A Pain Specialist's Challenges and Rewards

In the late 1980s, when Ira Fox, MD, DABPM, FIPP, ABIPP, joined a large medical group in south Florida, pain management was in its infancy. Being “the new guy at the practice,” Fox took an interest in the specialty and spent his spare time traveling and learning from national and international experts on the subject.

Now he looks back and considers himself very fortunate.

“Because there were not many people doing [pain management], they were amused by my interests, so they allowed me to visit with them and learn from them,” Fox recalls. “And after doing that for several years, I realized I was in a position to do a lot of different things to help people with chronic pain.”

Today Fox is an interventional pain specialist and founder of Anesthesia Pain Care Consultants in Tamarac, Fla. He is also chairman of the Advisory Board for the World Institute of Pain Executive Board until 2013 and is chairing the local organizing committee for the 6th Annual Pain Congress that will be held in Miami in February 2012.

Keeping things basic

In years past, anesthesiologists involved in pain management would do three epidural injections in someone’s back in the recovery room, and if that helped, great. If it didn’t, that was it.

Not satisfied with that take-it-or-leave-it approach, Fox began exploring the field of pain management and soon came to a realization. Many of the procedures performed would offer greater results if done under X-ray using fluoroscopy or X-ray guidance.

“We could make sure the medication was reaching targeted areas,” he says. “And the results were a lot more dramatic.”

Fox started Anesthesia Pain Care Consultants in 1996 with Jay Lazner, MD, his original partner, and began performing procedures that today are much more common, including radio frequency, a procedure that burns nerve endings so patients no longer feel pain. He made a commitment to play a large role in the development of the pain management specialty. The hours were demanding, he recalls, but very rewarding.

“When you can work with somebody who most people have felt could never get better, and you can get them better, that’s extremely rewarding,” Fox says. “And it really is what keeps you going. It provides you with a mentality of not giving up so easily. A lot of these patients are challenging, and you may have to try different things before you can get the results you hoped for. But once you get it, you really change someone’s life.”

Exam time

Fox still spends a great deal of time traveling, but it’s not necessarily for leisure. He is an examiner for the Fellow of Interventional Pain Practice, a board certification given by the World Institute of Pain. Candidates are not only tested on their didactic ability through a written and oral exam, but they’re also given a practical exam where they perform procedures on cadavers.

As an examiner, Fox is able to assess physician skills as well as their ability to be safe. He also believes that not only is the FIPP the only exam of its kind, but it’s also needed in other specialties.

“An orthopedist does a hip replacement,” Fox says. “No one has ever seen him do one, yet he’s board certified. So we have put together this exam that allows the observation of people’s techniques.”

Hitting the fairway

An avid golfer, one of Fox’s goals is to play on each of the top 100 golf courses worldwide. With his travel schedule, that might seem easy to do, but Fox admits that he’s probably only about a quarter of the way toward his goal.

“I just got back from playing the number two ranked course in the world, which is Pine Valley in New Jersey,” he says. “That was a big deal for me.”

Golf Digest

To put that in perspective, , which biannually ranks the top 100 courses, ranked Augusta, where the Masters is held, number one. Pebble Beach is ranked sixth.

“I’ve played Pebble Beach, but have not played Augusta. So if anyone out there reads this and can get me on Augusta that would really be good.”

First, Fox would have to fit it into his busy schedule, which includes working with the World Institute of Pain Foundation to raise money for indigent people throughout the world who need pain care. The foundation also raises money to develop educational programs to teach physicians worldwide the latest in pain management techniques. In fact, Fox recently returned from India where he lectured and gave workshops at the country’s first ever pain symposium.

It’s an exhausting schedule, but emotionally rewarding.

“I have people who thought they would never work again, and they’re able to go back to work and be productive, and prove everyone around them wrong,” Fox says. “It can be very emotional to hear their story and know that you’ve made a big difference in their lives. I can probably get at least one [story] every day that will just about bring a tear to your eye.”