Tuesday, January 16, 2007

Rife Machines, Travel Scams, Self-Referral, and Imaging Kickbacks

I just came back from a whirlwind visit to one of my relatives stricken with cancer. I am happy to report that she is doing well, with a clean PET/CT scan after 9 months of chemotherapy. Now, here's the bad news. My relative and her husband proudly announced that they had purchased a "Rife Machine," and this was the reason she had done so well. I'll let you Google the term to find out the details of this particular alternative medicine scam, but suffice it to say, it is supposed to zap the bacteria that "cause" cancer by sending a radio wave tuned to the exact "frequency" of the bacterium through the body. If you do take the time to Google, you will notice that the sites promoting this scam outnumber those exposing it by about 100 to 1. The Internet and human nature at their finest. Here is a good article debunking the outrageous claims. Check out this one as well. Anyway, in response I said, mostly under my breath, "It probably won't hurt you, and that's the best I can say for it." My relative then turned to me angrily and said, "I suppose you think it needs years of testing? You've been brainwashed by the medical establishment!" At that point, I changed the subject, knowing that I would not win this argument. I don't think I'm the one who was brainwashed at all.

There is a flaw in human nature that allows us to suspend rationality, to believe in whatever it is we want to believe at the moment. Sadly, there are people (I use the term loosely) with deficiencies of another sort that exploit the window of opportunity afforded by these lapses. This practice is not limited to health-care. My sick relative's husband, in the discomfort that followed the above exchange, went on to describe his latest money-making discovery, YTB Travel. To make a long story short, this is a multi-level marketing operation, like Amway, which sells travel-agencies. Well, to be more accurate, it sells websites that use the Travelocity engine to book travel. But the kicker is that each individual sucker, I mean client, can sell the program himself to other suckers, I mean clients, and the business they generate yields a commission for everyone in the chain above. Which means that the guys who are at the top of this pyramid scheme make big bucks, and the newly-joined make nothing. Oh, by the way, initiation into this little club is $500, and there is a $49 monthly fee. So, for $1100 the first year, you get a portal to Travelocity with your name on it. Whoopie. I went to half-a-dozen random YTB sites, and they are all absolutely identical. I even wrote to their owners, and received only one response, saying how good YTB was to him, and basically assuming that I would join up under his banner. You see, in the end, this is indeed nothing more than the same old pyramid operation with Dot.Com dressing. I'm anticipating a number of hateful emails from YTP devotees, but don't just take my word for it. Check this report from the BBB. A pyramid operation it is, folks. There's one born every minute, as old P.T. Barnum used to say.
Doctors are certainly not immune to any of these scams, and I am ashamed to say that there are real M.D.'s out there selling Rife machines, and probably owning YTB scam sites as well. Somehow, docs have become, well, indoctrinated with the idea that they know everything, that they can be experts at everything, and perhaps most unfortunately, that society owes them everything. You have read about self-referral, and that is a sad illustration of how far physicians will go to preserve the income some feel they deserve. One theory about imaging self-referral by clinicians is that since regulation and so forth have cut into their incomes, they are justified in "branching out" into other fields beyond their area of expertise to recover this income that was "theirs". One of these clinicians, Alan Boyar, M.D., admits as such in this AuntMinnie.com posting:

I was compelled to add these services because unlike radiology, office procedures are reimbursed significantly below cost and it is not possible to keep a private office open in So Cal with current rates. Before I closed, I'm in New Mexico now, I figured I really needed $85 an office visit to stay open and insurance was paying $48, EKG complete is only $28 dollars whereas my derm colleges are getting $60 to freeze a wart! My CA practice had turned into an expensive hobby and the AMA and societies didn't negotiate better rates for us.

I'm sure that's all true, and it is a very sad state of affairs indeed. Now, in Alan's case, he isn't forcing anyone to the best of my knowledge to have their hair depilated or their wart removed, or to be scanned in his Electron Beam CT emporium. But the basis of the downfall of medicine is contained in his statement. What I'm doing doesn't pay well anymore, so I'm going to start doing things beyond my scope of practice to bolster my income. I'll wager that Alan has no intention of going back and doing a Derm residency. Or a Radiology residency for that matter. He just wants the money to compensate him for his losses in primary care. Noble thought.

