I was pinged this weekend by an unfortunate gentleman with a spinal cord injury. We only treat orthopedic conditions, so he sent a clinic link for me to review and asked if this was a good clinic. It took me less than 60 seconds to answer a resounding NO. Why? It’s all about the physician or lack thereof, let me explain.
Businessmen Running Clinics
One of the things that’s become more common these days is business people running medical clinics. That model has flourished in the stem cell wild west, where we have many clinics owned by a non-physician. While this arrangement can work, it’s also ripe for abuse. Let me explain.
Running a medical clinic is hard work. There are a hundred little medical details that need to go right that need to be supervised by a physician. Hence, having a physician on-site full-time is key. However, doctors are expensive, so looking at a spreadsheet, the best thing to do is either limit the doctor’s involvement in the clinic or replace him or her altogether with a lesser trained provider like a nurse practitioner or physician’s assistant.
Where’s Dr. Waldo?
You may remember that game from when you were a kid called “Where’s Waldo?” Well, the same applies to clinics. When I was asked to look at the clinic for the patient with a spinal cord injury, the first thing I did was to go hunting for a doctor (Dr. Waldo). I clicked on the “About US” page and only saw a business guy and a bunch of office staff. No doctor. I looked everywhere on the site and saw the name of no physician who worked full time at the clinic. In fact, I found no name at all. Hence, the doctors in this clinic are just part of some business guy’s spreadsheet entry. So I told the guy with the spinal cord injury to look elsewhere, as it’s likely that the quality of care at that clinic is an afterthought.
The Average Chiro Clinic Has the Same Issue
The average magic stem cell clinic run by a chiropractor has the same “Where’s Dr. Waldo” problem. Meaning that often you look and see no physician. This is a dead give away that this clinic is a business first and a medical clinic second.
What if You Find Dr. Waldo?
Some clinics will have a doctor listed, but your next question should be, is that doctor there full time or does he or she have control over the medical details in the clinic? All too often, he or she is for rent. An easy way to find that out is to Google the doctor’s name to see if they are listed elsewhere, if so, then you have a “rent a doc” scenario going on, which may be just as bad as not having one, as the doctor likely has little say in what goes on at the clinic.
There are exceptions to this rule. Meaning, there are clinics where doctors work where they may not be there full time, but they have control over what goes on when they’re there and the clinic is set up around what they deem is safe. An example of this is a hospital ER. Many doctors may work there, but there is usually a medical director who oversees the safety mechanisms built into the clinic. Another example would be the clinic we work out of in Grand Cayman. Many different doctors work there, but this is an established medical facility with many specialties and we have immense control over the medical aspects of what’s done and how.
If the doctor is only practicing at that clinic, next make sure that it’s he or she that you’ll be seeing. As I found out with one chiro owned clinic chain called IMAC Regeneration Centers, patients first see a non-physician who does the diagnosing and deciding if the patient is a candidate for the treatment. What’s the use of having a doctor performing regenerative medicine procedures if he or she is not the one figuring out how and when to use the procedure?
Another problem is that the onsite physician has no business performing the planned procedure. Obviously, you don’t want a psychiatrist performing a knee injection or a family doctor injecting something into your spinal canal. We also see plastic surgeons injecting muscles and cardiologists injecting hips. For orthopedic work, these are specialties that are more focused on this area:
- Physical Medicine and Rehab (PMR)
- Orthopedic surgery
- Interventional Pain Management (PMR or Anesthesia)
- Interventional Radiology
- Family Practice with a Sports Medicine Fellowship
The upshot? This may sound like a simple thing, but it’s an important one. Look for a physician when vetting a clinic and then look to see if he or she is practicing there full time. Also, make sure the medical specialty is one of the above for orthopedic work. Again, buyer beware!