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AI’s Future in Healthcare Is Not Entirely Rosy

There is a lot of interest and excitement surrounding integrating AI into healthcare, but there are a lot of hurdles that still need to be addressed.

By Alex Tate

There is a lot of interest and excitement surrounding Artificial Intelligence, or AI, and how it can bring sweeping changes to the healthcare ecosystem. The potential of AI is unlimited, and its avenues in healthcare are still predominantly unexplored. According to Accenture, successful and effective implementation of AI can save the US government up to $150 billion per annum, by 2026. For a government that is generously spending $3.5 trillion each year on its healthcare needs, such sizeable savings can ease some pressure. Accenture also predicts that the AI healthcare market will be valued at $6.6 billion by 2021.

However, despite all of the encouraging statistics, AI still has a cloud of uncertainty associated with it. There are various reasons why people are not comfortable with incorporating AI into healthcare. Technological limitations and complicated intricacies related to AI also do not help its cause. Even though experts are optimistic that AI will rejuvenate the healthcare system, there are implications which cast doubts over its future.

Here are some reasons why the use of AI in healthcare proves challenging:

AI Is Still a Black Box

In IT, black box refers to something which is not entirely understood, in terms of its internal workings. For example, you may know how to turn on your laptop by pressing the power button, but you are unsure what internal mechanisms kick-in during the process of turning on your device. In that case, a laptop may be a black box for you.

For data scientists and IT experts, AI is very much a black box. They are able to derive limited work from AI, but are, themselves, unsure how AI actually works. In theory, AI works by machine learning and neural networks. However, the exact intricacies and algorithms are still less understood.

Inadequate Technology to Support AI

Our current technology, especially in terms of hardware, is not fully capable of running AI and its algorithms. Only the most advanced supercomputers can manage AI. Whereas, the servers that most hospitals currently have may not be fully equipped to deal with the set of processes that take place in AI.

Public Acceptance

Even if we are able to comprehend AI completely, we may not be able to incorporate it into the healthcare setup, unless the public feels comfortable with it. People can be quite distrustful when it comes to the manipulation of their data. As long as AI does not get social acceptance, giving AI access to PHI (Protected Health Information) would be unethical.

Data Protection and Privacy Issues

The American healthcare system takes healthcare privacy very seriously. Breaches in patient information are punishable by a maximum fine of $1.5 million per violation. In light of such strict rules and hefty punishments in cases of non-compliance, scientists cannot risk giving AI open access to patient data. Even if we are able to understand the mechanism of AI, ensuring that data breaches do not happen would be an even more significant challenge. The downside of AI is, if this technology gets into the wrong hands, all the current protocols of data safety will become null and void.

Compliance and Regulations

Since the enactment of HIPAA, the US Government has been regularly enforcing compliances on the healthcare sector to ensure the safety of clinical information. Once AI regularly features in healthcare, the government may be required to enact a new set of regulations to streamline the applications of AI. At this stage, the scientists themselves are not sure how AI works. Aligning AI to federal and state compliances would be a different ordeal.

Employee Layoffs

Reduction in job security due to increased automation and ‘smarter’ computers has been a growing dilemma over the last few years. Since machines are taking over much of the work previously performed manually and businesses are pushing to reduce costs in the ever-competitive healthcare arena, showing employees the door is becoming increasingly common. A decrease in healthcare jobs, as a result of AI, will not only increase unemployment but it will also have detrimental effects on the national economy.

Limited Decision Making for Providers

Richard Baldwin said, “No matter how advanced AI gets, it may never have the ability to be creative and think independently – something which natural intelligence is optimized to do.”

With AI having complete access to patient data, it might be able to prescribe treatments on its own. This process may hinder the provider’s own ability to judge and do the requisite decision making. It can also make a provider complacent, which can be dangerous if the AI commits an error. As long as AI does not become error-free, we cannot trust it to make decisions that a seasoned provider can.

Curtailed Provider-Patient Relationships

AI will completely change the dynamics of the provider-patient relationship. Since AI would be doing most of the things, the provider may not have holistic control over the entire treatment process. AI will also allow patients to self-diagnose their ailments, and the providers would be required to justify it, instead of examining the patient and diagnosing appropriately.

