This week’s episode of the Pod of Inquiry features a fascinating discussion with Dr. Scott Martin, a leading interventional physiatrist from Las Vegas. Dr. Martin specializes in physical medicine and rehabilitation, with expertise in cutting-edge regenerative medicine treatments.
Regenerative medicine is an innovative field that focuses on harnessing the body’s own healing capabilities to restore function and health. During the episode, Dr. Martin explains the principles behind regenerative therapies and how they can be used to treat a wide range of conditions and injuries.
Some of the regenerative medicine approaches covered include:
- Platelet-rich plasma (PRP) therapy
- Stem cell treatments
- Prolotherapy
- Latest research and clinical trials
Dr. Martin shares insights from his clinical experience using these regenerative methods to help patients recover from debilitating issues like arthritis, tendon and ligament injuries, back and joint pain, and more.
He discusses the potential benefits of regenerative medicine, who may be a candidate, as well as safety considerations and what patients can expect from these innovative treatments.
Whether you’re looking to learn more about the fascinating world of regenerative medicine or are seeking options for an injury or chronic condition, this engaging episode with Dr. Scott Martin offers invaluable information.
Tune in to the Pod of Inquiry this week for our interview with the regenerative medicine expert from Las Vegas. Simply search “Pod of Inquiry” on your favorite podcast app.
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Show Notes from this episode
Dr. Martin is a board certified interventional non-narcotic pain doctor
He is a physician, product inventor, author, patent holder, an Executive Consultant for the BioTech Industry and Medical Expert at the ALJ for amniotic fluid and Wharton’s jelly. He has professionally consulted for varied pharma, device, and nutraceutical fortune 250 companies over the past 10 years.
Dr. Martin was the subject of recurrent litigation by some of the largest companies in the world in 2017 and 2018 for first creating a holistic alternative to narcotics and then an herbal alternative to energy drinks. In 2020, he co-founded Telehealth Clinical Evals and disrupted a 2-billion-dollar Complex Rehabilitation Technology space. Over the past 16 months he has taken 9 manuscripts through peer reviewed, medical publication in the Clinical Biologics Research space.
Dr. Martin is a partner at Liv Beautiful Here - an Elite Medical Aesthetics practice in Las Vegas and soon to be Scottsdale, Arizona, and Orlando, Florida with expertise in non-surgical hair restoration and elite level collagen resurfacing, small volume lipo-sculpting, and image optimization.
Dr. Martin is singularly devoted to the application of Allogenic and Autologous Biologics as the only sustainable solution to global healthcare.
Dr. Barrett 01:06 Introduction of Dr. Martin
Dr. Martin 02:02
No, I'm humbled. Thank you very much for the opportunity. So, by training, I'm a board-certified interventional pain doctor. And for about 10 years I practice in Southern California and I was very busy. 30% of my practice was oncology. These are these are folks in the very, very latest stages of disease. This is both adults in children. The kids were in particular hard. This terrible 30% of my practice was oncology. Like I said, 30% was narcotic addiction. I did a lot of detox. I took care of a lot of very, very sick patients on very, very high dose narcotics at the height of the narcotic epidemic, then 30% of my practice was trauma. I practiced at a level four Trauma Center in Mission Hospital.
Dr. Barrett 06:37
Let's talk about osteoarthritis.
Dr. Martin 06:47
So, it when we look at the United States, as a patient, if the United States was a patient, we have some, some growing trends. Right now, as we sit today, around 46% of the US population is diabetic or pre-diabetic, in just about the same number of folks have osteoarthritis. And we've seen this this cataclysmic change, almost where, where the standard bearers the the, what was considered the standard of care for osteoarthritis, these giants are literally getting chopped out. In and I don't mean that in a in a small way, I mean that in a big way. And what do I mean by these giants are getting chopped down? Well, forever. The Goliath of the industry was, was steroid, the 2020. And an article came out in radiology, it proved that steroids can actually accelerate degeneration of joints. But that took everybody by surprise.
