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Doctors & ESWT

Posted by JudyS on 4/10/01 at 13:12 (044176)

Can anybody answer this question (especially Docs...);
Why are phsicians so very reluctant to explore, investigate, research and/or accept ESWT as a PF treatment?
I saw my Pod yesterday and gave him more data on ESWT......he labeled it as only 'PR' - he wants to see medical research/fact. Can you believe it...that's what I gave him 2 weeks ago from the ESWT website(s)! He said he didn't recognize names on the Healthtronics list of ESWT providers except Dr. Wiel in Chicago. He also has a bit of familiarity with the Doc in Orange County who does ESWT but labeled him as a less-than-traditional practioner! He said he tends to try any hocus pocus treatment that comes along!
I finally told him that I will be undergoing ESWT which peaked his curiosity but continued to respond as though it was a joke. He said he couldn't 'get' how a single zap from a spark plug could 'cure' PF, he said he'd heard about possible nerve damage and even Plantar rupture! But he also said he knew nothing about the treatment!
I referred him to Dr. Reid and Dr. Z but I doubt that he'll pursue it. Then he told me to go home and rest my sore feet.....
Why the reluctance to accept this procedure - especially in the face of apparent success?

Re: Doctors & ESWT

Dr. Zuckerman on 4/10/01 at 15:28 (044188)

Doctor are people and people are always afraid of change. The typical reponse when afraid of change is to be negative and to invalidate .

I have many colleagues tell if it so great why isn't everyone doing this. Well that was over a year ago and now there is ESWT in 35 states.

There are some doctors afraid to present any treatment if insurance doesn't cover the procedure. . In the beginning there were the negative now i get their referrals. So time is the only answer .

Re: Doctors & ESWT

Dr. Marlene Reid on 4/10/01 at 23:30 (044230)

I agree

Re: Doctors & ESWT

Pauline on 4/13/01 at 21:56 (044514)

Some doctors like to wait for the studies and paper presentations before
jumping into new treatment. You have to remember that the OssaTron was only approved by the FDA in Oct 2000. Others may have run the double blind studies on other machines and are waiting for the FDA to appove those machines in order to use them. Various medical centers are often
loyal to certain manufacturers because they use some of their other equipment as well as the deal they strike with these companies.

Ossatron by Healthronics has recieved full FDA approval to be used in the treatment of Plantar Fasciitis. Approval granted Oct. 2000

Epos Ultra by Dornier have finished their studies and presented the proper documentation to the FDA. They could have their approval for the Epos Ultra as early as May, but certainly by the end of the year. This machine I understand will be able to be used in areas other than the insertation point. My Ortho. ran the studies for Dornier here in Mich at one of our largest Major Medical centers.

Orbasone by Norland although seemingly a great machine has for some reason not provided the necessary documentation required by the FDA for approval for it to be used specificly to treat Plantar Fasciitis. There are different approval codes. There is ligitation currently going on between Norland Medical and the FDA and because of this their machine cannot be marketed or advertised to treat plantar Fasciitis. Scott has put a link on the warning letter that Norland received from the FDA on his ESWT site. I personally think that an agreement will be reached and Norland inorder to compete with the others will provide the necessary documentation to satisfy the FDA and all will be right with the world.

Ortho Wave as I understand in currently doing their studies in preparation
to submit them to the FDA.

There will probably be others as well. As you can see with so many manufacturers all with machines to sell its not easy for a physician to just run out and jump on the band wagon. They want to make sure what they invest in is the right choice for them and their patients. In the Major Medical Centers, I'm sure the centers themselves figure in to which machine will be used at that site. Lots to consider.

Re: Doctors & ESWT

JudyS on 4/14/01 at 01:19 (044536)

Pauline, clearly you've done your homework - and we all get to benefit from it so - thank you!
Perhaps I would have communicated my concern better by asking 'why do doctor's have such 'attitudes' about this new treatment?' I can easily understand any concerns they have regarding the research and development of the treatment, but to be derisive and essentially ridicule it while freely admitting that they know virtually nothing about it is just frustrating for those of us who have done our homework. Then, of course, we walk out of the office feeling like morons! Now, if a doc can show me substantial evidence as to why ESWT could be seriously harmful (as can surgery), then I'd be less inclined to be frustrated. But so far none who I've seen know the slightest thing about it. In fact, I think I'll add your thorough description of the different 'machines' to my 'doctor's file'! Thanks again.

