The symptoms of spinal leaks, like post-dural puncture headaches (PDPH), can have a devastating impact on a patient’s quality of life. These patients often find it challenging to secure accurate diagnoses that pinpoint the sources of their debilitating headaches and reduced mobility.
Based on research rates for accidental dural punctures, our estimates indicate that as many as two million women annually in the U.S. will have PDPH after labor epidurals.
Research has also rejected the idea that PDPH is self-limiting, as quantitative studies have shown that the majority of women will continue to be symptomatic for years after a dural puncture without care. The number of patients who report post-dural puncture headaches rises exponentially when you factor in other causes of spinal leaks like lumbar punctures, spontaneous leaks, and epidural steroid injections (ESI).
It’s estimated that over 20 million people in the U.S. need spinal leak care due to being misdiagnosed. This provides a critical opportunity for anesthesiologists to serve an underdiagnosed patient base, enjoy the feelings of fulfillment they get after administering epidural blood patches, and build a financially rewarding pain management clinic.
Tapping Into the Demand: Anesthesiology Private Practice for Spinal Leak Care
The spinal leak care market is currently valued at around a trillion dollars. Yet, many patients struggle to find comprehensive care, highlighting the growing need for pain management clinics specializing in long-term care for spinal leaks.
The crisis offers a profitable, fulfilling opportunity for anesthesiologists trying to figure out how to start a pain management clinic.
The rate of accidental dural punctures during epidural procedures is around 1.5%, and as many as 58% of these patients will continue to experience symptoms 18 months after getting an epidural blood patch. Many patients with spinal leaks are misdiagnosed with anxiety, chronic fatigue, migraines, or postural orthostatic tachycardia syndrome (POTS), leading to ineffective care that focuses only on the symptoms and not the root cause.
One of the main reasons why so many patients with spinal leaks are misdiagnosed is inappropriate diagnostic tools like lumbar punctures, which can also lead to dural punctures. Current research has emphasized continuously that measuring opening pressure is not a reliable way to check for a spinal leak and is likely to lead to further harm.
Studies show that newer diagnostic methods like the Bern Score are more effective at diagnosing spinal leaks when used to assess the magnetic resonance imaging of the patient’s brain.
Some of the opportunities the growing demand for pain management clinics that specialize in spinal leak care offers anesthesiologists include:
1. Financial rewards
A pain management clinic specializing in spinal care is one of the best opportunities available for anesthesiologists wondering how to start a business. The spinal leak care market is valued at approximately one trillion dollars in the U.S.
Establishing a private anesthesiology practice specializing in spinal leak care gives you a competitive edge because of your experience performing procedures like epidural blood patches.
Starting a spinal leak care clinic allows anesthesiologists to bypass the low insurance reimbursement rates typically offered in a hospital. Some insurance providers offer rates as low as $75 per blood patch.
Data shows patients are willing to pay as much as $750 for an epidural blood patch administered in a private clinic by an anesthesiologist who does not require an invasive lumbar puncture to diagnose patients and provide minimally invasive care.
2. Building up a recurring revenue stream by offering long-term care
One of the critical advantages of specializing in spinal leak care is the potential to offer ongoing, long-term care. Patients with spinal leaks may need repeat epidural blood patches initially while experimenting with what works and then on an ongoing basis.
Some spinal leaks may reopen, especially if they are due to a small osteophyte, for which surgery would be devastating to the body and spine. Still, some physicians are opting for a maintenance approach to blood patching in cases of osteophytes to manage patients’ symptoms without exposing them to the risks of surgery.
Anesthesiologists who run pain management clinics can charge patients $100 monthly for access to their services, $300 per quarterly visit, and $800 per epidural blood patch, bringing their annual revenue per patient to around $4,000 annually. Serving 100 patients brings the clinic’s revenue to $400,000 yearly.
3. Demand for spinal leak care is outpacing supply
Many patients with spinal leaks report having difficulty locating specialists who are familiar with their condition. Anesthesiologists who open pain management private practices are in high demand from day one but often report a lack of knowledge on how to perform blood patches.
Yes, pain management anesthesiologists administer blood patches in their residency, but that’s where their experience usually ends. This is evident in stories of patients accidentally being punctured by pain management anesthesiologists in private practice who are not accustomed to the viscosity of blood and sometimes need to go in through the ER to get a blood patch with a regional anesthesiologist due to the puncture from the first patch.
A physician who was a regional anesthesiologist and performed dozens or hundreds of blood patches over their career in a hospital setting has a clear advantage in experience over an anesthesiologist who went directly into private practice after a pain management fellowship.
Patients with spinal leaks currently spend as much as $20,000 on conservative pain management treatments like IV saline, home visits for physicians due to being bedridden, and unnecessary treatments due to being misdiagnosed. Patients are often willing to travel great distances for excellent care.
Starting a spinal leak clinic allows anesthesiologists to develop long-lasting relationships with patients while increasing awareness about the importance of comprehensive, long-term care.
4. Opportunity to provide non-clinical services
Anesthesiologists who run private pain management clinics can position themselves as experts on spinal leak care by providing non-clinical services like employee wellness programs, consultations on best practices, and community education.
Overcoming the challenges facing the diagnosis and treatment of spinal leaks
One of the most pressing challenges in spinal leak care is the high rate of patients being misdiagnosed. The majority of patients with spinal leaks are misdiagnosed due to physicians relying on outdated diagnostic tools like lumbar punctures to check for opening pressure, which can also lead to accidental dural punctures.
Research shows that most patients with spinal leaks have normal or high opening pressure. Relying on opening pressure as a diagnostic measure will inevitably lead to failure to diagnose.
Anesthesiologists trained on more effective diagnostic tools like the Bern Score to better read brain MRIs can drastically improve patient outcomes. Artificial intelligence tools are being improved as well to help with better reading of brain MRIs to assess for intracranial hypovolemia for physicians who may need more support in assessing imaging to look for clues missed by other physicians.
By helping to bridge the gap between the high demand for spinal leak care and the limited supply of specialists, anesthesiologists can position themselves as experts in the field. Clinics that focus on cutting-edge diagnostic tools and non-invasive treatment options can charge premium rates for their services, especially given that many patients are desperate for an accurate diagnosis and long-term relief.
An untapped opportunity that’s tailor-made for anesthesiologists
The statistics show that the spinal leak care market has a massive demand for anesthesiologists who can provide effective long-term care. Anesthesiologists who start pain management clinics that run on a cash-based model stand to reap financial rewards from this fast-growing trillion-dollar market while providing life-changing care to patients dealing with spinal leaks.
