Anybody have experience with Dr. Filler?

[Stephen]

I went to see Dr. Filler in July due to pain in my coccyx and sacrum area, so my problem is different from yours. He sent me for MRN (neurography) from which he ascertained there was pathology at my pudendal nerve, near the coccyx. Then I went in twice (in August and September) for nerve blocks using his MRI-guided method; but he was unable to achieve the blocks on both occasions. The reason for that is still unclear.

I have always found him to be a pleasant man who has attended carefully to my questions. My only complaint would be that on two occasions, following the nerve block procedures, he failed to keep scheduled telephone appointments with me. I understand a neurosurgeon gets very busy and unavoidable circumstances arise; but I thought it would have been appropriate for him to notify his office staff of telephone appointments he had missed so someone could at least call me to explain and reschedule. As it is, I called and rescheduled and he finally got to me the third time.

Overall, my experience with him has been favorable. I hope he can find a solution to your problem.

[nopain]

Interesting that I logged on today to see if there were any posts on Neurgraphy.

To differientiate between sciatica and piriformis it seems a God send.

It bothers me immensly that the patent prevents distribution. You would think the alogrithums could be used across the nation and across the world. Why not distribute them at a reasonable cost. Limiting a potential treatment to 3 scanning centers seems selfish. I hope someone can set me straight on why these are not available at other centers.

Sure I know all about the need for Doctors to be trained to read and interpret these scans, but they are trained and read other types of scans... so it is certainly not out of the question.

I hope this doesn't come down to just money.

I called the center and the woman on the telephone was less than friendly to me. Perhaps I got her on a bad day. I was quoted $1,800 per scan plus the visit with the Doc at $500 to $700. So it's not an inexpensive proposition.

I have paid anywhere from $450 to $1,100 for traditional Cervical Spine Scans.

It only makes sense that pathology suspected in the nerves and not visible on regular MRI scans would be steered towards a technique which could show the nerves more clearly.

Very frustrating to know about a technology and not have it reasonably available. It's like the battle with the FDA to get ADR's approved in the USA, while we already know they work in Germany. Sure you need to be a candidate, but why limit ones options... especially an individual who is suffering.

Reminds me of the Old "Cheeseburger Pepsi" skit with Dan Aykroid from Saturday Night Live. No matter what you ordered you got a Cheeseburger and a Pepsi.

I have no doubts in the competency or genuine desire to see patients improve that I have read in whatever I could find about Dr. Filler. I'm sure as a Doctor he is excellent. I was impressed that he does procedures while using MRI as the imaging tool - avoiding the use of radiation (I suppose there is not magnetic material in the instruments?).

If I were you I would definiately keep the appointment. And please post your experiences. Getting in to see world class physicians can be tough. If you know in fact you do need surgery... I can also recommend you take the time to send your Films to Dr. Stanton Schiffer in Freemont California. He is a very genuine and caring person. Mark has first hand experience with him as well.

Again please post your results and experiences. I am trying to save the money to get the 2 scans I need. And after 4 traditional MRI's I am certainly ready for someone to take a closer look at the nerves themselves.

[mmglobal]

I asked at Neurography Institute about the patent limiting access to such important technology. This is not a direct quote... I'm paraphrasing some of the reply...

The MRN is patented to protect the quality of the scans delivered. There are many radiological facilities claiming to produce nerve imaging. The problem is there are no nerves appreciated on them past the nerve roots (that have been seen so far). The quality of some studies would be very low, and of no use, if we “opened the gates” and let everyone use the MRN protocols. Some sites have been shut down because the technologists failed time after time to run correct MRN protocols. We simply must maintain the quality.

Based on what I've seen, $1800 for this scan does not seem unreasonable. While cash pay patients can get traditional MRI's for under $1000, I've heard of several patients who were expected to pay 'billed amounts' in excess of $2000 when their insurance companies denied coverage. (This happened to me personally, but I never had to pay, because the insurance company finally came through.

