What Does It Take to Be a “Renowned Regenerative Medicine” Expert?

By Chris Centeno, MD /

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This morning, on the drive into work, I heard a commercial for a local Boulder, Colorado, orthopedic surgeon who took a weekend course on how to use Lipogems and began offering “stem cell therapy” last year. What struck me is not that she is advertising, but the fact that the commercial claimed that she is a “Renowned Regenerative Medicine Expert”? Which brings up a good point for this morning’s blog. What does it take to be a medical expert in a new field? Can anybody who takes a weekend course claim to be one, or is the bar higher than that? Is this an isolated problem, or is it bigger? Let’s explore this a bit further.

What Is a Renowned Regenerative Medicine Expert?

Medical expertise has always been a pretty fixed thing throughout my career. If we look at the definition of “expert” that’s found on Wikipedia, it’s pretty clear:

“An expert is someone who has a prolonged or intense experience through practice and education in a particular field…is accorded authority and status by peers or the public in a specific well-distinguished domain. An expert, more generally, is a person with extensive knowledge or ability based on research, experience, or occupation and in a particular area of study…by virtue of credential, training, education, profession, publication or experience, to have special knowledge of a subject beyond that of the average person, sufficient that others may officially (and legally) rely upon the individual’s opinion.”

So let’s distill this into some component parts that work in medicine:

  1. Credential, Training, and Education: Given that orthopedic stem cell therapy is a new field, you can’t yet go to a residency for this subject. We offer a fellowship that’s uniquely focused on regenerative orthopedics, but we only turn out 2–3 physicians a year, and we have never trained this surgeon. You can rest assured she got zero education in stem cells in residency or fellowship and to my knowledge only took a weekend course on the use of a Lipogems kit and how to perform a mini-liposuction.
  2. Publication. This means that the physician has published extensive, original research in this field. Has this surgeon published anything on the orthopedic use of stem cells? Nope.
  3. Extensive Experience in a Field of Study. In medicine, this would be a minimum of several-thousand procedures. Given that this physician just began to offer Lipogems a little over a year ago, she definitely wouldn’t qualify here either.

So this Boulder surgeon would fit none of the criteria above to be called an expert. She certainly, therefore, is not a  “renowned expert.”

Is Lipogems a Stem Cell Procedure?

This physician’s ad claims that she performs stem cell therapy, and last time I looked, she was using the bedside kit called Lipogems that performs fat processing. Is this a stem cell procedure? Watch my video below:

This Problem Is Not Unique to Surgeons with Egos Bigger than Their CVs

While it would be great if this were the case of a single physician whose ego is writing checks her expertise can’t cash, that’s not accurate. We see this issue all over the Internet, TV, radio, and newspaper. Physicians and chiropractors with no credentials, no publications, and little experience, who take a bad weekend course in how to perform stem cell injection procedures, who claim to be experts.

As an example, I got pinged this weekend by a local emergency-room doctor who wanted to “get into stem cells.” I had to tell him that he didn’t even have the base training to get the additional training he would need to be competent to treat musculoskeletal problems. I’m pretty sure he will ignore me and soon begin offering substandard care.

So now experts are created by marketing campaigns, which is interesting as throughout my career they have been created by things like publications, book chapters, and experience. This trend is disturbing. The problem is that the average consumer has no real way to vet these marketing claims without doing a good deal of homework. How would John Q public know that this surgeon isn’t really a “Renowned Regenerative Medicine Expert”? There is no easy answer to that question.

Are We Renowned Regenerative Medicine Experts?

So let’s apply the same criteria to the Regenexx founders:

  1. Credential, Training, and Education: While there was no education when we began using stem cells in 2005, we’ve authored numerous book chapters in orthopedic regenerative medicine as well as created an entire standards course in interventional orthopedics using regenerative medicine as part of IOF. We also run a world-class orthopedic regen med fellowship here in Colorado.
  2. Publication: As of last year, we had published 50% of the world’s orthopedic regenerative medicine research, based on the number of patients published, in bone marrow stem cells. We also actively publish several papers a year in the peer-reviewed journals on original orthopedic regenerative medicine research.
  3. Extensive Experience: Given that we have treated tens of thousands of orthopedic patients with stem cells over 13 years, we pass this part of the test with flying colors.

Given the test for expertise, Regenexx is a “Renowned Expert” in orthopedic regenerative medicine.

The upshot? This local surgeon is an example of a bigger issue. Expertise in medicine is a fixed thing that takes time and original research to obtain. It can’t be manufactured in a weekend course or claimed in a radio or TV ad!

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11 thoughts on “What Does It Take to Be a “Renowned Regenerative Medicine” Expert?

  1. Allison Suddard

    Haha! I heard the same commercial in the car this morning. As a former patient of said doctor, I thought “Huh??” She’s a lovely person but no “expert”.

    Thank you for clarifying for all those who do not know her medical pedigree. I’ll stick with the real experts (Regenexx) and come away with the best results money can buy.

