“The Refill” is a Q&A column designed to provide Clinical Pain Advisor’s readership with various opinions, beliefs and suggestions on managing a pain management practice.

Today’s expert: David Rosenblum, MD. Dual board certified in Anesthesia and Pain Medicine, Dr. Rosenblum is currently the director of Pain Medicine at Maimonides Medical Center. He also sees outpatients at his various office locations.

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He completed a fellowship in interventional pain medicine at New York University. He also completed an internship in internal medicine at St. Luke’s Roosevelt hospital.

Clinical Pain Advisor: What is the biggest challenge to your practice?

Dr. David Rosenblum: In general, treating patients pain is the easy part. Running a multi-physician practice, enforcing policies and staying compliant is the challenging part — especially when the rules keep changing.

CPA: How have you been impacted by the Affordable Care Act?

DR: Yes. Whether directly related to the Affordable Care Act, or coincidental, many of my patients complain that they are spending more money on health care. Others have trouble finding specialists who take their coverage.

CPA: Where do you believe the future of pain management is going?

DR: I believe that patients will bear more and more of the financial responsibility. In some ways it will lead to more cost effective heath care. On the other hand it may be more challenging to treat patients who require multiple procedure or expensive medications. Patients who fail conservative therapies may find that they cannot afford more invasive or costly procedures.

I also foresee ultrasound use for interventional pain procedure becoming more and more common. It is cheaper, and does not involve ionizing radiation.