This week was interesting in that we had a clinic in Pakistan, of all places, claim to be working with us (that really wasn’t), and this morning I’d like to focus on issues closer to home. I’d like to use what we found out about a local clinic as a way to help all patients nationally vet orthopedic stem cell clinics. How can you find a good one doing high quality work versus one that’s trying to make a Motel 6 look like the Ritz?
The Local Clinic
I mostly ignore local clinics claiming to be doing advanced stem cell work that are really just a doc who took a weekend course and bought a simple bedside machine. However, sometimes we call other clinics when what’s online seems to be incongruent with reality. Case in point is a local clinic offering orthopedic stem cell injections. According to the Internet Archive, the clinic first appeared on the Internet, advertising stem cell therapies, in March of 2015 (14 months ago). Despite that, they make claims that they are very experienced in this area, so let’s explore this a bit more. Is 14 months’ worth of experience really “very experienced”? Read on…
The Clinic’s Beginnings and the Stem Cell Expert
The clinic was founded by a local chiropractor. There’s nothing wrong with that as I know a few chiropractors who have gotten involved in starting stem cell clinics and hiring competent MDs or DOs to perform injections. I even know one or two who are trying to do research. On the other end of that spectrum, I know quite a few who are offering amniotic or placental baby-pee shots and trying to pass them off as stem cell therapy.
This is where things begin to get a bit sketchy about the claim of offering advanced therapies. The clinic employs a green physical-medicine and rehab physician and claims that he has done “thousands of injections” and that this provider is an expert in stem cells. So is this remotely true?
The physician graduated from what I consider to be a good residency for basic injections skills. I happen to know exactly what he learned there since two our of fellows have come from that same program. When they arrived here at our clinic, they had performed a reasonable number of basic low-back and peripheral-joint injections in residency. While this was a solid background, they both needed a significant amount of additional structured training in interventional orthopedics before we would consider them to be fully trained to work at our clinic. If you review the video below, they were at the stage to the left (knowing how to perform simple joint injections), and with substantial additional training we moved them into the 1% category.
What was really unusual about this clinic was that our caller was told that this kid out of residency, performing stem cell injections had taken a “four-year regenerative medicine residency.” Knowing the program he came from, this week I asked our old fellow who had attended the same program a year ahead of this physician about that claim. He laughed and confirmed that while there was the ability to watch a few bone marrow stem cell procedures being performed by the head doctor, there was no hands-on regenerative medicine training.
Did this kid buff up his resume beyond reality, or did the chiro training the folks who answered the phone magnify his training? Unsure. Basically, the real truth is that everything he learned about stem cells came from a weekend course after residency. In addition, like our fellow, he would have been qualified to enter our fellowship upon graduating, but even today, he would not have the qualifications and training to be hired as a clinic physician in Colorado. We would tell him his skills weren’t up to snuff.
As to the claim that the doctor is a stem cell expert, there’s little support for that as well. A US National Library of Medicine search shows no publications for the doctor, so he’s clearly not an expert in stem cells. There were also other red flags we identified, which I’ll discuss further…
What Can Patients Learn About Looking for a Quality Stem Cell Provider?
So how would a patient know to ID red flags? This is what you can learn from our experience with this clinic:
- RED FLAG—The doctor went to a four-year “regenerative medicine” residency. There is no such thing. I’ve interviewed about 100 candidates to work for our clinics, and no residency program or fellowship in the country provides significant experience in this area. Some do prepare doctors better than others in basic injection skills that can form a solid background from which to learn interventional orthopedics, but none provide any real training in stem cells or platelet rich plasma or advanced interventional orthopedic injection techniques.
- RED FLAG—You don’t need an MRI! This was interesting and is a dead giveaway of a clinic more interested in business than medicine. While MRIs don’t reveal everything, they are critical in deciding candidacy for some joints (like hip) and deciding where cells should be placed.
- RED FLAG—No candidacy process! Our caller soon realized that everyone was a good candidate for care at this clinic. Regrettably, based on our research data and 11 years of clinical experience with orthopedic stem cells, this isn’t the case. Again, there is no medical procedure invented where everyone is a good candidate.
- RED FLAG—No research! At least the lady we spoke to on the phone was honest about the fact that this clinic had zero research or data collected or published to support that what they did actually worked.
- RED FLAG—Discounts galore! Medical procedures aren’t commodities in the same way that mass-produced products are commodities. They differ widely in quality and sophistication. I like a deal as much as the next guy, but I also realize that if what I’m buying is the identical product (let’s say a new computer) from two different stores, then it pays to shop on price. That’s different from a cheap and expensive hotel. In the latter case, both are rooms, but that’s where the similarities between the Ritz and the Motel 6 end. In this case, what you’re getting is a minimally trained provider, a cheap bedside centrifuge product, a low-sophistication bone marrow aspiration and reinjection, and a procedure that has no research to back up that it works. It had better be cheap!
The upshot? I can’t blame a clinic for trying to make a Motel 6 seem like the Ritz. Having said that, when it goes beyond spit shining your resume to fiction (e.g., our doctor went to a four-year regenerative medicine training program and is a stem cell expert), that’s where it’s critical that we educate patients on how to identify the red flags! While this kid has minimal training, he’s actually just a few miles away from the Interventional Orthopedics Foundation, where he can learn from true experts how to do this right!