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Lots of patients are performing the Google search stem cell therapy near me. However, this is a search with some peril for uneducated patients. Why? One of the hardest things for patients to understand is that the level of knowledge of >90% of the physicians and other providers out there offering stem cell treatments is insufficient. So this morning I’ll delve into why this is and help you decipher the code to find a provider that knows which end is up. Let’s dig in.

Standardized Medical Education

If you have had surgery or been taken care of in a hospital or clinic by an MD or DO physician, you have been the beneficiary of a standardized medical education system that’s more than a century old. In fact, in 1933, the American Board of Medical Specialties was formed to make sure that physician specialists had specific levels of training to be able to call themselves “board-certified”.  It’s because of this concept that the doctor in New York City and Rural Nebraska take the same ACGME medical school curriculum and residency and then take the same board tests. Hence, you can expect a certain minimum level of competence wherever you go.

However, while this is true in orthopedic surgery, pain management, dermatology, and general surgery, where this system utterly falls apart right now is in the delivery of regenerative medicine or stem cell therapy. Why? Because doctors didn’t learn anything about stem cells or PRP in their medical school, residency, or fellowship program and what each knows is dramatically different. So much so that this is a wild west “buyer beware” marketplace. So let me show you why the stem cell therapy near me search can often turn up more bad apples than good.

Quickly Understanding Interventional Skills

The big idea behind regenerative medicine, especially in orthopedics (where I will focus this blog), is that less invasive injection procedures can take the place of more invasive surgeries. However, before we dive into a deeper understanding of the levels of training that you MUST know, a quick tutorial on Interventional Orthopedics is in order:

The Levels of Knowledge You Need to Know to Protect Yourself

As one of the founders of this field who did the many of the first orthopedic procedures with stem cells, it’s easy for me, within a few minutes of looking at a doctor’s credentials, website, and other information to tell you if or she has any reasonable knowledge of stem cells or is dangerously uninformed. However, how does the average person learn enough quickly to make that same assessment? Meaning how can you turn that stem cell therapy near me search into solid gold? Let’s dig in.

The Categories I’ll define here are:

• The Mid-level Practicing Over Their Skis
• The Mismatched Physician
• The Clueless Specialist
• The Weekend Course Special-A Few Sandwiches Short of a Picnic
• The Rare Bird-A True Regen Med Specialist

The Mid-level or Alt Med Practicing Over Their Skis

If you want the easiest category where you can identify who to avoid in 10 seconds or less, this is it. However, the crazy thing is if you run the search stem cell therapy near me, these are the most prevalent providers that will come up. Hence, with a little education, you can reduce most of your risk.

Here, all you need to do is to look at the credentials of who is doing the injections. If it’s a Nurse Practitioner or Physician’s Assistant then you’re at the lowest level of expertise. The abbreviations here to look for would be NP or PA after their name. In addition, NPs will have lots of other abbreviations like ARNP, CRNP, CNP, LNP, or NPC. Why are these providers an issue? They aren’t physicians and they have about half the training of an MD or DO.

In addition, beware of alternative medicine providers like NDs (Naturopaths), Acupuncturists, and Chiropractors who also inject. Most states haven’t been foolish enough to allow these providers to perform these procedures and even in the states where they make a claim that they can do them, most are practicing way out of the small lane the state legislature created. Again, here you have much less medical training when compared to a physician specialist.

If you want to see how dangerous this category gets, check out a Naturopath training chiropractors how to perform a fake intrathecal stem cell injection that could kill the patient:

The Mismatched Physician

This one is a big problem because we have doctors who were trained in X and practicing in Y. In regenerative medicine, this usually occurs in age management and functional medicine practices. Some examples that I have seen are family doctors, ER physicians, neurologists, and plastic surgeons injecting knees or claiming to be injecting spines. They often don’t know how to accurately diagnose musculoskeletal conditions, so they often inject the wrong stuff at the wrong spots. They just don’t have enough basic training and experience in dealing with why knees, shoulders, ankles, and backs hurt. A bit like taking your Porsche to a mechanic that only works on Ford Trucks. The mechanic may have some idea of which end is up, but lacks the experience and training to know what usually goes wrong with Porsches.

Also, beware of a scam that’s out there which is common in this category. The doctor claims to be “Fellowship Trained” in stem cell therapy through an outfit called A4M. This is not a fellowship, but a series of weekend courses. See my link above for more information on this one.

