Our Approach to Your Health Care - Thinking Inside and Outside the Box
Our EECP program is 11 years old while our MME program started up in September '04. Both consume a lot of your time and the cost of MME will likely be out-of-pocket. You probably don't understand how these treatments work; they may be entirely new to you. Your personal physician may or may not know about these techniques. Basically you will be the one deciding whether or not you wish to be treated. The rest of this website is designed to give you the information that you need to make a solid, informed decision.
But you won't just be choosing a treatment program; you'll also be choosing to be treated by me, within the framework of an Integrative Cardiology practice. My Curriculum Vitae is attached for your review; it contains the usual credentials and letters-behind-the-name of a 52 year old physician. But you are not deciding whether you wished to be treated by my credentials; you are deciding whether you wish to be treated by me - the sum of my training, 20 years of experience, and or greater importance, my approach to medicine, which may be different from what you are used to.
I have a certain philosophy that has evolved over my 21 years of clinical practice. It works for me and it works for my patients; it works a lot better than when I confined myself to invasive procedures and drug therapy alone, and it is how I wish to practice today, and tomorrow. Integrative Cardiology describes my practice - I understand and prescribe the cardiovascular drugs, do lots of heart catheterizations, and I will send patients on to angioplasty, stent placement, or bypass surgery, if I think that that is the best approach for them at that time. I also treat a lot of patients with what are described as "Alternative Medicine" techniques, all aspects of Nutritional Medicine, Chelation Therapy in all of its forms, reverse cholesterol transport with Phosphatidylcholine, and many others. After the bypass patients recover from their bypasses, and the stent patients from their stenting procedures, they are advised to follow an integrated program of pharmacologic and nutritional therapy, designed to keep their grafts and native vessels open. This is a little unusual. Other invasive cardiologists don't practice Chelation Therapy; when it comes to nutritional supplementation, some still ascribe to the "expensive urine" doctrine (as I did 15 years ago). Other chelating doctors don't do heart catheterizations and many eschew pharmacologic therapy. The worlds of "Invasive Cardiology" and "Alternative Medicine" really aren't on speaking terms, not a constructive arrangement. Well, I speak to both groups, and I work with both groups, because I am both groups. I reject the "Alternative Medicine" label. The patients who you will read about in the outcome sections of this site all had received the best drugs of standard medicine, they had been evaluated with invasive diagnostic procedures (often carried out by myself), and they had undergone revascularization procedures, often several rounds of revascularization procedures, and this alone hadn't worked. They came to me or were referred to me, and I continued, and in many cases added to, their standard medical regimen, and then I added what I had learned outside the box, at meetings given by the professional societies listed on my CV, and these patients got better. Standard medicine alone hadn't worked, non-standard medicine alone probably would not have worked, but combining these two approaches did. I reject the label "Alternative Medicine" - for if you describe what I do to be "Alternative", then you have to describe "Standard Medicine", the drugs and procedures that these patients received before they came to me, as "Ineffective Medicine". Well, standard medicine is not ineffective medicine; millions of people benefit every day from the advise of their doctors, and my own patients benefit from drugs and surgery, but when a physician, or a society of physicians, confines themselves to one particular approach, and refuses to read or even consider the science published by other groups, when they insist of practicing only in the box medicine, then they are hastening the need for their patients to require a pine box.
I am not going to practice "Standard Medicine" nor am I willing to practice only "Alternative Medicine", and if you want to confine yourself to just one of these approaches, don't come here. If you are financially strapped, and can take only the drugs on your insurer's preferred list, then I will emphasize drug therapy, but I'll also push you to follow a low-cost basic nutritional program. If drugs haven't worked for you or if you can't take them, then I'll emphasize nutritional approaches, but if I think you need a given drug, then I'll push you to take that drug. It doesn't make sense to me for you to devote 35 hours over 35 days to EECP, and then not get a good result because your BP was out of control because you just weren't willing to take a drug that would have controlled your BP, and given you a better EECP response. I also think it is insane to send you for bypass surgery or stent placement, without also advising you to take nutritional supplements that have been shown to improve short and long-term outcome following these procedures. If you do not want this kind of medicine, then you'd do best to work with another physician.