  2. Tony Wiertel

    Hello; I recently had a Lipogems procedure performed in Suffern, NY (about 30 miles outside NYC). The company is called Optimum Joint. They did not advertise their service as a stem cell treatment. They focused on the adipose aspect and the use of an ultrasound machine to inject the adipose in the knee areas where little or no cartilage is present. I had at least 6 or 7 injections per knee. I’m bone on bone in both knees and have osteoarthritis. That’s a lethal combination. Optimum Joint has been in business for several years and follows their patients in a clinical setting protocol. I’m 59 and my orthopedic surgeon obviously wants me to undergo a bi-lateral knee replacement. I’m not thrilled with that idea, hence my opting for the Lipogems procedure. I had the Lipogems Procedure on 12/21/17. This Thursday, 3/8/18, will be 11 weeks since the procedure. My right knee has responded better; the left knee is still a work in progress. I guess my mentioning all this is to say that you are correct about a doctor going to a weekend training session and thinking she is an expert in Stem cells. First of all, Lipogems is not stems cell based and you are not an expert in anything after a weekend! I’m curious on your thoughts regarding the long term success of Lipogems in reducing knee pain, knowing it is not a stem cell treatment, but using adipose and pin point injections to alleviate pain. I guess Lipogems would be a competitor of yours. I eagerly await your response. Thank you very much.

    1. Chris Centeno Post author

      Tony, Lipogems is a fat graft. We did this research many years ago and found no additional benefit to adding a fat graft to a bone marrow procedure, see https://regenexx.com/wp-content/uploads/2014/09/370621-1.pdf

  3. Shoaib Khalil

    Nice Clarification.

    1. Regenexx Team

      Thanks Shoaib!

  4. Mark

    Hi Dr. Centeno –
    Considering the gamut of regenerative modalities being touted other than SCT/PRP, what is your opinion of the following for treatment of symptoms related to cervical and lumbar spinal disc degeneration/osteoarthritis and how would they compare to your SCT/PRP:
    –  using a traction table to facilitate spinal rehydration
    –  using high power Class IV Laser (K-Laser) to speed up the healing of damaged tissue beneath the surface of the skin by rapidly increasing blood flow and oxygenation to the region.
    – ultrasound-guided autologous RBC/erythrocyte injections 

    Thanks!

    1. Chris Centeno Post author

      Ultrasound-guided blood injections where?

      1. Mark

        I am told the RBC injections would be placed in or near the damaged tissue. (in or near the spine in the case of spinal issues).

        1. Chris Centeno Post author

          Mark, first, placing cells of any type into the spine requires substantial training and should only be performed by an MD/DO specialist with significant interventional training (i.e. never a PA or NP in a chiro office or elsewhere). Second, we don’t use blood injections, so I can’t comment on that part. As far as what to inject, that’s very dependent on the specific diagnosis. There are about 100 different structures and precise areas in the spine that can be targeted and different structures and their different disease states respond differently. For example, a severely degenerated disc is unlikely to respond to PRP injected intradiscal under fluoro guidance any better than treating outside the disc and injecting into the ligaments, epidural, facets, and muscles. On the other hand, a disc with good height and an HIZ on MRI and a patient who can’t sit responds well to BMC.

          1. Mark

            Just curious as to why you don’t use blood injections. Are they less effective than PRP, etc., in your opinion? There seems to be some debate as to which is more beneficial in healing damaged tissue.

            Insofar as my DDD, MRI of cervical spine revealed moderate-severe disc space narrowing from C4-C7 + mild bone spurs; MRI of lumbar spine, L1 thru S1 discs are dessicated with minor bulging, no neural compromise. No HIZs reported on either MRI. My symptoms: chronic cervical and lumbar sharp pains when moving in certain positions; TMD.

            Given these results, do you think there’d be any benefit to PRP, BMC or any other type of regenerative therapy?

            Also – do you think there’s any real benefit to using a high power Class IV Laser to speed up the healing for someone with my issues?

          2. Chris Centeno Post author

            Mark, yes there is some debate over whether blood might work in some applications. We have done extensive work in-vitro using various PRP preps to stimulate young versus old MSCs to proliferate. Blood under-performs, LP-PRP stimulates proliferation in a direct dose-response relationship.
            We never rely on just an image to make a diagnosis and create a treatment plan, nor do I rely on the radiologist’s reading in looking at what needs to be treated and how. As I tell my patients as we spend 5-10 minutes just going over their imaging, “we have just spent about 5-10 times longer looking at your films than the reading radiologist ever did”.
            On DDD treatment, our registry-based data (just presented by Chris Williams at IOF) showed clearly that multi-modal therapy works better. Meaning precise fluoro guided injection of platelet lysate epidural combined with precise high dose PRP injections in the facets, precise ligament, and muscle injections work better than just facet injections.
            On PRP

Chris Centeno, MD

Regenexx Founder

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.
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