physician shortage issue. I know a lot of pain fellows finishing fellowship who are having a difficulty finding jobs in SoCal, much less well paying jobs. We can certainly make an argument for a gentle undersupply—but flooding the market with clinicians whether they be MD/DO's or APP's will only worsen job security and income if supply exceeds demand.

There was a good discussion on this in the rads forum:

https://forums.studentdoctor.net/threads/what-is-causing-the-resurgence-of-the-radiology-job-market.1436651/page-2#post-22728278

"The main point is that in this age of health care you can sink yourself with oversupply, but you can’t protect yourself with undersupply because big health systems are absolutely motivated to “innovate” you right out of existence.

It kind of seems like a gentle undersupply would be the best way to go."

 

[painfree23]

This is dumb

 

[au bon pain]

There’s virtually no chance this will pass as written. The number of CMS-funded GME spots remained essentially frozen for 25 years until the end of this past one where they upped the number by 1,000. And now these guys want to fund another 1,000 for 3 niche fields? Highly unlikely they have the dry powder to pull it off. While there isn’t a need for more pain fellowships right now, there certainly is for addiction...but the question is how of these 100s of proposed spots would actually fill.

Based on the language it really sounds like they want to find ways to curb inappropriate opioid prescribing and treat opioid use disorder which are noble goals. A better, more pragmatic way for them to proceed would be to legislate that insurers stop the pre-authorization shenanigans for non-opioid treatment options. They should also propose legislation to mandate that docs who treat opioid addiction are paid fairly to take these patients on. But that’d all be too logical, eh?

 

[Mona nucleosis]

Benefits vs Cost of doing a pain fellowship vs sticking with anesthesia is already a relatively close call. This expansion will tip the balance into making anesthesia a far better choice.

 

[Laryngospasm]

How does that recruiting dinner go.. “you’ll be so happy to join our ranks.. well train you to deal with the most difficult patients that exist all day long for the rest of your life..”

Sign me up..

 

[painfree23]

How does that recruiting dinner go.. “you’ll be so happy to join our ranks.. well train you to deal with the most difficult patients that exist all day long for the rest of your life..”

Sign me up..

If the price is right...

 

[TheLoneWolf]

If the price is right...

Haha, not if they flood the market as planned with new grads. Insurance learned to cut pain reimbursements long ago.

 

[painfree23]

Haha, not if they flood the market as planned with new grads. Insurance learned to cut pain reimbursements long ago.

So would this cut pain reimbursement more? Curious what the interventional societies stances will be on this

 

[Agast]

Double the number of physicians seeing their procedures denied by insurance because the patient has only suffered for 4 weeks instead of 6 and couldn’t afford PT.

 

[Ducttape]

otoh, this may very well help reduce CNRA/PA/NP/chiro creep into pain medicine.