Regen Medicine, Stem cells in PM&R

[todo]

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I'm a graduate, taking a year-off for research reasons.

Is anyone familiar with any PM&R docs working in regenerative medicine and/or using stem cell harvesting and injections.

Is this something one can do working in PM&R - at an academic institution of course.

Unfortunately, my institution did not have a PM&R rotation. I wish I could have done one.

-Li

 

[Gauss]

depends on if the academic institution buys the equipment and lets you do it, and if you generate any revenue from it

 

[SSdoc33]

Is anyone familiar with any PM&R docs working in regenerative medicine and/or using stem cell harvesting and injections.

Is this something one can do working in PM&R - at an academic institution of course.

Thanks

generally, these things arent paid for by insurance. it is very difficult (yet not impossible) to set up a cash-based practice at an academic institution that offers these services. there are some sports fellowships that dabble in it, but you will find most of the work is done via private practice clinics.

 

[DrMattOglesby]

Research on stem cells in spinal cord injury is performed in collaboration with the University of Miami:

http://www.miamiproject.miami.edu/

 

[Doctodd]

Go to a weekend course and teach your attendings. It is only a cash based practice....which isnt a bad thing. Figure 3-5 years before MC and insurance stick their tentacles in it. It doesn't work anyway so don't bother. 🙂

 

[Disciple]

Gave up on it already?

 

[todo]

doesn't work...yet

 

[Doctodd]

Gave up on it already?

Yea.....gave up.....don't bother with it

 

[axm397]

I think like anything else, it's a matter of patient selection. I have seen physicians inject everyone with PRP and stem cell just because they can - and sometimes even before exhausting conventional treatment (cortisone injections, physical therapy, medications, passage of time, etc.)

I do a few in my practice (probably only about 1 a month or so) - but the few that I have done have had good results.

Same with SCS - I only do 1-2 a month - and I have 90+% success rate - and the reps would likely argue that I am undertrialing - but I like to practice that way. I only trial people that I think would do well and don't have a lot of psych issues - since I have to see those patients after the implant for reprogramming, etc. anyway. There are docs who will trial any warm body that walks in their clinic - those guys have lower success rate and ruins the reputation of themselves but more importantly the treatment option - which makes PCPs very skeptical about SCS.

I see everything as part of my toolkit. I don't look at potential reimbursement as the primary motivating factor (obviously, i wouldn't do something that lost money) - but if i can get the patient better using whatever i can - i do it. I refer to chiro, i refer to acupuncture, etc. but i also try to diagnose the issues first and try conventional treatment before going down the cash only or alternative route.

 

[PMR2008]

This is exactly why many physiatrist including myself look up to you and Steve. Ethics>Profits

I think like anything else, it's a matter of patient selection. I have seen physicians inject everyone with PRP and stem cell just because they can - and sometimes even before exhausting conventional treatment (cortisone injections, physical therapy, medications, passage of time, etc.)

I do a few in my practice (probably only about 1 a month or so) - but the few that I have done have had good results.

Same with SCS - I only do 1-2 a month - and I have 90+% success rate - and the reps would likely argue that I am undertrialing - but I like to practice that way. I only trial people that I think would do well and don't have a lot of psych issues - since I have to see those patients after the implant for reprogramming, etc. anyway. There are docs who will trial any warm body that walks in their clinic - those guys have lower success rate and ruins the reputation of themselves but more importantly the treatment option - which makes PCPs very skeptical about SCS.

I see everything as part of my toolkit. I don't look at potential reimbursement as the primary motivating factor (obviously, i wouldn't do something that lost money) - but if i can get the patient better using whatever i can - i do it. I refer to chiro, i refer to acupuncture, etc. but i also try to diagnose the issues first and try conventional treatment before going down the cash only or alternative route.

 

[Gauss]

A great example of proper selection is the misuse of viscosupplements which now the AAOS may end up killing with their latest stance. If there ain't no cartilage why are you injecting a hyaluoronic molecule that binds to cartilage cells???
In addition to selection there's a lot to be said about the technique used, and if you ask Peck, Finnoff, Smith, Malanga, Mautner, etc. you'll find that is what everybody spends the most time doing and researching. The extraction mechanisms and concentrating abilities are getting better but have been good enough for some time.