Accountability Issues

In case AI fails to function appropriately and presents erroneous information, no one can be held accountable for it. In case of a wrong prescription due to AI, there is no way for a patient to be compensated. Also, there are no enacted laws and regulations covering errors due to AI. Considering that, at this point, we do not have a complete understanding of AI, resolving such errors would be another challenge.

Hefty Training Costs

During the implementation process of AI, providers and support staff would need specialized training on AI. Making AI comprehendible for providers who are usually not fluent in IT dialects, would be very difficult and may take several weeks of training, if not months. Plus, the support system delegated for AI-backed healthcare software would also need extensive training.

AI is probably the most advanced technological innovation that humanity has ever witnessed. In its pilot testing, AI has shown signs of promise, but its future is full of bumpy rides and twisty roads. Like most other technological innovations, one day, we may master AI and all its complexities, but for now, that phase seems distant. Until we reach that phase, we should not rely on AI and trust natural intelligence to do the crucial decision-making in the healthcare sector.

Alex Tate has served in various positions at health IT organizations for the past thirteen years. Most recently as Vice President at a leading EHR organization. He is currently overseeing EHR Programs and revenue cycle consulting for a number of organizations. He has previously supervised the development of many emerging products and held leadership roles in health-tech strategy, operations, service organization development, delivery, and optimization.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

“Hey, Google, Find Me A Doctor.”

60% of patients turn to search engines to find a doctor, while 51% rely on social media. If you don’t have an online presence, it’s time to get one.

Your online presence is more important than you may think.

Newly released results from Binary Foundation’s Healthcare Consumer Insight and Digital Engagement Survey indicate that digital research has skyrocketed for patients seeking the right provider. So, if you and your practice are not online, or if your online presence is poor, now might be the time to rethink your digital strategy.

According to the report, which surveyed 1,000 American adults to produce their findings, 60% use search engines to find a doctor, while 51% turn to social media. Both numbers are on the rise, but, in particular, social media searches are soaring, up from only 7% in 2017, or a 621% increase.

And what are patients looking for exactly? Ratings and reviews, it seems.

The survey found that 75% of patients are influenced by online feedback, such as reviews and star ratings, and it was also found that comments from other patients about a practice or provider are the second most important factor for patients when choosing a physician.

Factors that are less important to patients now than in 2017 as identified by the findings included hospital affiliation, facility location, and insurance coverage.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

September Is Pain Awareness Month

The month of September has been designated as Pain Awareness Month to shine a light on the 100 million Americans who live with chronic pain.

Pain is invisible. It cannot be seen, touched, or measured. But it is still very real for the 100 million Americans whose lives are impacted by chronic pain on a daily basis.

Yet, chronic pain is often misunderstood and invalidated by the chronic pain patient’s family, friends, coworkers, and even their healthcare providers.

To help the public understand the debilitating impacts of chronic pain, September has been designated as Pain Awareness Month.

“The only way we can create change is if we start speaking up–to loved ones, coworkers, neighbors, clinicians, and even policymakers,” said Nicole Hemmenway, Interim CEO of U.S. Pain Foundation, in a statement about Pain Awareness Month released this week. “Pain is silent, but we don’t have to be.”

Physical Therapists are often on the front lines when it comes to treating this silent epidemic. Through exercise, manual therapy, education, and teamwork, the therapy community helps chronic pain patients improve their quality of life, in place of dangerous and highly-addictive medications, such as opioids.

This September, take the time to speak with your patients about their pain, even more than you usually would. Sometimes, being heard can make all the difference.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

How Has Nursing “Broken” You?

During your career, you will see a lot of horrific things that will turn into cautionary tales. Nurses took to Twitter this week to discuss theirs.

This week, a trauma ICU nurse who goes by the handle @NurseKelsey, posed a question to the Twitterverse: “What is something non-medical people do [regularly] that you just cannot because of what you know/have seen working in healthcare?”

The replies poured in, ranging from funny gifs to more serious answers to the question, but one thing seemed certain—everyone who works in healthcare has seen something they would not want to happen to themselves or their loved ones.