As noted above, docs are not immune to the cessation of rational thought when it comes to making money. I love to cite the "scanner lease" arrangements that have become so popular. These are loosely camouflaged kickback arrangements, and they are considered by most to be just at the borderline of legality. Basically, I own a scanner, and you "lease" time on it for a set fee, then turn around and bill for the scan at a higher rate than the leasing cost. Thus you make money on every scan you order. I had an internist describe this very scenario with great glee, thinking he had discovered something new and wonderful. When I told him what he was really doing, he turned white as a sheet, and asked me, "Why didn't they tell me that?" Why, indeed...

Regulators, legislators, insurers, and everyone else who is sick and tired of the financial hemorrage are all starting to wake up to what is happening, and the results are not going to be pretty. There is currently a case in Illinois where a leasing scheme is under litigation for violating the kickback statutes:

The MRIs were performed at the radiology centers, though the financial arrangement made it appear that the doctors were in charge of the equipment and billed the services as their own, the suit said. The attorney general's office alleged that the centers concocted "sham 'lease' agreements" to benefit the doctors, who then referred patients to the centers, sometimes for unnecessary tests."Illinois has a clear policy against kickbacks, and making payments to doctors for referral of patients is illegal, no matter how those payments are disguised," Atty. Gen. Lisa Madigan said in a statement. "Our investigation revealed evidence showing that this practice occurs among doctors and radiology centers in Illinois. This is an illegal practice that must stop."

I truly anticipate more and more litigation and ultimately prosecution of this sort of thing. And this will extend to self-referral as well. We put our trust in our physicians, and that should not require a suspension of rationality. But some docs stretch this trust, if not violate it completely, by ordering tests that serve little purpose beyond padding their wallets. I guess I'm from the Marcus Welby school where doctors were good people who made housecalls, didn't testify against each other, and didn't worry about fees. Sadly, ol' Doc Welby is long gone, and his sidekick (James Brolin) is married to Barbra Streisand and is deeply involved in liberal causes.

I don't know how to return us back to the day when docs could be trusted to do the right thing, and not the lucrative thing. Some on AuntMinnie have seriously proposed that the government prop up the primary care docs so they aren't tempted to dabble in imaging and hair-removal. Personally, I think the government and insurers need to examine the increased revenue produced by self-referral mills, stop the bleeding, and retroactively penalize those gluttons who ruined the system. As for faith, one of the Rife-machine articles sums it up well:

Much of the frequency medicine practised today descends from Royal Rife, who did his research in the early 1930s. Rife identified the virus that caused all cancers (!), which he named “BX”. As this was before the invention of the electron microscope, Rife invented an optical microscope with a claimed magnification of 17,000x. A perusal of the web sites of Olympus, Nikon and Zeiss shows that the best theoretical magnification claimed today is about 1,400x, although practically it is about 1,250x. (Zeiss use an appropriate slogan to promote their microscopes: “Limited only by the laws of physics”.) The secrets of Rife’s microscope are lost, presumably suppressed by orthodox optical companies, but his method of curing cancer lives on.
Rife’s 1931 demonstration of the microscope involved creating a non-filterable form of the typhoid bacillus, which appeared as small moving turquoise dots in a static background. Scientists looked through Rife’s microscope and also saw these blue dots. Some astronomers once looked through Lowell’s telescope and saw canals on Mars; some scientists once saw evidence of the refraction of N-rays in Blondlot’s laboratory; some scientists were once convinced that deuterium could fuse at room temperature within the crystal matrix of palladium. All of them were mistaken. The difference between the last three delusions and Rife is that almost nobody believes them any more. The other difference is that a belief in Mars canals or cold fusion cannot kill anyone. A belief in a false cure for cancer can.

Ordering unnecessary scans probably won't kill anyone either, although the radiation exposure could add up eventually. But American Medicine is tarnished by the practice. In the self-referral scam, docs are the culprits; in the leasing scam, docs are the victims as well. But the patients are never at the top of the pyramid, and that is where they should be, lest we forget. My relatives with the Rife machine have made me very aware that a good segment of the population doesn't trust physicians or conventional medicine. They think they are a cabal organized for their own self-preservation, and the patient be damned, that organized medicine is the pyramid operation, designed to separate them from their money. They think the doctors would let a relative die rather than lose money on a simple "cure". With the behavior I'm seeing out there, I'm not sure I can blame them for their misbelief.


aldersen said...

Its an extraordinary information about rife machine.Royal rife machine gives us the real alternatives to chemotherapy and alternatives to radiation therapy.Thanks for posting this.

Jason said...

A guy who works at a firefighter job is considering buying one of these. I just emailed this article to him. I love the point of view.