Rating Feedback for Dr. Filler (1568296)

The rating:
'Dr. Filler totally misdiagnosed me. It turns out I have a large S.I joint lesion (on the bone) not the periformis syndrome he diagnosis everyone with. Staff wanted to schedule injections ($13,000) the same day as the scan. I insisted on having the scan analyzed before proceeding further. He charged me overtime for his interpretation. He said injection is a diagnostic tool. I could expect relief for a few hours or days at best. Surgery would be required (over $55,000). All out of pocket, insurance company considers his methods experimental. Second opinions: two doctors without my solicitation warned me not allow him to do surgery on me. He has a bad reputation amongst his peers. The scan was blurry and very low res. He dodged phone calls from second doctor I asked to discuss my case with. I was rescued from a useless surgery by seeking a second opinion. It's scary he's allowed to practice. Get a second opinion before you get yourself in a financial hole with Dr. Filler.'
(http://www.ratemds.com/doctor-ratings/74517)
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This person is saying they had a physical exam and an MRI scan. Another physician has suggested the person has an SI joint syndrome. We absolutely encourage patients to get the correct treatment. We are very capable of proving who does not have piriformis syndrome.

The 2005 Journal of Neurosurgery (JNS Spine 2005 vol 2:p99-115) article reported that from a group 250 patients diagnosed as "failed back surgery syndrome" we were able to prove 17 different diagnoses that accounted for 96% of the patients. Piriformis syndrome was just one of those diagnoses. SI joint inflammation is another.

There are no "blurry" MRI scans from the Neurography Institute. This person is referring to the calibration frames from the DTI images. The nerve images are world standard. MR Neurography is very good for visualizing SI joint inflammation. If there is no inflammation in the SI joints, it is unlikely the person will improve with a sacro-iliac joint fusion. SI joint injections are a good way to test this out. Accurate and correctly done piriformis injections are difficult to do blindly. The piriformis muscle and sciatic nerve are invisible on the X-ray fluoroscopy units that work well for spine injections. Ultrasound is very very blurry and unreliable. CT scanning can work but you get the equivalent of a thousand chest X-rays to your pelvis. MRI guidance - which we use - is the only proven reliable method to do these tests accurately and reliably. The writer of the post makes it sound as if "diagnostic" is a bad thing. The only way to be sure of a successful surgery is to have an exactly correct and precise diagnosis of the cause and location of a pain problem. There are many doctors willing to do a lumbar fusion or Sacro-iliac fusion with a vague diagnosis or no reliable definite evidence of the indication. Through textbooks, continuing medical education courses, and professional meetings organized medicine works continually to improve physicians and patient understanding of the importance of accurate diagnosis. As for the suggestion that an unknown future surgery would have a charge of $55,000 - well that sounds completely ridiculous. It is true that if I were doing a multi-level complex reoperative spinal fusion (and I have trained spinal surgeons at UCLA and Cedars Sinai since 1995) then the professional fee might get into that range. A single nerve neuroplasty - such as the sciatic nerve would be $2,500 one twentieth of the amount this poster is suggesting. In any case, most of our patients get very good reimbursement from their insurance companies for surgical professional fees and for hospital fees. Overall these cases are far less expensive for the insurance company than numerous failed spine surgeries and endless pain management - if the diagnosis is correct. Many patients think that if a spinal fusion is "free" then they should go ahead and do it. Having the wrong surgery for the wrong diagnosis can be a life sentence of misery. This posters advice to skip the diagnosis is not very good advice.

Overall, it is unlikely that this post is honest. It most likley comes from a competing physician. When courts have issued subpoenas, more that 25% of the anonymous negative posts on this website have proven to be from competing physicians and not from actual patients.

There is more accurate information on our procedures and success rates at our website www.nervemed.com

As for being allowed to practice - I have served as a co-director of the comprehensive spine program at UCLA, a director of the Institute for Spinal Disorders at Cedars Sinai. I have the lowest rate of complication (near zero) for any neurosurgeon at Cedars Sinai. I have a PhD from Harvard in addition to my University of Chicago MD and am board certified in the US and in the UK. My book on spine surgery published by Oxford University Press - "Do You Really Need Back Surgery" is widely considered an excellent informational source. I have excellent outcomes documented in peer review journals based on formal reporting. I am an editor of our major neurosurgery textbook - Youman's Neurological Surgery. I am one of a very small number of Americans invited to become a Fellow of the Royal College of Surgeons in England based on my surgical innovations and imaging advances that are now in wide use around the world. There were more than 7,000 peer reviewed papers published in the past four years based on methods I invented. Hundreds of thousands of people have been saved from death and pain by my inventions. This is all just fact. The writer of the post thinks that this means I should not be allowed to practice medicine. He also believes his insurance company when they say the MR Neurography is experimental. Your insurance company wants to take advantage of you. Remember, they make money by finding excuses not to pay your medical bills - they are not your friend.

I do wish I had 100% total cure rate of every patient I saw, no matter how complicated the problem and no matter the number of prior failed surgeries and wrong diagnoses - and that all this was free because some benefactor wants to pay the costs of your care. If you have a difficult pain problem that many doctors are puzzled by, I do think we have the best technology in the world and the best expertise for solving the problem. The charges are all standard and much less expensive than routine spine fusion charges.

Aaron Filler, MD, PhD, FRCS