One of the most popular responses included not using or letting their children use a trampoline or go to a trampoline park, or as one Twitter user called it, “otherwise known as the orthopedists’ waiting room annex.”

Some of the more serious responses included:

“Refuse the flu shot.” – @MarieJetteSLP
“Ride in the passenger seat with your feet up on the dash.” – @vfedirkadirka
“Live life without an advance directive and medical POA.” – @RN_Atheist
“Buy and use guns.” – @jro_joe
“Complain about wait times in the emergency room/clinic/urgent care.” – @AnnYoungMD

And some were a bit more lighthearted:

“So, I’m not remotely germ phobic (like, it hasn’t killed me yet), but I can’t watch medical shows without yelling at the TV.” – @MelissaSKeefer
“Oh, for sure, meth.” – @nazirahidris
“Get pregnant. L&D rotation is the most effective contraceptive there is.” – @darkwyngMD
“Eat at a normal pace at home. #NurseLunch #EatOnTheRun #NoTime” – @xo_Harmony_xo
“Say the ‘q’ word that rhymes with riot without cringing & checking to see if anyone heard. Especially on Friday & Saturday nights.” – @dawnphoenixk

What do you have to add? How has nursing “broken” you in ways that non-nurses don’t think about? Tell us in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

How to Talk to Patients Who Oppose Vaccines

Measles disappeared from the U.S. in 2000. Now, it’s back, with 1,172 cases across 30 states. Here’s how to talk to patients about the importance of vaccines.

As of August 1, 2019, the CDC reported 1,172 cases of measles across 30 states, the greatest number of cases reported in the U.S. since measles was eliminated from the country in the year 2000.

It is commonly known among healthcare professionals that the best way to protect against measles and many other preventable diseases is to vaccinate. However, since 2001, the number of people who did not receive vaccines for preventable diseases has quadrupled, thanks in part to what is commonly known as the “anti-vax” movement. The movement, which has been around for more than a hundred years, has found its foothold in pseudoscience and misinformation disguised as advocacy. At the very least, anti-vaxxers have made it harder for medical professionals to do their jobs and, in what is arguably the worst-case scenario, they and their message have put lives in jeopardy.

But not everyone who does not vaccinate is staunchly anti-vaccines—some are hesitant, others are misinformed. Still, speaking to them about vaccines may be challenging for even the most seasoned provider. Here are some tips that might make the conversation go a bit more smoothly.

Listen to Their Concerns

No one wants to feel like they are being strong-armed or railroaded. Though their concerns may be medically invalid, they are still personally valid to them. Be sure to listen to what they have to say, with empathy and without interrupting, so you know their concerns and, in turn, how to respond to them.

Counter with Facts

They may bring up misinformation as part of their concerns, such as claims that certain vaccines are “linked to” autism or SIDS. As you likely know, there is a barrage of evidence against these unfounded claims. It is your job as a medical professional to provide them with science-based facts to alleviate these concerns.

Stand Firm, but Know You May Not Win

It may take more than one conversation to quell all of their concerns and allow you to administer vaccinations. Be prepared to have the conversation the next time they come to see you, and be sure to explain the risks involved in their decision to not vaccinate in the meantime, as well as precautions they can take to keep themselves, their child, and/or the public as safe as possible while unvaccinated.

What other methods have you found to be effective in speaking to patients about vaccines? Leave them in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Elevate Your Nursing Job Interview Skills

Job interviews for nurses can be quite tricky, and a source of anxiety for a lot of nurses. Learn how to own your greatness and ace your next interview.

From Nurse Keith’s Digital Doorway

Job interviews are a source of stress for many job-seekers, and nurses are no exception. Nursing can feel like a rough and tumble profession when it comes to the high-stakes interview process, and for those nurses who are unsure how to articulate their value, the interview can seem like an insurmountable hurdle.

I’ve discussed interviews on this blog in the past, and I’ve also addressed the issue on episode 18 (Job Interviews 101) and episode 59 (Tips For Confident Job Interviews) of The Nurse Keith Show. I recommend those resources as a good place to start when it comes to optimizing your interview skills and strategies.

