Wednesday, April 18, 2007

Limits of Innovation - Innovation Limits

Dangers of Anti-Aging Nostrums

To some, “innovation” and “entrepreneurialism” smack of commercialism and hucksterism, not professionalism. Not to me. I regard innovation and entrepreneurialism as the salvation and distinguishing features of the American health system, if carried out legitimately. Innovators and entrepreneurs create products, jobs, and health care improvements, not government. Government can only monitor. approve, or disapprove.

But innovation and entrepreneurialism have limits. Drs. Ronald Klatz and Robert Goldman, Chicago-based osteopathic physicians, who hold M.D. degrees from the Central Amrican Health Science University in Berlize, which they admit never attended, may have reached these limits.

The State of Illinois doesn’t accept their M.D. degrees as legitimate. The State has ruled they should stop using their M.D. titles in their promotions, presentations, and publications. Meanwhile, Klatz and Goldman, under auspices of the Academy of Anti-Aging Medicine, which they founded, continue to hold conventions promoting anti-aging products.

In a New York Times story, reporter Duff Wilson describes a four day December 2006 Las Vegas convention sponsored by the Academy of Anti-Aging Medicine at the Venetian dedicated to the proposition that growing old is a “treatable condition.” (“Aging: Disease or Business,” New York Times, April 15, 2007.) The convention floor was festooned with booths advertising vitamins, hormones, and pharmaceutical drugs promising to help people either to look or feel young or to stave off aging.

At the Las Vegas convention, many “wellness” workshops were held. The workshops promoted, among other things, human growth hormone (HCG) as an agent for wellness, energy, strength, and a sense of well-being in aging individuals – claims the medical establishment and scientific literature have been unable to confirm.

Lately, the $50 billion “anti-aging” industry has come under legal scrutiny. Authorities in 3 states have indicted 20 people, including 4 doctors, for Internet trafficking in human growth hormone, used for anti-aging, and anabolic steroids, employed to enhance athletic performance.

Because of these agents’ rare complications – separation of the femoral head from the shaft, joint pains, carpal tunnel syndrome, headaches from increased intracranial pressure, osteoporosis, and diabetes – federal law prohibits their use except in certain conditions. HCG may be prescribed, for example, in childhood growth disorders, AIDS, and a rare condition, adult hormone deficiency disorder.

Physicians prescribing HCG has stretched the latter to mean almost anything associated with aging side effects – weakness, reduced strength, forgetfulness, loss of muscle mass – or with diseases or accidents that might remotely effect pituitary function. Drs. Klatz and Goldman say aging is a disease causing the pituitary to produce less growth hormone. Therefore, their books, articles and speeches say hormone replacement therapy at low doses is legal and beneficial in “properly diagnosed deficient adults.” The criteria for “proper diagnosis” remain elusive.

Fifteen years ago, Drs. Klatz and Goldman founded the Academy of Anti-Aging Medicine, now claiming 20,000 members. They recently sold 80% of their convention business for $49 million to the Tarsus Group, a London media company. Klatz and Goldman know what the public craves, viz, a modern Fountain of Youth gained through drugs or other products. The market to correct for aging diseases and appearance related products will grow to $71 billion by 2009, according to BBC Research, a marketing research firm in Wellesley, Massachusetts.

In pursuing wealth, however, Klatz and Goldman may have violated a tenet of medical innovation, primum non nocere, “First, do no harm.” In so doing, they may have breached the limits of medical innovation.

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