Dr. Barrett 08:01
Well, what about the acceleration in the degeneration of joints.
Dr. Martin 08:08
Literally, that it wasn't helping joints, it was actually accelerating the degeneration of joints. And for years, you know, in pain medicine, you could give kind of six injections a year, then it was encouraged, you could give four cortisone injections a year. Well, if you're a pain doctor, and you're doing injections, and you're doing maybe you're four, six a year, but you're also getting steroid shots from your orthopedic surgeon, you're getting them from your primary doctor, maybe you're getting them from a podiatrist, maybe you're getting them from a rheumatologist. So, you're not getting four six cortisone shots a year and you could be getting 1520 cortisone shots a year, because there's such poor communication between providers. So, these studies were only couched on folks getting three or four injections a year. Some patients are getting 15-20 steroid injections a year. And now we know that that repeated administration of glucocorticoids and steroids to the joint actually accelerates degeneration of the cartilage very well, that was kind of giant one to fall. Not a week ago, a systemic review article was brought. And that article, brain that hyaluronic acid as zero benefit and osteoarthritis, zero benefit. So now your big two kind of treatments for osteoarthritis, your two giants in the industry hyaluronic acid, which has not been proven to be actually worse than placebo for patients. In this systemic review, they were able to prove that there were more adverse events from hilar Unlike acid injections then there were with just injections in normal saline
Dr. Martin 10:28 Discusses NSAIDs
Dr. Barrett 14:17 What about osteoarthritis and inflammation?
Dr. Martin 14:26
I mean, it's a disease. It's a systemic disease. Nobody just has osteoarthritis of the left knee. They have osteoarthritis and the left knee, the right knee, both ankles, both elbows, shoulders, cervical spine, thoracic spine, lumbar spine, sacroiliac joints, right? It's systemic, but it isn't always inflamed. Your arthritis doesn't get inflamed until you inflame it. You may have osteoarthritis in your back, arthritis or the presets arthritis of the SI joints. You may have arthritis of your knees to generate cartilage all Still fights in the knee joint itself. But until you decide to pick up pickleball at the age of 62, and you've never played before, you may not irritate that osteoarthritis. Now when it becomes inflamed there's a reason they're to use NSAIDs. There's a reason they're to use glucocorticoids or steroids. Alright, but traditionally, what do we do? In this is where the paradox really meets the road. In the field of regenerative medicine, we have had holographs at our disposal for almost 100 years. For 100 years, doctors have taken tissue from one part of the body and placed it in another part of the body. In right now we have access to multiple different dollar refs, autologous meaning PRP, bone marrow aspirate stromal vascular fat and allogeneic. In particular, you know, Wharton's jelly, which is derived from the umbilical cord in there is this tremendous consternation in the market. Now, I know why the consternation exists. Just out of curiosity, how much do you think the fair market value is for osteoarthritis of the knee in the United States annually?
Dr. Barrett 16:20
Well, if you're including total knee arthroplasty…
Dr. Martin 16:24
There no non-surgical notes to the value of non surgical management of osteoarthritis of the knee in the United States annually,
Dr. Barrett 16:33
I would think it'd be astronomically high…
Dr. Martin 16:37
A $10 billion a year market.
Dr. Barrett 16:40
And that's just nonsense.
