Off Label Hyperbarics

[heybrother]

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Note sure if anyone has seen this in the news, but there are 2 semi-recent fatalities associated with hyperbarics. One unfortunately a child. The other the owner of the clinic. Obviously terrifying to think about. What's wild about both events is - the hyperbarics was not for wounds or carbon monoxide. The owner who passed offered hyperbarics essentially as a lifestyle treatment - “the tools they need to achieve peak health and recovery.” I believe the child who passed was at a clinic that offered hyperbarics for autism, learning issues and was there for ADD.

https://www.washingtonpost.com/nation/2025/07/12/walter-foxcroft-hyperbaric-chamber-fire-arizona/

Hyperbaric Oxygen Therapy - The Oxford Center

Hyperbaric Oxygen Therapy is a safe and effective researched based alternative treatment for more than 100 medical conditions.

theoxfordcenter.com

https://www.cnn.com/2025/03/11/us/hyperbaric-chamber-explosion-boy-killed

 

[EthylMethylMan]

Many, many snake oil places like this exist. There was some research in the 80s and 90s looking into HBO for autism and cerebral palsy, no statistically significant findings were reported to my knowledge. These people are either totally ignorant or they are shamelessly taking advantage of desperate people. When you guys are making referrals for HBO, try to refer to UHMS-accredited places when possible.

 

[Feli]

Many, many snake oil places like this exist. There was some research in the 80s and 90s looking into HBO for autism and cerebral palsy, no statistically significant findings were reported to my knowledge. These people are either totally ignorant or they are shamelessly taking advantage of desperate people. When you guys are making referrals for HBO, try to refer to UHMS-accredited places when possible.

This is unfortunately the case even for many accredited and hospital-owned wound/HBO centers... they look to expand to the "off label" mental health and longevity and other nonsense indications and want to do those dives a couple days per week to fill their $chedule$.

I'm sure there are a few ethical wound centers out there, but the majority are just a setup to sell fake wound grafts and the HBO sessions. I've had pressure or sales pitch from the center directors (usually MD, occasionally podiatrist) at every one I've ever seen patients at. Many of them also had the wound nurses try to convince me of how great it works also. I am just looking for a place to do wound care that's too advanced for office setting, but they almost instantly want me to increase my HBO refers and "graft" use on any and every who might qualify. It's hogwash.

 

[EthylMethylMan]

This is unfortunately the case even for many accredited and hospital-owned wound/HBO centers... they look to expand to the "off label" mental health and longevity and other nonsense indications and want to do those dives a couple days per week to fill their $chedule$.

I'm sure there are a few ethical wound centers out there, but the majority are just a setup to sell fake wound grafts and the HBO sessions. I've had pressure or sales pitch from the center directors (usually MD, occasionally podiatrist) at every one I've ever seen patients at. Many of them also had the wound nurses try to convince me of how great it works also. I am just looking for a place to do wound care that's too advanced for office setting, but they almost instantly want me to increase my HBO refers and "graft" use on any and every who might qualify. It's hogwash.

Sadly true in my experience as well. There are a lot of people even at more legit places who will push the envelope on what needs HBO. At the very least, the accredited places won’t be running cases that are straight-up nonsense, and their safety standards are generally much higher. And if you’ve got someone with a non-healing Wagner 3+, the evidence for HBO is pretty good. But yeah if the places around you are graft mills, I don’t blame you for your hesitance.

 

[msion]

Oh man, you guys should have seen what the plastic surgeons do in some areas.
I work with a local HBOT center from time to time for DFUs or venous stasis ulcers. I typically consider them adjunct therapy, and usually refer after any vascular procedure/surgical offloading. Other than my referrals, they told me plastic surgery patients are a big share. These patients almost always pay out of pocket, would be placed into a 5-star hotel room for post-op recovery with a dedicated nurse for dressing changes, and get transported to receive HBOT daily. Cash pay price? $8k for 30 sessions.

It's a complete different demographic and parallel universe where they practice. I recalled one time I was introduced to a plastic surgeon at a hospital Xmas party, and I was talking about how we could collaborate on muscle flap cases. He looked at me if I were insane. Later I found that he didn't take call, and only did all cash elective and cosmetic procedures.

 

[Retrograde_Nail]

In my region there are A LOT of independent hyperbaric facilities with off label treatments where they just charge cash and people do it because they just "believe" its good for them. Same thing with wellness clinics which are staffed by PAs and NPs basically letting you buy testosterone and GLP-1 medications.

People are willing to do anything except eat healthy and exercise to get healthy.

 

[Hybrocure]

People are willing to do anything except eat healthy and exercise to get healthy.

welcome to podiatry

 

[Bluecollarmed]

Easy Retro... that type of advice costs money and keeps us in business

 

[Boba Foot]

My local hyperbaric center wound care doc recently tried to ask me not to amputate a hallux that was completely eroded and floppy so that he could qualify him to lay in a tank for two months. Sometimes it's hard to find ways to tell people to kindly **** off.

 

[Homo sapien]

My local hyperbaric center wound care doc recently tried to ask me not to amputate a hallux that was completely eroded and floppy so that he could qualify him to lay in a tank for two months. Sometimes it's hard to find ways to tell people to kindly **** off.

That's ****ing gross

 

[air bud]

My local hyperbaric center wound care doc recently tried to ask me not to amputate a hallux that was completely eroded and floppy so that he could qualify him to lay in a tank for two months. Sometimes it's hard to find ways to tell people to kindly **** off.

Yup

 

[Adam Smasher]

This is just people following incentives. If instead of cutting physician reimbursement every year, the powers that be would pay us equitably for doing limb-saving surgical procedures along with the laborious day-in, day-out wound care patients need, then HBOT would be revealed to be nothing more than the false hope that it is.

As thing stand, the system exploits the providers, so providers exploit the system.

 

[heybrother]

This is just people following incentives. If instead of cutting physician reimbursement every year, the powers that be would pay us equitably for doing limb-saving surgical procedures along with the laborious day-in, day-out wound care patients need, then HBOT would be revealed to be nothing more than the false hope that it is.

As thing stand, the system exploits the providers, so providers exploit the system.

What's strange about it though is the true incentives flow to the hospital. I can't imagine though how miserable it would be to completely work as a non-operative wound physician. That would be like being a hospitalist at a hospital that has no general surgery and every condition has to be treated with medicine. The patients keep not improving and you just see them again the next day and keep rounding.