Dr. James Webb & Associates

10/13/2025

She should have just come to see us 🤷🏻

An 82-year-old woman was hospitalized after swallowing eight live frogs in an attempt to alleviate her persistent lower back pain.

07/07/2025

CMS’s WISeR model claims to cut waste—but it’s targeting the wrong procedures, which will result in excess patient deaths if implemented. They are targeting several revolutionary procedures that actually work, which is why utilization is increasing. If the goal is truly to decrease unnecessary procedures, then we should look at lumbar surgery for axial back pain and DCS.

Some of the proposed targets:
—Vertebral augmentation, a procedure that actually saves lives, with absolute mortality reduction that is BETTER than percutaneous coronary interventions.
1. Reduces opioids, and costs less than $5,000 in outpatient settings.
2. With a cost per QALY of $2,700–$13,500, it's also more cost-effective than most cardiology PCI, which run from $18,000 to over $50,000.

—RFA and MILD procedure: cost $2,000–$9,000 with cost per QALY of less than $13,000.

Yet WISeR burdens these outpatient, evidence-based procedures with prior auth. If we want to fix unnecessary procedures, here are some suggestions that WISeR should ACTUALLY go after:

—Lumbar fusion for axial back pain? Decompression without instability or radiculopathy?
1. Cost: $40,000–$120,000+
2. Cost per QALY: $70,000–$120,000+
3. Minimal benefit over conservative care—and not even targeted.
4. Causes INCREASED opioid use and low return to work.

—Dorsal Column Stimulators
1. 5-year costs: $70,000–$100,000+
2. Cost per QALY: $60,000–$150,000+
3. Increased opioid use.

If WISeR’s true goal is to reduce inappropriate care, it should prioritize value—not claims growth. Seniors deserve access to treatments that actually work and save lives. Otherwise, we should call this Withholding Interventions Seniors Emergently Require.

07/06/2025

Helping people get their lives back—without surgery or narcotics—is why we do what we do. Whether it’s getting through the day without pain or avoiding that next operation, we’re here to offer real solutions and real hope.

Grateful for every patient who puts their trust in us.

07/02/2025

Another back surgery?

I see so many patients who’ve had multiple spine surgeries, hardware implanted, and still live in pain. One patient told me, “Not a single surgery helped—just more scars and more meds.”

Here’s the truth: Most chronic back pain doesn’t need surgery. It needs the right diagnosis. That means examining the patient, finding the true pain generator, and using minimally invasive image-guided treatments that actually work.

No opioids. No long recoveries. Just results.

If you’re stuck in a cycle of failed surgeries, we may be able to help—without going under the knife again.