Dr. Martin 16:43
It’s a $10 billion a year market non-surgically where it is so I have no idea, but ballpark on knee operations per year, are on the order of 1.2 to 1.4 million joint replacements annually. That doesn't include arthroscopy, that's just joint replacements, right. So, in an average cost of about 40,000, the joint replacement, you can do the math, billions of dollars in in joint replacements. So, when you have a market, that's that valuable to $10 billion dollar market, you're going to get competing interests. Right. Right in so there isn't any question that allogeneic Allah wraps. An autologous Allah grafts are better than steroids are better than the hyaluronic acid. There's no question about it, right? The issue comes when doctors try to market these in the face of FDA regulations, then this work gets this is where it gets sticky. And this is where I do most of my work, right. And this is kind of where the rubber meets the road for the entire osteoarthritis marketplace. If a doctor were to tell a patient you have osteoporosis, your bones are weak, that I need to give you a calcium, magnesium and vitamin D to supplement your balance. So you don't break though. Everyone generally understands that everyone accepts, that Right? Right. But people find it hard to accept that if I gave you growth factors, if I gave you type one, type three collagen if I gave you hyaluronic acid, if I put in your name I applied an hour graph to your knee I applied the building blocks for cartilage regeneration to your name not that the stem cells would magically heal your knee that your body has the ability to heal itself but if you don't have the right building blocks, it can't do that. Your bones have the ability to get stronger but you have to have the right building blocks the right supplements for your bones to heal the joints no different the joint is no different. A cartilage-based effect in the knee degeneration of the knee joint cartilage if you apply the right building blocks to that and you give the body tone the body will heal itself
Dr. Barrett 19:35 Articular cartilage regeneration?
Dr. Martin 19:55 Explains the process.
Dr. Barrett 23:26 What is the canvas you have to paint on?
Dr. Martin 23:37
I love it.
Dr. Barrett 23:40
It's absolutely right. How can you expect greatness if you don't have a foundation to allow for greatness?
Dr. Martin 23:48
1,000% 1,000% in so you know where I think we have gone astray in the whole arthritis conversation. Then this happened the horribly through COVID. Right. We de-emphasized exercise. We de- emphasized the appropriate unhealthy eating because you couldn't get fruits and vegetables in the grocery store. What was open fast food restaurants. McDonald's was opened over COVID Right Taco Bell was opened over COVID Right? You could go and you can get frozen pizzas. You can get fish sticks, you can get all sorts of candies and stuff like that but she couldn't get fruits couldn't get vegetables. Right? Couldn't get meat and no gym was open. And if you went outside just even take a walk you had to be six feet from somebody else and you carry you know a six-foot stick so you didn't run into somebody else. If you're out surfing in Southern California you got arrested, right for being out in the water by yourself. Right better chance of getting eaten by a shark than getting you know COVID out surfing in the middle of whatever block he's in San Diego, by yourself, then then you know getting COVID. And unfortunately, this is what this is what our society is being calm, right? We want we want our health care, like we want our food, we want to write a check for $10. And we want our big mech Extra Value Meal. If they don't fill our soda up all the way in, if they're, the fries aren't extra salty, and they didn't put enough french fries in the thing where they're spilling over. We're upset. Right? Right. The hard truths are that the giants that were going to fix osteoarthritis for us, the steroids, the NSAIDs, the hyaluronic acids, they don't work, they actually make us worse. It's the David's, it's the David's out there not the Alliance, that David's that allow you to actually heal and the David's out, there are 15 minutes of exercise twice a day. Sensible eating habits, right, maintaining a healthy weight, going to bed at a fixed time at night, getting up at a fixed time every morning, right, fueling your body. taking supplements as you get older, adding essential amino acids to your diet, if you're going to exercise and you're over the age of 50, adding protein to your diet, more protein, if you're over the age of 50. If you have injured yourself, as opposed to, you know wishing on a golden star, you know, wishing on a magic shot, or believing a doctor is going to charge you $30,000 In some back alley in Costa Rica. Why don't use what's been used for 100 years, and go see an expert in the field of regenerative medicine who will actually tell you the truth, right, that your body has the ability to heal itself, but your body has to be healthy, number one and number two, we have to put in the appropriate building blocks to get that done.
Dr. Barrett 27:05
Well, there's some problems inherent in that, and I agree with you 100%. You know, you talk about all of these, what I call the four pillars of health, good nutrition, exercise, good sleep, and then some component of spirituality or whatever you want to however you want to categorize that. But interestingly enough, if a patient will buy it on those four pillars, all of a sudden that condition that you are specifically treating or on specifically treating may enhance and get get better and but then all all the time they'll say, you know, I had this other thing if it's bad, I had the psoriasis and well, all of these crazy things because you given the body and she had sticking to itself.
