Cite as: Cohen S. President's message: My foray into the most enthusiastic, capable, and resourceful pain medicine community. ASRA Pain Medicine News 2025;50. https://doi.org/10.52211/asra080125.001.

President’s Message

As I assume the helm as the 33rd president of ASRA Pain Medicine, I heed the words of Harry S. Truman, the 33rd President of the United States, a historic role model who assumed his position in turbulent times. While World War II was at its 11th hour and the United States was facing questions about the use of atomic weapons to hasten the defeat of Japan, navigating a new world order on the precipice of the Cold War, and rebuilding Europe, Truman purportedly popularized the expression, “It is amazing what you can accomplish if you do not care who gets the credit.”

Today, the field of pain medicine faces several challenges, including high anesthesiology salaries that have led to declining fellowship applicants, more stringent prior authorization requirements associated with diminished access to care, physician burnout, decreasing reimbursement, and questions regarding the effectiveness of our interventions. Yet, just like when Harry Truman became president, we are equipped to face these challenges with the most enthusiastic, capable, and resourceful membership of any pain organization in the world.

Similar to what President Truman alluded to, the unsung heroes of ASRA Pain Medicine—the pillars of the society that provide its foundation—are those who serve in peer review roles for the journal, engage conference speakers with insightful and provocative questions, moderate and present posters, lead and serve on special interest groups, advocate on behalf of the organization and its members, and serve on committees, without which the society could not function. I am looking forward to continuing to work with these talented individuals as we navigate the evolving fields of regional anesthesia and pain medicine.

My Journey at ASRA Pain Medicine

I began my ASRA Pain Medicine journey 15 years ago at the Pain Medicine Meeting in Phoenix, AZ, where I spoke on facet joint injections, a topic I continue to discuss and write about today. The reason I gravitated towards ASRA Pain Medicine rather than other societies was that I believed it was the most evidence-based, ethical, clinician-centered pain organization in the world with an incredibly diverse and talented membership. In fact, it is its membership and contributors that make ASRA Pain Medicine the premier pain society.

During that meeting in 2010, Dr. Joseph Neal, who was treasurer at the time and later became president and editor-in-chief of Regional Anesthesia & Pain Medicine (RAPM), asked me to chair the 2013 Pain Medicine Meeting. Dr. James Rathmell, editor-in-chief of Anesthesiology, had recommended me to Dr. Neal. Drs. Rathmell and Neal handled the first manuscript our group ever published in RAPM, the earliest modern-day description of sacral lateral branch radiofrequency ablation for sacroiliac joint pain. At the 2013 meeting, Immediate Past President Dr. David Provenzano was in charge of workshops. He went on to chair the 2014 Pain Medicine Meeting.

My decision to pursue the presidency was driven in part by encouragement from individuals such as Drs. Honorio Benzon, Samer Narouze, Joseph Neal, Oscar De Leon-Casasola, Asokumar Buvanendran, David Provenzano, and Eugene Viscusi. I regularly bounce ideas off and seek guidance from many of these individuals, who, in turn, have sought advice from their predecessors. This is how medicine, politics, and life in general work - in the words of Sir Isaac Newton, “We stand on the shoulders of giants.”

ASRA Pain Medicine is a leader in education, research, and advocacy, and I’ve been honored and humbled to be a part of many of these activities, which I will support and expand under my presidency.

I am looking forward to continuing to support the journal’s long tradition of dedication to ethical publishing.

Building the Evidence Base

My first assignment on the ASRA Board was to chair the Guidelines & Regulatory Advocacy Committee, where we developed guidelines on the use of ketamine for acute and chronic pain, the treatment of facet joint pain, and pain management during the COVID-19 pandemic.

More recently, ASRA Pain Medicine has led multispecialty guidelines on a host of different topics, including, but not limited to:

• Infection control led by Dr. David Provenzano
• Anticoagulation led by Dr. Sandy Kopp
• Anesthetic management in cannabis users led by Drs. Shalini Shah and Samer Narouze
• Myriad steroid guidelines led by Dr. Honorio Benzon
• Postdural puncture headache led by Dr. Vishal Uppal
• Perioperative pain management guidelines in patients with chronic pain, opioid tolerance, or substance use disorder led by Dr. David Dickerson
• Gastric point-of-care ultrasound to assess aspiration risk in patients undergoing nerve blocks led by Dr. Stephen Haskins.

These guidelines represent the best available scientific evidence and are referenced worldwide to inform clinical judgment and promote best practices across various settings. I remain committed to further developing guidelines like these to provide ASRA Pain Medicine members with the resources they need to deliver the best possible care to their patients.

Another way ASRA Pain Medicine is a leader in building the evidence base is through its association with RAPM, the journal that is essentially the oldest anesthesia subspecialty journal, now in its 50th year. Medical publishers are also facing a slew of challenges, including issues like a surge in artificial intelligence (AI)-written or facilitated manuscripts, fraudulent research (which has been accelerated by the use of AI), proliferation of predatory journals, and a push for rapid publication and open or improved access.

