President’s Message: First, Do No Harm (Hippocratic Oath)

Jul 17, 2018, 12:49 PM by Asokumar Buvanendran, MD

First, Do No Harm (Hippocratic Oath)

A recent article in The Atlantic Monthly put into perspective the huge responsibility we, as health care providers, have in staying informed about the ever-evolving discoveries being made in medicine and health care. “When the Evidence Says No But the Doctors Say Yes” illustrated the challenges of incorporating the latest research findings into practice, not just because our understanding of conditions and treatments is constantly evolving but also due to a slew of confounding factors such as expanding technological advancements, institutional protocols that may be slow to change, insurance coverage requirements, and, frankly, an innate desire to proceed with business as usual as we manage a great number of patients.

 ASRA’s responsibility to you as a member is to provide not only the education about how to do your work but also to provide the foundational research that guides why you do it. High-quality outcome-based research guides every step of this process, not only the why and how but also whether what you do is reimbursed by insurance. Staying on top of this is a critical component of our mission and a critical component of your practice. As such, the ASRA Board has approved and will be having the first strategic meeting of the ASRA Research Committee, headed by Chair Stavros Memtsoudis, MD, on September 22 at the ASRA National Office in Pittsburgh, Pennsylvania. At this meeting, key thought leaders will develop a 5-year master strategy for acute and chronic pain and present their decisions to the ASRA Board.

ASRA supports two research grants, the Carl Koller Memorial Research Grant and the Chronic Pain Research Grant, with funding of $200,000 available annually. We work hard to ensure that the results of those grants are shared back with members, and recipients are asked to submit their findings to the journal. We encourage all members to support these research grants by making a tax-deductible donation at Through your support, we can continue to work toward our shared goals for the ultimate benefit of our patients.

For many ASRA members, keeping informed is one of the biggest challenges, and our membership survey demonstrated that with a number of people asking for more quick resources, summaries of the latest findings, and interpretation of those findings. These are all areas in which ASRA continues to work to support you.

ASRA currently offers two annual meetings, three weekend courses, and a wealth of resources in our journal, newsletter, and website. As a testament to the quality of our programs, our first-ever “Introduction to Perioperative Point-of-Care Ultrasound” sold out months before the event in February 2017 and garnered a huge wait list. We will have two offerings in 2018: February 24–25 in San Diego, California, and December 1–2 in Chicago, Illinois.

 I also welcome all ASRA members to take advantage of our early-bird registration deadline for the 16th Annual Pain Medicine Meeting being held November 16–18 at Disney’s Yacht and Beach Club Resorts at Walt Disney World in Florida. The rooms are already starting to fill, and this will be a great opportunity to combine a family vacation with your CME learning, as the location is just steps from Disney’s Epcot Center. Visit the meeting site at pain.

We work diligently to push out the latest information in a wide variety of ways.

Here are a few other things you can do to connect to resources:

  • Use the search button on our website to find content on your desired topic. We have an extensive list of resources on the “Resources” page, but the search button also enables you to search through all of the ASRA News as well. Webcasts of select sessions from the last meetings help you stay informed as well.
  • Join a special interest group to find others with your same areas of interest. Use the ASRA Membership Directory to find other members and reach out to them.
  • Follow @ASRA_Society on Twitter. Our active community responds to questions regularly and opens the discussion to more than 6,000 followers.

This informal exchange of information may work in the heat of the moment, but if you need more information, ASRA’s research program offers a number of ways to be informed and contribute.


Even if you don’t consider yourself a researcher, you have a way to contribute to and benefit from the knowledge base twice a year via abstract submissions to our annual meetings. (Abstracts for our upcoming 16th Annual Pain Medicine Meeting [#ASRAFall17] are due September 6. Visit for more information.)

Perhaps you are not interested in conducting formal research projects. You may still have interesting subjects in your daily practice that would be ideal topics to address in a medically challenging abstract submission. Abstracts often evolve as discussions ensue during formal presentation and result in further dissemination, collaboration, and research.

ASRA’s Professional Development Committee led by Brian Sites, MD, is also working on identifying projects related to mentoring new researchers and authors as well as thing such as learning how to better interpret research studies, among other ideas. The ASRA Board will have a strategic session on September 23 to build on our Faculty Development project. The ASRA Board recognizes the value of investing in our future, developing tomorrow’s faculty, researchers, and leaders.

 As I mentioned, one of the more difficult challenges of putting evidence into practice lies with the larger institutions and organizations in which we move. Your best intentions may be very difficult to put into action if insurance will not cover procedures. This is another arena in which ASRA is working hard on your behalf. We regularly interact with organizations such as the Centers for Medicare and Medicaid, the Food and Drug Administration, and state health organizations to provide testimony and expert commentary on guidelines and other regulatory matters.

As a testament to our role in the health care community, regulatory bodies and other organizations often approach us with invitations to get involved. For example, the Centers for Disease Control invited us to be a part of its Adaptation & Dissemination of Outpatient Infection Prevention project, the Accreditation Council on Graduate Medical Education asked for our feedback on its pain medicine graduate medical education guidelines, and the American Association of Hip and Knee Surgeons (AAHKS) has invited us to participate in a number of projects, most recently development of tranexamic acid guidelines.

We also monitor regulations at the state level and regularly provide insight, sharing the latest research findings, such as when threats to coverage of epidural steroid injections occurred in California, Oregon, Washington, Tennessee, and Pennsylvania. An understanding of the latest research, putting the research into a larger framework, and having access to these decision-making groups are some of the ways that ASRA is able to help you in your efforts to be a better provider. In addition to AAHKS, we regularly partner with groups such as the North American Neuromodulation Society, the International Anesthesia Research Society, and the Oncology Nursing Society, to name a few, as we work to encourage multidisciplinary collaboration.

 To emphasize the importance of ASRA’s role in advocating for improved patient outcomes through our various education, research, and advocacy efforts, we have officially changed our mission. The new mission reads, “Advancing the science and practice of regional anesthesia and pain medicine to improve patient outcomes through research, education, and advocacy.” You’ll begin to see our new mission on all of your ASRA materials over the next few months.

Medicine is constantly evolving. As health care organizations work to standardize treatments, insurance companies try to fit everyone into a predetermined slot, and health care costs continue to escalate, it is more important than ever that we question the status quo. You may feel that you are too busy to interpret the latest research findings. Your organization likely has protocols in place. Insurance covers only specific procedures. It is not easy to make changes in this busy and complicated environment, but ASRA is committed to being your partner through this challenging journey. Be sure to take advantage of these resources.

As always, if you have suggestions on this or any other aspect of ASRA, please email me at And thank you for your support of ASRA!

Quote: “To emphasize the importance of ASRA’s role in advocating for improved patient outcomes through our various education, research, and advocacy efforts, we have officially changed our mission."

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