Dr. Martin 27:50
You know, it's interesting in all of the osteoarthritis guidelines, there's not a single element offered about an anti-inflammatory diet. Right, right. Nothing. There's nothing about an anti-inflammatory diet.
Dr. Barrett 28:10
Yeah, interestingly, I have a lot of folks that have very complex neuropathy, and the carnivore diet worked for them.
Dr. Martin 30:34
Look, I would argue that neuropathy is almost an autoimmune disease. If you had autoimmune disease, I like an autoimmune disease to to sisters, you know, skipping to church or skipping to school, they're all kind of holding hands. I had very few patients that had lupus that didn't also have inflammatory neuropathy and inflammatory bowel disease. I have very few patients that had graves that didn't also have some issue of inflammatory skin disease and some issue with inflammatory joint disease. When you are overweight, when you do have significantly elevated levels of blood glucose, you are now in an inflamed state. And in that state of inflammation, the first thing that goes is the outer third of the nerve. There are three layers around the nerve, you've got the inner layer, the endometrium, the middle layer, the perineum, and the outer layer. So, when you see folks with degenerative joint disease that is inflammatory is you know, not inflammatory depending on how they treat their body and how they, how they fuel their body and how they supplement their body. You find that same degeneration in the nerves, cartilage-based degeneration in the nerves. That's the first heralding sign of neuropathy, numbness, tingling abnormal feeling to your feet or your hands in the shower. What is hot water feels ice cold, what is cold water feels burning hot, right? Those are neuropraxic defects. All right, you were remodeling the inflammation in your body by adopting an anti-inflammatory diet by supplementing, you know, in any and all manner, growth factor complexes, these type things that doesn't just improve joints, it can improve neuropraxic deficits. You know, when I was working at this biotech, we had a group of we had a group of doctors that that were completely invested in neuropathy. And they were just very frustrated by the results. And they tried everything in so I said, Look, I want you to try and allogenic our craft, and we want you to apply it twice. But we're going to be very regimented, very scientific about this. I want you to get a nerve conduction velocity study across the perineal nerve, which is a nerve kind of in the upper leg, upper outer leg, going across the tarsal tunnel, which is a nerve region in the medial ankle. And that nerve conduction velocity looks at how fast information travels how fast information is traveling to the nerve. And they want you to do a monofilament test, meaning a test to see how sensitive their skin is. And that's all they did. They didn't change diet, they didn't change anything else. They were able to objectively measure a near 40% improvement in nerve conduction velocity in 38 of the 40 patients a lot of filament testing improved 43% in 39 of the 40 patients, and that correlated with ace symptomatic improvement in those patients of around 46% in almost 95% of the patients was a phenomenal observational study. So how
Dr. Barrett 34:38
Where is the application?
Dr. Martin 34:43
He explains the technique.
Dr. Barrett 35:15 What about subchondral administration?
Dr. Martin 35:47
Now, two weeks ago, the state of Utah approved a law that said that any doctor in the state of Utah can apply stem cell products and the use of the term stem cell products, even if they're not FDA approved, in the course of practicing medicine in the state of Utah. Where steroids are no longer gold standard, where hyaluronic acid is no longer gold standard. If anyone made the effort to look at true mortality associated with NSAIDs they would find that it that it overwhelms narcotics more than you could possibly imagine. So, what is left? What's left? In what's left is the application of Allah grafts both autologous and allogeneic. Every doctor in the United States has the ability to practice medicine in US products off label or GABA Gabapentin. Gabapentin is prescribed more than any other drug in the United States.
Dr. Barrett 37:14
FDA?
