Commentary

Patented knowledge


 

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The other day I had a chat with a chiropractor I’ll call Stan. Stan was excited about a new technique he has used to build his practice, whose clients now number several celebrities (some of whom I’d even heard of). “I specialize in muscular work and performance enhancement,” he said. “Performers with strenuous routines and a lot of stress need to sustain peak performance.”

A colleague out West whom Stan described as “very brilliant” had developed this technique. “It’s patented,” he said.

Stan went on to describe how this method has given him a whole new sense of the body. “I can actually feel the small transverse muscles of the vertebrae respond under my fingers,” he said. “The results are amazing.”

“How did you learn this technique?” I asked him.

“I took courses with the inventor,” he said. “His courses are patented, and can only be taught by accredited instructors. That ensures that the method is being done right. There are nine levels of certification.”

“Nine?”

“Yes, you have to keep taking more courses, learning new things. It’s very exciting.”

“By the way,” I asked, “how do you know that this method works better than the older ones you learned when you went to school?”

“Oh, you can feel and see the difference,” he said. “If you’re asking if there are studies or things like that, I guess there aren’t. But there’s no question that it’s better.”

“Do they teach this technique in chiropractic school?”

“No. As I said, it’s patented.”

“In that case,” I said, “it seems your professional schools are teaching inferior treatment methods.”

That gave Stan some pause. While he was thinking, I continued.

“It’s interesting,” I said. “In my profession, if someone came up with a treatment that was better than what everyone else was doing, he would need to do studies that proved he was right. He would also feel ethically bound to let everyone else know about the method, so all patients could be treated that way.”

Stan’s blank look suggested that this line of analysis had not occurred to him.

“But you must have some special techniques you use in your practice,” he said.

“No,” I said, “actually I don’t. I just practice conventional dermatology. Nothing special or unique about what I do.”

“What about the teaching hospitals in Boston,” he went on. “Don’t they do things no one else does?”

“Possibly,” I said. “But if they come up with a new technique, they have to convince others in the profession – and insurance companies – that their innovation is better in some measurable way.”

I’d gone as far as I wanted to. “It’s exciting that your patients do so well,” I said. “By the way,” I said, “what are celebrities really like up close and personal?”

“Most of them are very nice people,” he said. “They work hard to be good at what they do.”

“Do they ever complain that your treatment didn’t work, didn’t give their performance the boost they were expecting?”

“No,” he said. “Not one. They’re all happy.”

“That is really amazing,” I said. Stan nodded in agreement, though I don’t think he knew what I found so remarkable about it.

Stan is no cynic. He truly believes that what he does is valid, and that it helps his patients more than other treatments do. His patients believe it too.

Nor is our own profession as selfless and sharing as I made it sound. Hospitals love to trumpet their cyberknife technology or state-of-the-art orthopedic techniques or comprehensive cancer care, implying that they do whatever they do better than anyone else can.

Patients love to read this. They want to believe they’re seeing the “top” doctor, the one with the best results. Boston magazine (and the equivalent in every other city) publishes a list of “Top Doctors” this time of year.

Patients sometimes say, “I came to you because you did such a great job clearing up my sister’s acne,” or “You cleared my older son’s wart when nobody else could – one freeze, and it was gone. You’re a miracle worker!”

Oh sure I am. Nobody sprays liquid nitrogen the way I do.

I didn’t patent it, though. Teddy Roosevelt banned patent medicines in this country in 1906. But I guess in some quarters, patented never has gone away.

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years.

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