Re: Doctors & ESWT

Dr. Zuckerman on 4/14/01 at 16:58 (044619)

I don't want to sound difficult but there is no ESWT treatment in the world that is made for any area beside insertional when we are talking about soft tissue sites. I have researched the use of Dornier EPOS and this machine sounds like a winner but is still used for insertional pf and other tendon problems.

Re: Doctors & ESWT

Dr. Zuckerman on 4/10/01 at 15:28 (044188)

Doctor are people and people are always afraid of change. The typical reponse when afraid of change is to be negative and to invalidate .

I have many colleagues tell if it so great why isn't everyone doing this. Well that was over a year ago and now there is ESWT in 35 states.

There are some doctors afraid to present any treatment if insurance doesn't cover the procedure. . In the beginning there were the negative now i get their referrals. So time is the only answer .

Re: Doctors & ESWT

Dr. Marlene Reid on 4/10/01 at 23:30 (044230)

I agree

Re: Doctors & ESWT

Pauline on 4/13/01 at 21:56 (044514)

Some doctors like to wait for the studies and paper presentations before
jumping into new treatment. You have to remember that the OssaTron was only approved by the FDA in Oct 2000. Others may have run the double blind studies on other machines and are waiting for the FDA to appove those machines in order to use them. Various medical centers are often
loyal to certain manufacturers because they use some of their other equipment as well as the deal they strike with these companies.

Ossatron by Healthronics has recieved full FDA approval to be used in the treatment of Plantar Fasciitis. Approval granted Oct. 2000

Epos Ultra by Dornier have finished their studies and presented the proper documentation to the FDA. They could have their approval for the Epos Ultra as early as May, but certainly by the end of the year. This machine I understand will be able to be used in areas other than the insertation point. My Ortho. ran the studies for Dornier here in Mich at one of our largest Major Medical centers.

Orbasone by Norland although seemingly a great machine has for some reason not provided the necessary documentation required by the FDA for approval for it to be used specificly to treat Plantar Fasciitis. There are different approval codes. There is ligitation currently going on between Norland Medical and the FDA and because of this their machine cannot be marketed or advertised to treat plantar Fasciitis. Scott has put a link on the warning letter that Norland received from the FDA on his ESWT site. I personally think that an agreement will be reached and Norland inorder to compete with the others will provide the necessary documentation to satisfy the FDA and all will be right with the world.

Ortho Wave as I understand in currently doing their studies in preparation
to submit them to the FDA.

There will probably be others as well. As you can see with so many manufacturers all with machines to sell its not easy for a physician to just run out and jump on the band wagon. They want to make sure what they invest in is the right choice for them and their patients. In the Major Medical Centers, I'm sure the centers themselves figure in to which machine will be used at that site. Lots to consider.

Re: Doctors & ESWT

JudyS on 4/14/01 at 01:19 (044536)

Pauline, clearly you've done your homework - and we all get to benefit from it so - thank you!
Perhaps I would have communicated my concern better by asking 'why do doctor's have such 'attitudes' about this new treatment?' I can easily understand any concerns they have regarding the research and development of the treatment, but to be derisive and essentially ridicule it while freely admitting that they know virtually nothing about it is just frustrating for those of us who have done our homework. Then, of course, we walk out of the office feeling like morons! Now, if a doc can show me substantial evidence as to why ESWT could be seriously harmful (as can surgery), then I'd be less inclined to be frustrated. But so far none who I've seen know the slightest thing about it. In fact, I think I'll add your thorough description of the different 'machines' to my 'doctor's file'! Thanks again.

Re: Doctors & ESWT

Dr. Zuckerman on 4/14/01 at 16:58 (044619)

I don't want to sound difficult but there is no ESWT treatment in the world that is made for any area beside insertional when we are talking about soft tissue sites. I have researched the use of Dornier EPOS and this machine sounds like a winner but is still used for insertional pf and other tendon problems.