Dr. Martin 37:30
And now we know that they help with COVID. And now they're no longer contraindicated if somebody asked COVID right. My point being that Gabapentin and ivermectin were written off label almost 90% of the time. All right, that doesn't mean it didn't work. But it was off label and a doctor can practice medicine in so when we talk about applying holographs then there's some very big thought leaders out there. Some others that have echoed the same, right. They just cannot make claims when they do it. It in the field of regenerative medicine, no biologic, whether it's autologous or allogeneic can be used to diagnose, treat, prevent or cure a disease process. And this is where it gets interesting. Osteoarthritis is a systemic disease process. You need a drug to treat a systemic disease. And if I just gave you an allograft, in your left knee, would it be reasonable that all of the arthritis in the body got better? That you know, cervical stenosis from osteoarthritis suddenly got better? Because I put it in the holograph Daniella graft in the left knee, of course doesn't make sense, right? In this is where the FDA has come down on doctors for making claims that stem cells we're going to cure you right that stem cells really regenerate cartilage, right. But that does not preclude a provider any provider from applying and holography as long as they're applying the Allah graft to a cartilage-based defect and they see what they're doing.
Dr. Barrett 39:56
So, when we go back then about the place of administration.
Dr. Martin 40:03
If it is an osteochondral defect, you want to put in building blocks that are going to go through osteoblastic differentiation, you should be using B Mac, you should be using bone marrow aspirate concentrate and applying it to the bone-based defect.
Dr. Martin 42:34
My answer to that would be Yep. It can it falls completely on your level of training and expertise. If you've done 4000, intra articular applications you should do in particular, even if intrachondral, or subchondral application is better, if you haven't done it, and you have been trained to do it, you shouldn't do it.
Dr. Barrett 43:03
Sound advice, right?
Dr. Martin 43:06
Right? Absolutely.
Dr. Barrett 44:34
Dr. Martin 45:00
I think I think the young gun out of training is a specific entity, a young gun out of training with experience in DaVinci Robot for prostatectomy. All right, who went to fellowship, where DaVinci Robot was taught first? Okay, that's probably somebody you should see for a prostatectomy if you want a DaVinci Robot prostatectomy, right. You know, in endodontist, it's using, you know, robotic dental implants, right in there, right out of training. And they trained on this robot, okay, great. Probably better, you know, much faster loading time for dental implants than just open surgery, far fewer risks of infection and dry sockets and everything else, right? That's very different than somebody who goes to see a doctor, and they've had forefoot surgery and totally amputation, they're diabetic. There's potential pseudarthrosis of a forefoot fusion, right? If you're looking, you know, collapse metatarsal and potentially a tendon rupture, and it's going to be an extensive pediatric surgery, or orthopedic foot surgery, you should not be going to a bar straight out of training. Right? Because that's 100%. Yeah, they don't have the breadth of experience to know what's gonna happen.
Dr. Barrett 46:34
Are you familiar with the Dunning Kruger effect?
Dr. Martin 46:41
I am, but…
Dr. Barrett 46:42
So, the Dunning Kruger effect, I think it's very great, because on the on the x axis, it's life experience. And on the y axis, it's the level of your certainty of how something's going to go. And the highest point on the diagram occur is with the least experience, and either the most esoterically break trained individual does not have a higher healing of himself, for lack of a better way to put at time zero then windings out at 10 years or 20 years post experience or post the beginning of experience. And the psychologists refer to that initial high spot on the on the, on the extreme left side of the x axis, it's about stupid, because you don't have to, you don't have enough experience to really know what's going on, it's likely so hard or not ever sleep that airs, you know, very thin and you're, you're deluded, because you just think that everything stopped work like it's supposed to, but then that clinical experience over that over the x axis as you go out and tie all of a sudden humbles people quite a bit.