If you want this kind of medicine, then see us. We will knock ourselves out to help you and will ask you to knock yourself out, at least a little, to help yourself. If your personal physician is hostile to my approach, then you might do better to receive your cardiovascular care, EECP, or MME, somewhere else. In the HMO-style medicine that seems to be the fashion today, patients are referred to specialists like myself by their primary care physicians. If we want the referrals to keep coming, we need to please the referring doctor. If the primary doctor is not enthusiastic or supportive of the specialist's approach, then the specialist must either compromise on his recommendations, or risk alienating a referral source. Young physicians have little choice but to struggle with this dilemma, but I have enough grey in my hair that I can ignore it. Don't expect me to compromise one bit if I feel that that will compromise your outcome. Now, if you are referred to me for EECP and an important decision needs to be made or if I want to radically alter your treatment program, then I am going to discuss the situation in detail with your primary cardiologist, and will keep him/her informed of your status in writing. But if a physician with considerably less training and experience than myself, one not ultimately responsible for your outcome, tells you, for no apparent reason, to stop a treatment that has science to support it, or if they push you to do something that I feel to be dangerous, then don't expect me to back down or to trade patient outcomes for political peace. I'll do my best to work with your physician, but if he or she is hostile to my approach, please think things through before deciding to see us.
If you are worried that MME is "too new", let me try to assure you that it is not. Before bringing MME to town I picked Dr. Bonlie's brain extensively, and I sent several of my own patients out of town for MME treatment. I learned the theory and saw that it worked. The first patient treated in Toledo was a family member. Also, this medical practice has a long history of successfully evaluating and bringing on line "new therapies". I want you to have confidence in myself, my approach, and in my practice, so here I'm going to toot my own horn a little. I was the first cardiologist in Toledo to carry out doppler echo studies of the heart; I picked out the first machine at my primary hospital and taught doppler echocardiography to the techs. One year later came intraoperative echo and soon after that color doppler echo. In my second year of practice a colleague and I put the "Cardiology" into Nuclear Cardiology - before then the studies were being read exclusively by radiologists - we formed a combined panel composed of ourselves and a group of radiologists. The first Persantine Cardiolite and Dobutamine stress echo studies (chemical stress tests) carried out at my primary hospital (back then cardiologists only went to one hospital) were done by myself. Transesophageal echo (TEE) was another of my early projects, and the first mitral valve and aortic aneurysm repair procedures under transesophageal guidance were carried out in my presence, because I was the only guy in town that knew the TEE technique. The major cardiology journals now publish articles extolling the virtues of fish oil and the evils of oxidative stress, but I was lecturing to the public on these topics 10 years ago, when it was "expensive urine". We were the 30th practice to offer EECP in 1997, but two years later we were the leading contributor to the International EECP Registry Study, which tracked patient outcomes following EECP therapy. Today there are hundreds of EECP centers in the US. Somewhere in my training or in my upbringing I learned to keep an open mind and to keep looking for new ways to solve difficult problems or to help patients who previously couldn't be helped. This attitude has not enamored me with segments of the medical community, who consider anything not in practice for 10 years or handed to them by the drug rep that brought their lunch to be "Alternative", but again, this attitude sure works for me and it sure works for my patients. If you feel that this inside and outside the box attitude and this approach is right for you, then let us try to help you with MME, EECP, or one of our other techniques.
James C. Roberts MD FACC, last modified 12/1/07
AMRI of NW Ohio provides MME treatment under the guidelines of an Investigational Review Board, consistent with FDA regulations.
Please note that MME treatment is considered to be experimental by the FDA. Although many patients have improved, no guarantee of success is implied.