The story below from the July 2nd 2008 Wall Street Journal helps show why inexpensive and effective therapies such as HBOT do not quickly become better known.

 

 

Curricula at medical schools and in doctors' private practice is heavily influenced by drug companies.   CME ("Continuing Medical Education") courses are sponsored directly and indirectly by drug companies, as the Pfizer story shows.    These are professional and well-researched course but leave out any therapies that conflict with the drug company profit, no matter how effective.   Besides direct consumer advertising, billions of dollars from drug and medical equipment companies are spent sponsoring company-oriented research grants for the top medical publications read by doctors and used by medical schools, and also to influence national and state legislature, executive and judicial branches, to encourage only expensive patent-protected recurring drug therapies and discourage low-profit therapies, even if they work better.     Such corporate support is beholden by law and custom to stockholders over patients' interests and hostile to simpler, cheaper, more effective, or more permanent therapies, especially those which are non-patentable.   If such therapies are not promoted by a profit-making enterprise who can pay for a place at the table, they become crowded out.

 

An example right here in the Sacramento Valley is the awful statistic that nearly 900 amputations occur each year for diabetic extremities, such as toes and feet.  The cost of amputation sugery is in the range of $45,000, not including possibly millions in lifetime disability costs.   It is now well accepted (see http://www.podiatrytoday.com/article/8026)  that HBOT prevents 75% of these amputations, as well as preventatively healing other limbs by growing new blood vessels and increasing circulation to prevent future non-healing wounds.   The cost of HBOT is a fraction of the cost of amputation surgery, yet the HBOT clinics in this area are referred less than 50 cases per year.   The result is nearly 600 unnecessary amputations and $15 million extra costs per year just for initial surgery per year, and many times that for the future lifetime disability of each patient.  It should especially be noted that this is not just dollars and cents problem.  The pain and suffering of pre- and post-amputation patients is excruciating, and immediately starts to reduce as HBOT is started.   There is no problem with payment for HBOT -- Medicare/MediCal and nearly all insurance pays for HBO treatment to prevent such amputations.   So what's not to like?  

 

How can it possibly happen that many doctors don't know about a therapy that likely will save limbs, terrible suffering, and many millions of dollars?    

 

The WSJ story provides a clue.