In previous positions as a nurse manager, Director of Nursing, and Chief Nursing Officer, I’ve interviewed a great many nurse job candidates. And in my career coaching practice, I’m privy to the fears and anxieties of nurse interviewees who are feeling the (interview) heat.

Many nurses who contact me about interview anxiety are often having trouble owning their greatness and elucidating what separates them from the pack. Standing out from the competition is paramount, and a nurse sitting in an interview has to deliver what makes him or her the ideal candidate for the position in question.

If your interview anxiety is all about not knowing how to make yourself shine, this is a calculus that needs to be changed as soon as possible.

Where Is Your Passion and Genius?

An interviewer wants to know where your passion lies. They would like to hear how you view your place within the nursing profession and how you’re able to bring the best of yourself to the table.

If you have special interests, areas of specific inquiry, notable experiences, or larger career goals, making these known can be a smart move. Ambition, critical thinking, the desire to learn and grow, and rich life experience can go a long way towards painting a picture of a forward-thinking, self-aware nurse job applicant who the potential employer would be foolish to pass over for someone else.

How Do You Relate to Organizations and Colleagues?

Interviewers want to know how you see your place in the world, how you relate to others, and the quality of your relationships with organizations you work for or interact with.

A potential employer wants to know if you’re a loyal team player. They also want to know if you value the collective genius of the organization and the people within it, as well as your willingness to contribute to that collective genius as an active participant within the workplace community.

Nursing doesn’t happen in a vacuum, it’s a collaborative venture. They want to see that you’re up to the task and if you’d be a good fit for the corporate culture.

How Do You Communicate?

In a job interview, you’re being very clearly assessed for how you communicate, both verbally and non-verbally. This is so important to pay significant attention to.

Your body language says a great deal about you, and there’s no doubt that your interviewer will be “reading” how you use your body to communicate. Crossed legs and arms can demonstrate a closed way of communicating with others, and poor eye contact can betray a lack of self-confidence. Are you busy drumming your fingers on your notebook or tapping your foot out of anxiety?

You must also remain aware of your facial expressions during the interview process. Do you smile easily? Do you make eye contact when speaking, or do you look at the floor or to the side? If you have a tendency to frown or wrinkle your forehead when thinking or speaking, that habit could be easily misinterpreted. Self-awareness is key.

In your communication, your potential employer wants to know if you’re a boastful person who thinks you know it all and have nothing to learn, or if you’re humble, self-reflective, and willing to acknowledge what you don’t know. They also want to see if you can own your intelligence and be clear about any specialized knowledge you hold.

Your Sense of Mission and Purpose

In the bigger picture, the employer wants to know why you’re even there in the first place, petitioning for a position within their organization. Are you just needing to get a job and put food on the table, or are you looking for an opportunity to truly grow as a member of their organization? What do you want and expect from them, and how much are you willing to give?

Some employers and interviewers may be seeking to clarify how you define your professional purpose and mission. They want to know what makes you tick. Make it clear.

Walk In Their Shoes

One method of interview preparation is to put yourself in the interviewer’s shoes. What are they after? What are their pain points when it comes to hiring and retention? What is the stated mission of the organization? What hiring mistakes have they made in the past? What would make you stand out from the pack? Which of your answers would shine with the authenticity that they’re dying to hear?

If you were the interviewer, what would you want to hear from a nurse applicant? What is it that would make you say “yes” to one candidate and “no” to another? Is it just a gut feeling or is it something else?

Market Yourself

Finally, when preparing for the interview process, you must think of yourself as a commodity — a brand — that needs to be marketed. You are, in essence, selling your services as a nurse to this potential employer, and for all intents and purposes, your interview is a sales pitch.

In business, we identify what’s known as the unique selling proposition (USP) behind our product or service, and we then use that USP to appeal to potential customers and buyers. To sell a product or service, we need to know our target market and use a sales pitch that appeals to their sensibilities. A product or service simply needs to affordably solve a “pain point” (problem needing to be solved) felt by the consumer.