Dr. Martin 47:53
Sure, well, you don't know what you don't know. Because you haven't seen it. When I was in Michigan Hospital, I mean, I, I had a crew of guys that were all my good friends. And all my good friends were the guys who were in the hospital on a, you know, a Thursday night or a Friday night at 10-11 o'clock, you know, waiting for trauma to move through. So, we could do an elective case that was scheduled at two or three in the afternoon. Then these guys kind of were my crew, because they were my people, right? That there was so much dedication to patient care. That, you know, it didn't matter what time day or night it was, we're gonna try to get these folks better. We've lost a lot of that in medicine, we just have. I mean, I think that, you know, there have been so many great promising drugs that were going to make patients quality of lives better that turned out to be side effect nightmares. There were so many great procedures that were going to dramatically improve client's, you know, quality of life that that ended up just being boondock you know, complete mastectomy, complete mastectomy of the knee was sexy for a while, right? Every orthopedic surgeon was doing this, what didn't help the patient, the people in really helped were the people who were doing the surgery because three, six months later, they got a knee replacement. You know, and as medicine evolves, we find these things, but, you know, kind of circling all the way back to the beginning. We have a population of patients that are less patient, or less healthy patient, meaning that they're, they're less contemplative. They're they want they want to be better right now. Right? And they didn't get sick right now. They've been sick for a while. They're less healthy. They're less dedicated to their health. And, in in all fairness, things like GLP ones are not helping. Right? That The whole GLP one craze where I can take a shot, and I can still drink half a bottle or a bottle of wine every night, I can still go to McDonald's to three times a week, I can still have two Krispy Kreme donuts a day, and I'll still lose two and a half pounds a week. I don't think is a good thing. And in all the people are looking at scale. They don't realize that they're getting sarcopenia, the you know, they're getting ozempic, Thiess or the face herrings. They're losing their hair, right? They're losing their eyelashes, and their eyebrows, their skin integrity is terrible. All of these things are bad, because any shortcut to health is just that it's a shortcut. Right?
Dr. Barrett 50:42 Patients don’t want to do any work!
Dr. Martin 51:15
Well, but I mean, I think this is what's happening in medicine. And I agree with that. And I think we're moving gradually, I trained in England, my third year of clinical training was in Kingston upon teams, that one of the Royal College hospitals there in London, outside London, and they had a two-tier system. Everybody wants a national health system that, you know, they just had standard insurance, right. But almost every surgeon almost every doctor had a private day, get on that private day they saw patients’ cash will do this secondary market is is being fueled by apathetic doctors practicing apathetic medicine. It's given rise to the social media influencer, that can actually be a health coach with no formal medical training, and get patients healthier. It's given rise to two, you know, cash based and concierge clinics that are doing a great job at keeping people healthy, in in, you know, maintaining quality of lives. You know, regenerative medicine is a misnomer, you're not regenerating anything, it's really restored in that scene, you're trying to restore somebody to prior quality of life. If you have a heart attack, you didn't save somebody's life, right? You're trying to restore them to their prior quality of life before they have a heart attack. That's my personal argument. But I think this, this gives opportunity, in your practice, in my practice, right. In, in every successful doctor's practice, you find a similar paradigm that it is quality of care, that gets you busy, right. And that quality of care is predicated on the outcome. Right? If you have great outcomes, you're going to be crushed, busy, right? Somebody that has terrible outcomes that has a terrible, even if you have an awful bedside manner, if your outcomes are good, people will go to see you. And they'll know this guy has a terrible bedside manner. He's awful to talk to, well, you know what, you don't want to be great friends with your doctor. If you're seeing your doctor all the time. You're not out doing all the stuff you should be doing. Right? You don't want to see your spine surgeon all the time. If you're speaking your spine surgeon all the time, you've had a lot of surgery. Right? Right. You want to see your spine surgeon one time, and then never see him again. And maybe it'll pass them on the golf course or, you know, whatever, see what a restaurant
Dr. Barrett 53:52
So, one last question for you before we wrap up, and I really appreciate this discussion. I thought it's fantastic. But you have any knowledge of Glucopuncture?
Dr. Martin 54:44
And you're using it for Hydrodissection of the nerves?
Dr. Barrett 54:47 Explains his use of hydrodissection
Dr. Martin 55:33
It makes sense, right?
Dr. Barrett 57:40 Discusses the future of hydrodissection
Dr. Martin 59:15 Talks about studies and the FDA
Dr. Martin 1:02:40 Nerve fellowships