So here, once you run your stem cell therapy near me search, you want to look for MSK specialties and the following board certifications: physical medicine and rehabilitation, orthopedics, pain management, family practice sports medicine, etc…

The Clueless Specialist

Remember when I discussed how no physician gets any training in regenerative medicine through the traditional channels? That means that once you pick a specialist who knows about how to diagnose why people hurt, you now need to make sure that physician specialist has additional knowledge and training in two key areas:

• Regenerative Medicine
• Functional Injection Treatment

Here I’ll give you a few examples so that you can get a sense of what I mean by clueless:

• An orthopedic surgeon claims to understand how to perform PRP injections, but then injects a knee with PRP blind without imaging guidance and adds in some high dose cortisone for good measure. The problem? Any basic course on regen med would have instructed that cortisone kills cartilage cells while PRP may help them. So injecting both at the time is not smart. In addition, there is no justification these days for not at least using ultrasound to inject a knee, as even in experienced hands, the doctor misses the joint about 1 in 4 times when injecting blind.
• A pain management doctor who performs radiofrequency ablation of a facet joint and when that doesn’t work decides to try to stick some stem cells in the joint. In doing so he uses a local anesthetic called Marcaine to numb the joint because that’s what he usually does. Here, they just destroyed the nerve that innervates the muscle (multifidus) that stabilizes the spine and protects the facet joint and then decided to try to help the facet joint with stem cells. That’s like removing parts of your suspension and then going off-roading. The Marcaine also killed the stem cells he placed into the joint as it’s highly toxic to these cells.

So what you look for here? Regrettably, this one goes beyond your stem cell therapy near me search and requires calls or emails to the office. The biggest red flags are physicians who haven’t devoted a significant part of their practice to regenerative medicine. Ask questions like:

• Has the doctor taken any courses in regenerative medicine?
• How many stem cell or PRP injections does he or she do each month? These numbers should at least be 10 or more.
• Does the doctor have two treatment tracks? Meaning one for traditional procedures and the other for regen med? Regen med often doesn’t mix well with traditional procedures.

The Weekend Course Special-A Few Sandwiches Short of a Picnic

This is where things get a little tougher. Here we have a doctor that’s in the right specialty area and who has taken additional regen med training in the form of a few weekend courses. Hence, we’re almost to regen med nirvana, but not quite there. Let me give you a few examples so you can see what I mean:

• A pain management doctor who uses stem cells in the spine like he would cortisone. He or she tries to inject them in the place that hurts. The problem? The opportunity with regen med to help patients with spine pain is that we can begin to fix the problems that caused the pain, rather than being hyper-focused on what hurts. Hence, if a facet joint hurts because it’s arthritic, it’s likely that way because the spinal segment got sloppy. So the expert in regen med will treat the facet joint, but also the ligaments, the irritated nerve, and the atrophied muscle that have caused the facet arthritis. The novice will treat just the painful facet.
• An orthopedic surgeon who instead of knowing how to precisely inject a damaged ACL ligament using x-ray guidance to try to heal the ligament, takes the patient to surgery to rip the ligament out and replace it with a tendon (ACL Reconstruction) and then adds in PRP or stem cells to help his ACL graft heal. While some patients with ACL tears need surgery, most can get their damaged ligament healed with a precise injection into the ligament. However, the surgeon doesn’t have the skill set to perform that procedure, which is advanced interventional orthopedics. He may not even know the procedure to heal the ligament exists. In addition, there is no C-arm fluoroscopy in the surgeon’s office to get it done.

How can you tell if what the doctor is offering is a few sandwiches short of a picnic? This is the hardest one to easily teach, but here are some red flags:

• Your injection should include lots of parts and pieces, not just into a joint. Hence, ligaments, tendons, nerves, and muscles might also be injected. This is because proper regen med care involves treating the cause of the pain, not just the pain generator.
• These procedures require expertise in both ultrasound and fluoroscopy guidance. Hence, your doctor should be able to tell you why you’re a candidate or not for things like stem cells. For example, in the ACL example above, that procedure requires x-ray guidance, and only about 2/3rds of cases that usually require surgery can be healed with an injection. So the first question for the surgeon should be; “How many ACLs have you injected using x-ray guidance?” Is this your area of expertise or is that only surgery?

The Rare Bird-A True Regen Med Specialist

The actual true expert in this area has devoted a sizable chunk of time to get educated. They attend regen med conferences regularly, they have taken actual certification programs with set curricula (like the one offered by IOF), and this is what they do all day every day. So how do you find this needle in the provider haystack? One way is to do lots of research on the doctor using the guide above. Another would be sticking with a network of physicians like Regenexx where all are carefully vetted and trained. The first can be daunting and the latter is easy.

A Whole Book on this Topic

A few years back I wrote a whole book on this topic and how to navigate the results of a stem cell therapy near me search, which is yours just by clicking on the cover below you can read in just 10 minutes or so:

The upshot? As you can see, the Google search for stem cell therapy near me can turn up quite a few results that are more bad than good. However, at the end of the day, it’s easy to learn the red flags to avoid. It just takse a bit of time, research, and know-how to figure out how to get the best value for your money.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile