Also evolving is the science
of pharmacogenetic testing,
which lets a physician ana-
lyze a patient's genetic code
in order to determine how
he'll react to a specific med-
ication. What is the likeli-
hood of experiencing a seri-
ous side effect? Or addic-
tion? And what is the best
dosage?
"Reimbursement from
insurance companies has
held this back," says Dr.
McCarty. "They want more
evidence that it matters.
Some of the newer drugs
being released come with
companion diagnostics that provide information on the genes respon-
sible for metabolizing a drug or turning it into an active form. So
there's more motivation on the part of the drug manufacturer to
advise patients and lobby for coverage."
Evolved ablation
Trigger point injections and peripheral nerve blocks are increasingly
being incorporated into chronic pain management protocols. While
they are not new, the way doctors are administering them is.
"Fluoroscopy X-ray has allowed this specialty to grow," says Dr.
McCarty. "In the past, these injections and blocks were done blindly.
Now, with the use of this machine, we're able to make better diagnos-
J U N E 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 0 5
"A decade ago, doctors believed they
needed to prescribe painkillers, or risk
being reported to their medical board.
But what I teach people is that this is not
the only way. More and more, physicians
are open to embracing alternatives."
— Robert Saenz of VIP Medical
