Medical ProfessionalShuchita Garg 2

Today, we are interviewing Shuchita Garg, MD, an American Board of Anesthesiology (ABA) certified board super specialist in Pain Medicine and a specialist in Anesthesiology, with rich experience in this advanced field of medicine for about twenty (20) years now.

After successful completion of four-year ACGME accredited residency in Anesthesiology and having gone through a rigorous selection and ranking process, she was selected to be a fellow in the ACGME accredited pain fellowship program, which is at the University of Iowa Hospitals & Clinics. This facility offers cutting edge training for Chronic Pain Management. She got an opportunity to train with world-renowned mentors and faculty and be fluent in her practice.

Subsequent to completion of her pain fellowship training in June 2015, she successfully passed her pain board exit examination. She was offered a faculty position of Assistant Professor by her alumnus institute.

She now works as the Director of Pain Clinic, University of Cincinnati Medical Center (UCMC), Clifton Downtown Center, and Clinical Assistant Professor in the Department of Anesthesiology and Chronic Pain Management, UCMC, Cincinnati, Ohio.

She has recently been chosen and awarded as one of the TOP Pain Physician in the USA and Cincinnati by the poll conducted by Cincinnati Magazine.

 

1. How did you get into what you do right now?

My medical career journey has indeed been a long one. I feel blessed to have received training from esteemed teachers at the top-notch institute throughout my career. I entered medical school back in India in the year 1992 after a rigorous entrance exam. Although my primary specialty is anesthesia and OR job responsibilities, I had a flavor of working as a critical care faculty for about three years before I moved to the US with my family. The desire to be able to treat pain briefly brushed past me during my career as a faculty in India. However, I got more motivated to take this field up as a career after I started my anesthesia training at the University of Iowa. Rotations through the pain clinic at my institute during my anesthesia training gave me an insight into the practical world of pain. To the outside world, chronic pain medicine may seem just an opioid prescribing business, but it was amazing to discover the various other options that could be offered to the patients to help them through this ordeal. I have been hugely inspired by one of my mentors, who do an exemplary job at taking care of their patients. Their work ethics and philosophy have impacted my practice immensely.

 

2. Please tell us more about your journey?

please-tell-about-your-journey

I started with my journey in anesthesiology via a residency training back in January 1999 from Dayanand Medical College & Hospital, Ludhiana, India. Thereafter, I have continuously been working in this field of medicine. I was working as the faculty at Dayanand Medical College & Hospital, Ludhiana, India, in 2010, before I had moved to the United States of America.

I got an opportunity to start my four-year Anesthesiology residency at the Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA after a tough and competitive round of selection amongst national and international medical graduates. Subsequent to completion of a very fulfilling and prestigious residency, I was selected into the Chronic Pain Medicine fellowship program, again at the University of Iowa Hospitals and Clinics, Iowa City, IA.

Having completed the one-year fellowship successfully, I was appointed as the faculty in the Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA, where I worked in both the Department of Anesthesiology and Chronic Pain Medicine.

In January 2017, I started my stint as the Clinical Assistant Professor in the Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, Ohio.

I now contribute via:

• Providing pain management care in both out-patient and in-patient settings

• Providing anesthetic care to my patients

• Teaching medical students, anesthesiology residents and chronic pain medicine fellows

• Publishing scholarly articles in a peer-reviewed scientific medical journal

• Publishing book chapters to help peer practitioners and students of the science of anesthesiology and pain medicine

• Participating in national level meetings and CMEs

• Being a member of a global task force that has been entrusted the responsibility to formulate guidelines for the treatment of chronic low back pain

• Being on the panel of medical student selection to the University of Cincinnati College of Medicine

 

3. Please tell us about the college where you are working as an Assistant Professor of Anesthesiology and Chronic Pain medicine.

The University of Cincinnati College of Medicine, which is a public research university in Cincinnati, Ohio. Cincinnati College was founded in 1819. It is the oldest institution of higher education and learning in Cincinnati and has an annual enrollment of over 44,000 students, making it the second-largest university in Ohio. It is part of the University System of Ohio. On Nov. 2, 2018 — For the second year in a row, UC Health was named among the nation’s top healthcare organizations for information technology by the College of Healthcare Information Management Executives (CHIME).

As an Assistant Professor of Anesthesiology and Chronic Pain Medicine, I treat patients in both Chronic Pain Management Clinics, Acute In-Patients Chronic Pain consults, and patients who come for anesthesia (& surgery) from both in and out of the state of Ohio. We also treat foreign national patients who come for treatment from abroad. Other than patients coming from all parts of Ohio, we cater to patients from adjoining states like Kentucky, Indiana, and various other distant states.

