Cite as: Arnold DE. ASA and ASRA Pain Medicine: speaking with one voice. ASRA Pain Medicine News 2025;50. https://doi.org/10.52211/asra020125.003.

“If you want to go fast, go alone; if you want to go far, go together.”

This proverb perfectly captures the essence of one of the American Society of Anesthesiologists' (ASA) core strategic priorities, strengthening the specialty's visibility and voice as a leader in the healthcare ecosystem. Strengthening relationships and effective collaboration with other medical specialties is key to achieving this as well as to enhancing patient care and member value. This approach is essential in our advocacy work with payers, in legislative and regulatory initiatives, and as we tackle the essential health policy priorities of this time.

Nowhere is intentional collaboration more important for ASA than between ASA and other anesthesiology organizations, including subspecialty organizations that have an active role in ASA governance. They provide important input on appointments to relevant committees and identify a society representative to serve on the ASA Committee on Specialty Societies. Regularly scheduled meetings between subspecialty society leaders and ASA leaders support shared work on the challenges impacting members to ensure alignment. Additionally, formal and informal collaboration occurs often, and there is a benefit for our shared profession from ASA incorporating the deep subject matter expertise of our subspecialty societies.

ASA's partnership with ASRA Pain Medicine is a critically important relationship. Our shared interests crosscut the range of member-serving activities of our organizations from joint efforts on key payment, coverage, and regulatory matters to education and collaboration on practice guidance and the recent co-founding of the Pain Medicine Coalition (PMC).

Attending ASRA Pain Medicine’s 23rd Annual Pain Medicine Meeting in Las Vegas last November was an absolute pleasure. I joined ASRA Pain Medicine's President David Provenzano, MD, on stage for the opening session to discuss the PMC. The PMC builds on the specialty-specific subject matter expertise and vision for the future of pain medicine residents within ASRA Pain Medicine and on the full capabilities of ASA as we partner to jointly lead the PMC, strengthening the visibility and voice of pain medicine specialists.

The coalition will give us a foundation from which we can work to address contemporary issues in pain medicine, including challenges faced by government payers and commercial payers, such as prior authorization, legislative and regulatory advocacy, and other matters impacting the pain community. The coalition will communicate with one voice on issues of concern in the pain community. Top priorities also include ethical pain care, access to multidisciplinary pain care, and eventually, pain medicine research, training, and education. The newest member of the PMC is the International Pain & Spine Intervention Society, and we look forward to welcoming other like-minded pain organizations in the future.

ASA and ASRA Pain Medicine have been hard at work on addressing the key challenges facing members of both of our societies. ASA and ASRA Pain Medicine continue to work with the American Medical Association (AMA) on shared efforts to ensure the support of AMA on issues such as Medicare and Medicaid payment and commercial payment and coverage. ASA and ASRA Pain Medicine also have effective delegations in the AMA House of Delegates, participating in the Anesthesiology Section Council, Specialty and Service Society, and Pain & Palliative Medicine Specialty Section Council.

In addition, ASA's pain medicine physician members represent ASA on the Current Procedural Terminology and Relative Value Scale Update Committees. In recent years, ASA and ASRA Pain Medicine have collaborated on the valuation of several pain codes. We also share an interest in scope-of-practice issues,preserving pain medicine as a physician practice and actively aligning goals and tactics for participation in the Scope of Practice Partnership.

At ASA, our state affairs team works closely every year with our state component societies to prevent nurse anesthetist advocacy efforts from expanding into interventional pain and related "pain management" and prescriptive authority efforts. Performance of pain medicine procedures should be reserved for physicians with appropriate education, training, and background. We've been successful in stopping these efforts; most recently, in 2024, our state affairs team worked with Pennsylvania to stop legislation that, among other things, would have authorized nurse anesthetists to be responsible for the total anesthesia care of patients and implement acute and chronic pain management modalities, all without physician oversight. We also worked with Wisconsin to secure a veto of legislation that would have authorized nurse anesthetists to practice and perform pain management procedures without physician oversight or involvement.

The relationship between ASA and ASRA Pain Medicine extends beyond our joint advocacy efforts and truly shines during our ANESTHESIOLOGY^® annual meetings. Last year in Philadelphia, there were 24 regional anesthesia and pain sessions and 14 pain medicine sessions. ASRA Pain Medicine also hosted two subspecialty panels, including "Hot Topics in Regional Anesthesia and Acute Pain Management" and "ASRA Pain Medicine 2024: Transforming Pain Care and Education."

ASA and ASRA Pain Medicine have been hard at work on addressing the key challenges facing members of both of our societies. ASA and ASRA Pain Medicine continue to work with the American Medical Association (AMA) on shared efforts to ensure the support of AMA on issues such as Medicare and Medicaid payment and commercial payment and coverage.

I'm also very proud of the work by ASA and ASRA Pain Medicine members in committees and workgroups that have led to ASA participation in developing ASRA Pain Medicine buprenorphine guidelines, ASA promotion of the ASRA Pain Medicine perioperative cannabis guidelines, and partnership to explore a pain medicine certificate post fellowship to support transition into practice. The ASA Committee on Pain Medicine has been active in discussions about scope of practice and access to safe and physician-led care in pain medicine as well as publishing several pain-related statements on topics such as ketamine for chronic pain, the practice of pediatric pain, and access to pain care. The Anesthesia Quality Institute is ASA's quality and payment organization, which works with physicians to help them demonstrate quality and receive payment for achieving certain metrics. ASA developed six quality measures with ASRA Pain Medicine in 2017 and 2022, which we will continually review.

Research is another essential area of focus for ASA, as one of our foundations is dedicated to developing the next generation of physician-investigators. Since 2010, the Foundation for Anesthesia Education and Research (FAER) has awarded at least 39 grants in pain-related research totaling $6.9 million—pain research is its most awarded area of investigation.

Jointly funded by ASA, the International Anesthesia Research Society, and FAER, the Anesthesia Research Council was formed to advance initiatives related to the future of academic anesthesiology and anesthesia research. Areas of research include intraoperative anesthesia care, the basis of consciousness, reduction of organ injury during transplantation, opioid-sparing techniques, and interventional pain.

More work is needed in the years ahead to address the issues facing anesthesiology and pain medicine practice. We will meet the challenges of these times in health care together. ASA and ASRA Pain Medicine will continue to advance high-quality and ethical patient care, support the development of new knowledge, improve the practice environment, and address other needs of our members. Strengthened by our new Pain Medicine Coalition, we will develop forward-looking solutions for physicians in practice and for the benefit of the patient communities served by our expertise. Please share your concerns, thoughts, and ideas for our shared work through asramembership@asra.com or president@asahq.org.