For you and your nursing career, the pain point of your potential employer is that they need to fill a nursing position with the best possible candidate who will give them the best possible return on investment (ROI). Nurse turnover can cost tens of thousands of dollars; thus, a hiring manager wants to try to choose high-quality nurse employees who will contribute in positive ways and remain with the organization for as long as possible.

As you market yourself to your potential employer, the case you make must clearly proclaim that:

  • You are the ideal candidate for the position
  • Your longevity within the organization will provide them with an excellent return on their investment in your training and acculturation
  • You will be a good cultural fit within the organization
  • The skills and experience you bring to the table are exactly what they need
  • You have exactly what it takes to deliver consistently high-quality nursing services (in whatever capacity you are hired for)
  • They will never regret their decision of bringing you into the organization

An interview is about marketing, language, mission, purpose, values, and communicating that you, the candidate, have a contribution to make. You need to differentiate yourself from the pack. The relationship between employer and employee is a two-way street, and you can also hold the expectation that the organization will offer its allegiance and commitment to you, the highly valued and valuable nurse.

Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AUSMed, American Sentinel University, Black Doctor, Diabetes Lifestyle, the ANA blog, NursingCE.com, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and remarkably intelligent cat, George.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Physician Pay Up, Productivity Stagnant

Physician compensation rose significantly in 2018, according to findings from the AMGA. See a breakdown of the numbers here.

Physician compensation increased significantly in 2018, while productivity stagnated, according to the newly released findings of the American Medical Group Association’s 2019 Medical Group Compensation and Productivity Survey.

Overall, physician pay rose by a median of 2.92% in 2018, a sharp rise over 2017’s 0.89%. Productivity, however, did not see such a large increase as a whole, up only 0.29% from 2017’s 1.63% decline.

Median pay for all Primary Care specialties increased by 4.91%, a staggering difference over the 0.76% compensation growth in 2017. Within Primary Care, Family Medicine saw the highest increase in compensation at 6.25% in 2018, followed closely by Internal Medicine (5.90%), while Pediatrics saw a slight decline in compensation of -0.04%.

The overall median compensation was up for medical specialties, as well, seeing growth of 3.39% in 2018, with Psychiatry seeing the sharpest increase of 15.6%.

“The 2019 survey shows that physician compensation in 2018 rebounded from a stagnant 2017,” said Fred Horton, M.H.A., AMGA Consulting president, in a press release. “While productivity also increased, it did not increase enough to surpass the decline we saw in last year’s survey, meaning productivity still has not risen since 2016.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Landmark Decision Holds Drug Maker Responsible In Opioid Crisis

An estimated 130+ people die every day from opioid-related drug overdoses, and now a landmark decision in Oklahoma is holding one drug maker responsible.

An Oklahoma judge has ruled that pharmaceutical company Johnson & Johnson deceptively marketed opioids, which helped fuel the state’s opioid crisis, a crisis that claimed the lives of more than 6,000 people, and must pay $572 million to the state.

The landmark decision, which was handed down by Judge Thad Balkman on Monday, is the first of its kind, in which a pharmaceutical company is being held directly responsible for one of the worst drug epidemics in American history.

“Defendants caused an opioid crisis that is evidenced by increased rates of addiction, overdose deaths and neonatal abstinence syndrome in Oklahoma,” Judge Balkman said in the ruling.

Johnson & Johnson immediately released a statement in which it was said that the company “plans to appeal the opioid judgment in Oklahoma.”

The case and the subsequent ruling have undoubtedly been closely watched by plaintiffs in other opioid lawsuits, of which there are currently more than 2,000 pending.

It is estimated that more than 130 people die every day in the United States from opioid-related drug overdoses.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Suicide Risk Among Nurses Higher than Non-Nurses

Nurses are at a higher risk of suicide than the general population according to the findings of the first national investigation into nurse suicide in over twenty years.

Nurses are at a higher risk of suicide than the general population according to the findings of the first national investigation into nurse suicide in more than two decades.