The patients seen by me are a good mix of patients. A significant number, about 25% of patients that are under my care, are covered by Medicare and Medicaid on a yearly basis. A majority of this population group is underserved, has complex medical needs, and benefits immensely from the care and services provided.

 

4. What keeps you going when things get tough?

Personally, my family is my greatest pillar of support. My daughter and husband have always been the people who have kept me going. They are always keeping me amused and inspire me to outdo myself in all aspects of life.

Professionally, I have always had the pleasure of seeking the advice of my mentors and peers who have always pitched in with help and advice that has been like a lighthouse in rough seas.

 

5. What inspires you?

What-is-Success

If I look back at my life, my answers to this question has changed dramatically over time, and rather frequently too. 

As a teenager, I desperately wanted to be a famous singer.

Once I got into medicine, I was inspired by vibrancy offered by the field of chronic pain medicine. Currently, I am inspired by the devoutness and humility we need to show to each and every patient that walks into our clinic with pain issues. We need to strive in order to accomplish even the slenderest improvement and states that this facet of pain medicine is what inspires her to continue her work and to become a better physician. To me, the measure of success is the number of patients I can impact for the better daily.

 

6. I hear that you have been on the panel of experts who will be formulating some guidelines for the management of chronic pain, could you please elaborate upon that.

In 2019, I was nominated as a member of the national task force to formulate working guidelines on the lumbar facet mediated pain blocks and interventional procedures. Lumbar facet joints are very small joints located at each segment of the lumbar spine and can become painful due to arthritis, injury, or degenerative processes in the back. Lumbar facets mediated pain blocks aim at injecting a local anesthetic into these joints and provide pain relief and improve the range of motion of the spine.

Diagnostic nerve blocks are typically followed by neurolysis or destruction of nerves by heat called radiofrequency ablation. These procedures are done under fluoroscopic/ultrasound guidance, and mainly address the chronic low back pain originating from lumbar facet arthritis/arthropathy. These serve as a part of the multimodal approach towards managing chronic pain.

I am part of the select group of experts that will formulate the guidelines for Facet Joint Blocks for low back pain. This committee comprises of national and international experts put together from various pain societies. The committee will formulate evidence-based medicine guidelines, standards of care, and promote uniformity for all practitioners of Pain management.

The task force comprised of experts representing various societies in the field of Chronic Pain Medicine. Esteemed faculty members from the American Society of Regional Anesthesia, American Society of Anesthesia, American Academy of Pain Medicine, American Society of Pain & Neuroscience, Canadian Pain Society, World Institute of Pain, Korean Pain Society have worked under the same umbrella in this task force.

Low back pain is not only common but also holds a high cost and health care utilization burden in a country where the rate of health care expenditures is skyrocketing in relation to GDP growth, and overutilization is a major concern. In 1998, total direct health care costs attributable to low back pain in the USA were $26.3 billion. Apart from direct monetary health care expenditures, low back pain leads to significant opportunity cost as well; the 2010 Global Burden of Disease study identified low back pain as the leading contributor to disability and workdays lost. The common etiologies of low back pain can be related to facet joint arthritis, discogenic disease/degeneration, SI joint mediated pain, failed back surgery syndrome. Facet-mediated pain is a result of a multifactorial process associated with degeneration of the intervertebral discs that leads to lumbar facet joint degeneration. It is important to standardize the procedural details for this commonly performed procedure. This will not only improve patient care but will also cut down unnecessary interventions.

 

7. Please share your views on the opioid epidemic, and are you involved in some mitigation efforts for the same?

As part of the mission to address the ongoing national crisis on opioid use disorder (OUD), I am also involved in two research projects to explore non-addictive and non-opioid therapies. The first project is to assess epidural steroid injection with supplemental oral eplerenone for low back pain treatment. This is a prospective, double-blind, randomized clinical trial aimed to address a key question: why epidural steroid injection only works in some patient with similar back pain conditions. Upon successful completion of the project, it is hoped to provide a guideline for using steroids in back pain treatment, i.e., what type of steroids should be used; what to do to avoid potential side effects. The other project is focused on the identification of biomarkers for Complex Regional Pain Syndrome (CRPS). This is an intractable neuropathic pain condition. The only effective treatment is a sympathetic block. However, its outcome is inconsistent. The goal of the project is to determine whether certain serum biomarkers are related to the reoccurrence of CRPS.

 

Thank you so much for sharing these important insights!

P.S. If you felt inspired after reading this Interview, request you to please share with your friends on social media because your friends might get inspired too!

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