Refining Our Targets

As the neuromodulation industry begins to recover from a crippling pandemic that seriously impacted the number of procedures performed in 2020, it is worth reflecting on another scourge that impacted our nation last year. We’re referring to the growing incidence of racism and discrimination that came to a head in several high-profile incidents.

A newly published article in the journal Neuromodulation: Technology at the Neural Interface, looked at the issue of racial and socioeconomic disparities in access to neuromodulation therapies. The study’s authors, who included Mark Jones from Weill Cornell Medical College, Stephanie Vanterpool from the University of Tennessee, Richard Urman from Brigham and Women’s Hospital, and Lawrence Poree from UC San Francisco, examined a CMS database of more than 1 million chronic pain patients who were treated with some form of therapy in the years 2016 through 2019. Of those, 4.8 percent received SCS therapy.

Multivariate regression analysis revealed that, compared with White patients, Black, Asian, Hispanic, and Native American patients were significantly less likely to receive SCS. In addition, patients who were dual-eligible for Medicare and Medicaid were significantly less likely to receive SCS than those eligible for Medicare only. “Similar to the racial disparities noted in other medical specialties, recognizing the historical, institutional, and individual racial biases that exist is just the first step in correcting these inequities,” the authors conclude. “Only through enlightened and informed policies can we expect change.”

Of course limiting access of neuromodulation devices to minority communities not only short-changes those communities, it also hurts the vendor community, which should always be on the lookout for under-penetrated markets. So it’s clearly in the industry’s interest to find ways to reach underserved communities.

One obvious approach is to increase the number of minority clinicians who are aware of and competent in prescribing and implanting neuromodulation devices. The North American Neuromodulation Society has formed a Diversity and Outreach Committee that has been charged with assessing the current state of ethnic diversity within NANS and investigating any possible barriers to accessing neuromodulation therapies by those who live in traditionally underserved communities. The committee has undertaken mentorship, outreach, and research projects to achieve that goal. “I think it’s really important to increase the pipeline,” said Johnathan Goree, one of the committee members. They have reached out to minority medical student associations to expose them to neuromodulation therapies.

Hopefully, efforts like this will reap rewards for the industry and for society as a whole in the years ahead.

James Cavuoto
Editor and Publisher


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