The study, which was published in Archives of Psychiatric Nursing, found that suicide incidence was 11.97 per 100,000 female nurses and even higher among male nurses, with suicide claiming 39.8 per 100,000. Both figures are significantly higher than that of the general population, which is 7.58 per 100,000 women and 28.2 per 100,000 men. Overall, the suicide rate was 13.9 per 100,000 nurses versus 17.7 per 100,000 for the general population.

In all, over 400 nurses per year die by suicide, and according to the study, nurse anesthetists and retired nurses were at the highest risk.

“We are overworked and stressed, and on the edge of the breaking point at any given moment,” said Ariel Begun, BSN, RN, who was willing to speak with us regarding the alarming rate of nurse suicides. “In the last 10 years I have seen the expectations of nurses increase and the staffing and quality of supplies decrease. Nurses have been told they need to do more with less for years and it keeps getting worse.”

When asked how the healthcare industry and its employers can better support the mental health of nurses, Begun had a lot to offer.

“First, fix the systemic problems in healthcare. Starting with patient to nurse ratios being lowered, and increased staffing for support of the department and to ensure someone is available to help in emergencies. We should not consider barebones staffing to be the norm. We also need to provide better resources for nurses to care for patients without having to use the cheapest thing on the market. Additionally, we need better hours and shift options. We should not need to work to the point of jet lag mental conditions, where our basic thought capacity is diminished to the point where we have trouble remembering to care for ourselves.

“Guilt is also a driving factor for nurses. We don’t call out when we are sick because we know the department will be hurt by us not being there. We don’t get decent breaks and we work to the point of dehydration and kidney failure potential. Toss in Neurogenic Nurse Bladder, a condition that develops because of the nurse’s lack of bathroom break time. Can’t pee, I might miss a call from the doc, or my patient might code while I am away.

“In regards to mental health specifically, it would be nice to have group support sessions where nurses can get together and talk about the issues they have. Resources for home-work balance need to be available, too. I always thought that a group yoga session would be a nice thing to have as a way to get your day started in a healthy manner. The first lesson I learned in nursing school was, now is not the time to try to quit any vices you have, in fact you might as well double down on them, because they are going to be what helps you get through your day. Nurses are taught to do the things that we then need to teach our patients not to do. Nurses are not taught coping strategies for how to handle their stress. They are only taught that it is a thing and you can’t escape it.”

If you are having thoughts of hurting yourself or others, we encourage you to seek help by calling the National Suicide Prevention Lifeline at 800-273-8255 or by texting 741741 to have a conversation with a trained crisis counselor via the Crisis Text Line.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Superstar Athletes Popularize Unproven Stem Cell Procedures

Stem cell injections are costly, controversial, and unproven to be effective. So, why are professional athletes pushing them?

By Liz Szabo, Kaiser Health News

Baseball superstar Max Scherzer — whose back injury has prevented him from pitching for the Washington Nationals since he last played  on July 25 — is the latest in a long list of professional athletes to embrace unproven stem cell injections in an attempt to accelerate their recovery.

But many doctors and ethicists worry that pro athletes — who have played a key role in popularizing stem cells — are misleading the public into thinking that the costly, controversial shots are an accepted, approved treatment.

“It sends a signal to all the fans out there that stem cells have more value than they really do,” said Dr. James Rickert, president of the Society for Patient Centered Orthopedics, which advocates for high-quality care. “It’s extremely good PR for the people selling this kind of thing. But there’s no question that this is an unproven treatment.”

Stem cells and related therapies, such as platelet injections, have been used for the past decade by top athletes: golfer Tiger Woods, tennis pro Rafael Nadal, hockey legend Gordie Howe, basketball player Kobe Bryant and NFL quarterback Peyton Manning. Stem cells are offered at roughly 1,000 clinics nationwide, as well as at some of the country’s most respected hospitals.

Depending on the treatment, the cost can range from hundreds to thousands of dollars. Insurance does not cover the treatments in most cases, so patients pay out of pocket.

Yet for all the hype, there’s no proof it works, said Paul Knoepfler, a professor in the department of cell biology and human anatomy at the University of California at Davis.

Referring to Scherzer, Knoepfler said, “There’s really not much evidence that it’s going to help him, other than as a psychological boost or as a placebo effect.”