Mark

[fortitudine]

I cancelled our MRN appointment with Dr. Filler after I received some wise words from someone who is way further along the brachial plexus thing than we are. At the time I asked the question that started this thread, we were unable to get an MRI here and the MRN looked like a good bet. But we ended up getting the MRI here, and I had meanwhile learned that MRI's are not the answer, nor are MRN's - things can be missed on both. (Not to mention out of pocket costs of $4000+) And as someone else said, (was it you, Mark M.?) if you are looking for anomalies on nerves, you'll always find them. That said, my contact has seen Dr. Filler for BP issues and is reasonably impressed with him.

As to why the technology is so limited in its availability, it is not so much an issue of copyright or even competence, as it is one of proof of efficacy. There are some published articles on MRN, but insufficient conclusive data yet to satisfy others that the extra training and software is worth the cost. For example, my contact was pleased that the MRN showed nerve avulsions that the MRI had not, but when the surgeon opened him up, he found another avulsion that read as normal on the MRN.

[tisury]

I called the MRN center also, and as No Pain said, the woman was definetely less than friendly. I can't help but think that maybe this test could help with my "disgnosing dilemna". Maybe not though. I was told $3000 for the lower spine. She said it was a flat fee .......regardless. The cost is a little overwhelming since I am still making payments on other procedures that I had to pay out out of pocket for, and deciding whether to go to Germany. It is considered experimental by my insurance.

[nopain]

As to why the technology is so limited in its availability, it is not so much an issue of copyright or even competence, as it is one of proof of efficacy.

Not trying to offend you here but the bottom line is when you have one guy who controls the technology via patent you are not going to see many studies.

And for them to even imply that other facilities are not capable of properly running the Alog's is rediculous.

They may own the patents to the scans but the MRI machines are nothing special.

They can say whatever they want but it is ALWAYS About the money. And while $1,800 may or may not be "Reasonable" it still does one no good if they can't get to LA.

So is this technology going to help people. Perhaps a select few.

It's a sad world when treatment options are withheld in the name of profit. This is my opinon... you are of course free to differ. You are also free to speculate on the value of the outcome. But seeing nerves that are otherwise not viewable via traditional MRI certainly has it's merits... too bad it won't be widespread or tested until the patent runs it's course.

[DROGERS10@san.rr.com]

If I can save one patient from going to this physician, this posting will have been worth it.

The first flashing red light I ignored was that Dr. Filler’s office did not take any insurance, and was a cash only, pay up front operation. My initial office visit was $500 cash. He was extremely tardy for the appointment. With virtually no conversation, he looked over my chart and concluded, big surprise, that I needed an MRN on my butt/pelvis. Dr. Filler’s big contribution to the world is piriformis forma syndrome which is where the sciatic nerve becomes intertwined in the piriformis forma (deep butt) muscle. Problem is that I had had seven previous lumbar surgeries and lumbar pain, not piriformis forma pain. I wrote Dr. Filler a letter and suggested that a lumbar MRN might also be appropriate. He agreed and added a lumbar MRN to my prescription. Why wouldn’t he, now instead of my MRN costing $1800, it cost $3600 because it included two areas. Surprise, surprise, after reading the MRNs (Dr. Filler’s cut is about $1300 to read each MRN–way beyond normal and customary charges), he said I had several pinched nerves in my lumbar spine, but no problems with my piriformis forma area. So, his initial reaction to see every patient as a piriformis forma patient was dead wrong in my case. By the way, the MRNs had to be paid in cash.

After scheduling an MRN at a facility near my home in San Diego, they called me back and told me that they could no longer accept me. When I pressed them as to why, they told me that Dr. Filler’s office had not paid their bills, and they were no longer doing business with him. I should have stopped after this flashing red light, but I stupidly pressed on. I had my wife drive me to Los Angeles (120) miles) to get my MRN.

