My Turn: The malaise of medical care

For the Monitor
Published: 12/2/2019 6:00:17 AM

I recently had an experience that highlights, for me, some of what is wrong with our medical insurance system.

I love playing tennis, but my knees have been deteriorating. The cushioning material is wearing away, and there is arthritis. The increasing pain and swelling I was experiencing led me to consider knee replacement surgery, or the end of my tennis career. Neither choice was appealing.

My naturopathic doctor suggested I consider PRP therapy. Platelet-rich plasma treatment has been growing in popularity because it often provides an alternative to knee- and hip-replacement surgery. It can also help tennis tendinitis and rotator cuff injuries. Professional athletes, including Tiger Woods, use PRP therapy. Despite its successful track record, it is not covered by insurance, Medicare or otherwise.

PRP therapy involves removing a small amount of one’s blood and separating out its components in a centrifuge. The concentrate is then injected into the area that needs help. The platelet-rich blood attracts stem cells, the body’s repairmen, to the area to rebuild tissue, muscles and tendons.

I love this concept because it uses the body’s own healing ability to rebuild worn-out parts. As a lifelong proponent of homeopathy and other natural healing modalities, I decided to give PRP a try. On Sept. 10, I drove to the office of Dr. John Herzog in Falmouth, Maine, to check it out, despite the fact that Medicare would not cover the cost.

Dr. Herzog is an osteopathic orthopedic surgeon who has performed thousands of surgeries to replace knees and hips over his 30-year career. In 2009 he decided to stop doing surgery and focus on PRP, after finding how much it helped his own knee condition. He has treated more than 3,000 patients since then, with an 80% success rate.

After a basic physical exam to see how well my knees flexed, we looked at them with ultrasound. It was fascinating to watch as Dr. Herzog explained the state of each knee cavity. Fortunately, I was not in a complete bone-on-bone condition; both knees were good candidates for PRP treatment.

I initially thought I would test the treatment on one knee, but opted to have both done. The cost was $600 for one knee, $1,000 for both. Despite paying for this out-of-pocket, it seemed a reasonable cost given the much more expensive alternatives. Knee and hip replacements average $30,000.

Dr. Herzog drew a cup of blood from my arm, put it in a centrifuge and injected the platelet-rich concentrate into both knees. I was out of the office on my way home in a little over an hour. I was told results were normally felt within 4 to 6 weeks, and could last up to a year or more. Every person responds differently, some return for tune-ups after a year.

The following day both knees were quite sore and swollen as blood and oxygen rushed to the area. The next day the swelling began to subside, and five days after the treatment I played tennis. Now, some two months later, the results have been remarkable. Both knees are stronger. Recovery after tennis is greatly reduced. I stopped wearing knee braces, and my movement on the court is now the best it’s been in years. I’m considering playing three times a week instead of two. I feel a little bit like Forrest Gump!

Given the significant success rate of this treatment, the low cost, low risk and absence of side effects, why is it not covered by medical insurance? When I posed this question to a spokesperson at Concord Orthopedics, where one doctor now offers the treatment, their guess was the lack of clinical data on PRP therapy. It’s clear this therapy is rapidly gaining in popularity because it is effective and inexpensive.

Dartmouth-Hitchcock offers PRP treatments. Vermont Regenerative Medicine, located in Burlington, recently ran a series of full-page ads in the Monitor advertising their services.

You would think insurance companies and the medical establishment would jump on embracing such benign treatment. I was able to afford the $1,000 fee to have both knees treated, but how about all the people who cannot?

For many years, acupuncture and chiropractic care were not covered by medical insurance. Now they are. Similar to PRP therapy, they are effective, non-invasive and low cost. All therapies that employ our body’s healing ability to recover from injury should be put at the top of the list of treatments covered by insurance. Especially when they offer a true alternative option to more expensive and invasive surgery.

(Sol Solomon lives in Sutton.)




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