Scherzer, 35, said he received a stem cell shot Friday for a mild strain in his upper back and shoulder. According to a news story on the Major League Baseball website, Scherzer also previously had a stem cell injection to treat a thumb injury.

If the diagnosis of Scherzer’s mild muscle strain is correct, it should completely heal itself with 10 days of rest, Rickert said, so Scherzer would probably feel ready to play by Monday even without the stem cells. But Rickert said he worries about other athletes who are tempted to return to the field too soon.

“The risk from the stem cell procedure is that it could give someone a false sense of confidence, and they could go back to play too early” and reinjure themselves, he said.

A spokeswoman for the Washington Nationals declined to provide information about Scherzer’s treatment, such as the type of stem cells used or the name of the clinician who administered them.

Clinics that offer stem cell treatments prepare injections by withdrawing a person’s fat or bone marrow, then processing the cells and injecting them back into aching joints, tendons or muscles.

Another popular treatment involves concentrating platelets — the cells that help blood clot. Many people confuse platelet injections with stem cell injections, perhaps because the shots are promoted as treatments for similar conditions, said Dr. Kelly Scollon-Grieve, a physical medicine and rehabilitation specialist at Premier Orthopaedics in Havertown, Pa.

When it comes to pain, injections can act as powerful placebos, partly because suffering patients put so much faith in treatment, said Dr. Nicholas DiNubile, an orthopedic surgeon and former consultant for the Philadelphia 76ers.

In a recent analysis, more than 80% of patients with knee arthritis perceived a noticeable improvement in pain after receiving a placebo of simple saline shots.

Team doctors often treat athletes with a variety of therapies, in the hope of getting them quickly back on the field, said Arthur Caplan, director of the division of medical ethics at New York University School of Medicine. Athletes may assume that stem cells are responsible for their recovery, when the real credit should go to other remedies, such as ice, heat, nonsteroidal anti-inflammatory medications, cortisone shots, massage, physical therapy or simple rest.

“These are the richest, most highly paid athletes around,” Caplan said. (Scherzer and the Nats agreed to a $210 million, seven-year contract in 2015.) “So anything you can think of, they’re getting. But I wouldn’t use them as a role model for how to treat injuries.”

While athletes often talk about their stem cell treatments, Caplan said he wonders, “Would the inflammation or problem have just gone away on its own?”

Sports fans shouldn’t expect to have the same reaction to stem cells — or any medical intervention — as a professional athlete, DiNubile said.

In general, athletes recover far more rapidly than other people, just because they’re so young and fit, DiNubile said. The genes and training that propelled them to the major leagues may also aid in their recovery. “They have access to the best care, night and day,” DiNubile said.

Whenever a top athlete is treated with stem cells, word spreads quickly on social media. Fans often end up doing the stem cell industry’s marketing for them: A 2015 analysis found that 72% of tweets about Gordie Howe’s stem cell treatments were positive. Of 2,783 tweets studied, only one mentioned that Howe’s treatment, delivered in Mexico after Howe’s stroke, was unproved and not approved by the U.S. Food and Drug Administration. Howe died in 2016.

The Mexican stem cell clinic provided Howe’s treatment at no charge. Clinics use such donations as a form of marketing, because they generate priceless publicity, said Leigh Turner, an associate professor at the University of Minnesota’s Center for Bioethics who has published articles describing the size and dynamics of the stem cell market.

“Clinics provide free stem cell treatments or offer procedures at a discounted rate, and in return they can generate YouTube testimonials, press releases and positive media coverage,” Turner said. “It’s also a good way to build relationships with wealthy individuals and get them to refer friends and family members for stem cell procedures.”

Stem cell clinics often feature athletes and other celebrities on their websites and in marketing materials.

In a 2018 column, Los Angeles Times writer Michael Hiltzik noted that stem cell treatment has failed three baseball players with the Los Angeles Angels. Players Shohei Ohtani, Andrew Heaney and Garrett Richards, who is no longer with the Angels, tried stem cells in the past three years in an effort to avoid surgery. All ended up needing surgery anyway.

As DiNubile said, “the marketing is clearly ahead of the science, no question.”

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