Dr. Filler suggested that I needed a transforamenal nerve block at L-4. Later I found out that I had no L-4 nerve symptoms, but it was too late. Dr. Filler makes a lot of money on nerve blocks–one of his gravy trains. I had had many epidurals over the years, but this one was far different. I left in a wheelchair unable to walk.

I spent the next three months writhing in excruciating pain in my bed at home. I was in and out of the emergency room. It has been over two years since my nerve block. My life, and my family’s life, is far different from when I walked into to see Dr. Filler.

Dr. Filler did order some tests to see what had happened, but those tests were always in Los Angeles, not San Diego. Here is the lesson: If you go to an out-of-town doctor, what happens if things don’t go smoothly? The answer is, you are in big trouble because that doctor cannot make things happen outside his immediate area. In my case, I laid on an air mattress in the back of my wife’s SUV to make my LA appointments. If we would have lived further away, I wouldn’t have been able to keep these appointments. Let me tell you from experience, your local doctors are going to be very reluctant to clean up an out-of-town doctor’s mess.

When the months ran by and my problems didn’t clear up, Dr. Filler employed a new strategy. He suggested that I needed psychiatric treatment, and wrote a letter and a prescription for such. His letter was like something from the Twilight Zone. It was completely fabricated. He claimed in his letter that I called his office and said there was “blood running down my leg from my abdomen...” This is ridiculous, and simply fabricated by Dr. Filler.

I have learned that whenever someone says something stupid, such as “you need a psychiatric evaluation,” ask them to put it in writing. In my entire life this was the first time someone ever said something so stupid and then proceeded to put it in writing! I have never had any psychiatric problems or visits. I’ve been happily married for 26 years. I don’t even have speeding tickets. Yet, Dr. Filler, without asking any psychiatric questions, having spoken to me for perhaps a total of ten minutes, could ascertain that I needed psychiatric help. Clearly, the fabricated letter he wrote indicated it was him who needed some help. Later he wrote me a certified letter that he didn’t want me to contact his office any more. In other words–GET LOST PROBLEM PATIENT!

So, that’s Dr. Filler’s idea of medical care: Charge sky high prices, demand cash, then call the patient crazy and abandon them if things go bad. The worst of the worst in terms of physicians. Later I found out that Dr. Filler had quite a history for being sued, but his record is clean according to the California Medical Board. Here is a partial list from a search of the Santa Monica court house near his office. If you do settle a malpractice case, you can offer the defendant a settlement an get them to sign a “you did nothing wrong” letter. Later, you take that letter back to court and get your malpractice charges dropped even though you paid off the defendant–slick eh. Unless, of course, you happen to be a patient who is relying on the medical board information to reflect the physician’s actual record. I’m not saying that happened here, but it does happen. (http://www.lasuperiorcourt.org/Onlin...ages/index.asp) You can get details of these cases (and more) by going to this site and using your credit card. This is public information. Now imagine how many more cases went to arbitration. Imagine how many more cases are located at other court houses (this list is two years dated).

Malpractice 8/12/2003
Malpractice 5/16/2005
Malpractice 4/3/1998
Malpractice 3/10/1997
Malpractice 11/14/1996
Breach Rental/Lease 10/7/2004

Again, my purpose in writing this is to attempt to save another patient from what I am going through. You would not wish this on your worst enemy. If Dr. Filler reads this, I would hope it would cause him to reflect on his practice, and change his incredibly arrogant attitude before he kills someone (assuming he hasn’t already). Dr. Filler, if you are reading this, as a scientist myself, let me point out that an egotistical, arrogant attitude greatly interferes with your ability to think clearly. You have ruined my life.

Patients: perhaps you can get an MRN at other facilities (again a dated list):

Inview Medical Imaging - Fremont, CA - (510) 490-0961
Colorado Neurological Institute - Englewood, CO - (303) 788-1740

If you do choose Dr. Filler, do not let him perform any procedures on you. Let him do his MRN then leave with your films/DVDs.

Good luck, and please use extreme caution.