RAPM remains a respected source of high-quality research in a crowded field of publications. In fact, the number of journals devoted to acute and chronic pain has increased dramatically from a handful in 1990 to over 50 in 2025. Yet, RAPM Editor-in-Chief Dr. Brian Sites has deftly navigated these challenges with RAPM consistently ranking in the top 10 of all pain and anesthesia journals. Since he took over as editor-in-chief in 2020, the number of submissions to RAPM has increased significantly. Among anesthesia and pain specialty journals, RAPM is at the forefront in publishing guidelines, including those on the use of AI, which can both dramatically improve a manuscript and be used for more nefarious purposes.

I am looking forward to continuing to support the journal’s long tradition of dedication to ethical publishing.

Adapting to Change Through New Educational Offerings

Another area of change in pain medicine is that of education. Numerous instruments are available for obtaining continuing medical education credits as we’ve shifted from non-interactive formats, like lectures and written materials, to asynchronous resources that afford greater flexibility and personalization. The need to keep up with the exponential growth in pain literature has been hastened by financial challenges, which have led some academic institutions to restrict reimbursement for conference attendance.

In response to these and other factors, ASRA Pain Medicine is developing a state-of-the-art, learner-centric model featuring lectures, articles, and podcasts from a world-renowned set of subject matter experts on the entire range of topics affecting pain care providers, including acute pain, chronic pain, the transition from acute to chronic pain, and practice management. Current ASRA Pain Medicine Treasurer Dr. Stuart Grant is leading this initiative, and we’re looking forward to launching the new program this fall. Watch your email for more information on this exciting resource.

I’m looking forward to some new additions to the Annual Pain Medicine Meeting as well. This year’s event will be held November 13-15 in Austin, TX, the capital of the second-largest state and home to a vibrant nightlife and cultural scene. Co-chaired by Drs. Anuj Bhatia and Sandy Christiansen, the theme of the meeting is “The Full Spectrum of Pain Care,” and it includes world-renowned speakers from North America and around the world.

This year’s meeting will also be the setting for the inaugural preconference Advancing Practice Across the Military and VA Health Systems, featuring the United States. Army, Navy, and Air Force pain management consultants to the Surgeons General, Veterans Affairs anesthesia and pain management specialty leaders, speakers from Ukraine, and the rollout of the much-awaited Neuromodulation Guidelines in Active-Duty Service Members led by Colonel Brian McLean, Captain Ryan Phillips, and myself.

Returning for its third consecutive year, the Advanced Interventional Pain Management Course and Workshop for Fellows offers an exclusive opportunity for fellows to receive personalized instruction on the ‘latest and greatest’ advancements in interventional procedures from top experts in the field within an intimate, small-group setting.

Our weekend courses continue with the Introduction to Perioperative Point-of-Care Ultrasound Course, taking place on September 27-28 in Tampa, FL, and the Ultrasound-Guided Regional Anesthesia Course, scheduled for January 31-February 1, 2026, in a new venue—picturesque Chapel Hill, NC. This course will coincide with World Day of Regional Anesthesia and Pain Medicine, which has continued to grow since its inception in 2024.

Forging a Better Future Through Advocacy

ASRA Pain Medicine was initially devoted to education and pain research, but 10 years ago, the board decided to add a third cornerstone to the mission—advocacy. Drs. Oscar de Leon-Casasola and Asokumar Buvanendran led the effort to add advocacy as a core objective with Dr. David Provenzano continuing the push during his presidency. ASRA Pain Medicine was seated in the American Medical Association’s (AMA) Specialty and Service Society in 2018 and received official voting status in 2022. Today, ASRA Pain Medicine has members serving in the House of Delegates (Drs. David Provenzano and Gary Schwartz with Drs. Richard Chou and Lee Tian serving as alternates) as well as in the Resident & Fellow Section (Dr. Rosalynn Conic). This year, Dr. Richard Chou was elected as an at-large member of the Mobility Caucus.

Recent advocacy victories include garnering new CPT codes for fascial plane blocks (64466-64469, 64473-64474) and, effective January 1, 2026, percutaneous interlaminar lumbar decompression (62287, 62XX0, 62XX1). At the June AMA House of Delegates Meeting, ASRA Pain Medicine, along with the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, led the push for improved intrathecal therapy access that would allow compounded intrathecal medication syringes to be delivered directly to physicians’ practices for pump-treated patients. These efforts continue as we advocate for expanded coverage and access while navigating changing regulations.

ASRA Pain Medicine also advocates through the collaborative Pain Medicine Coalition (PMC), which continues to grow with the addition of the American Academy of Physical Medicine & Rehabilitation. Founded by ASRA Pain Medicine, the American Society of Anesthesiologists, and the International Pain and Spine Intervention Society, the PMC is now composed of four influential and ethical pain societies. Most recently, the PMC spoke out against Blue Cross Blue Shield of Massachusetts’ inclusion of several fascial plane blocks as investigational/non-covered services.

As we reflect on ASRA Pain Medicine’s 50th anniversary, we again reflect on those who came before us, while encouraging you to be part of the next 50 years. ASRA Pain Medicine is one of the five oldest pain societies in the world. It has evolved to become a leader across the entire spectrum of pain medicine, including acute pain, chronic pain, and the treatment of pain with both interventional and non-interventional techniques.

I am honored and humbled to continue this proud leadership over the next 2 years alongside you as we expand our reach and impact to positively influence even more healthcare providers and patients, thereby enhancing the wisdom and beneficence of our society.