

The Prescription Opiate Conundrum
Within any health care system the are many complex relationships between the parties based on economics and the provision of what is clinically deemed to be appropriate care. The current so called ‘epidemic’ in the US relating to the abuse of narcotic painkilling medications and their inevitable social spillover into the street use of heroin is, if the numbers quoted by certain governmental agencies and media outlets, are alarming. This increased shock value in 2014 is exacer


The global implications for minimally invasive spine surgery
The evolution of minimally invasive spine surgery since the early 1990s has seen some of the most profound changes in the way healthcare is delivered to patients with debilitating and deformed spines. The rapid advances in technology and understanding of the bio-mechanical processes that form the foundation for the multiple pain and disability syndromes associated with back pain have fast forwarded the specialty in to the modern era. Long gone are the days when overly aggress


The Future of Spinal Medicine
The trajectory of medicine over the last 30 years gives some indication as to where the speciality medicine will be in the next 30 years. The change will be exponential and will focus on an increasingly less invasive model that will ultimately not involve any invasion of the bodily compartments. The other area of spinal medicine that will see a marked development of technology will involve the development of increasingly sophisticated diagnostic tools that will both be able t


Fluroscopic guidance and interpretation-FGI
The use of x radiation to visualize the bony anatomy of the human body commenced about 100 years ago with cumbersome machines that produced grainy images a far cry from the high definition pictures generated today by advanced mobile radiological units such as fluoroscopic C-arms. The evolution of imaging modalities has played a defining role in the progress of spine surgery and particularly the minimally invasive variety which is now routinely performed in ambulatory or outpa


The path of the innovator
THE PATH OF THE INNOVATOR Medicine is notoriously slow to react to the introduction of new technologies into the practice of clinical medicine for a wide variety of reasons that include fear of litigation, inadequate skills or knowledge of the new technology and fear of professional jealousy. These powerful forces have not however through the history of medicine prevented the inevitable progress of innovators who despite the many attacks on their professional reputations have


Spine in space
The inevitableness of planetary colonization is now rooted in the human consciousness. The ever expanding global population and finite resources on planet earth have caused an acceleration in the race for space stations, planetary exploration and a very clear sense that humans have a limited time on this planet. There are many questions as to what impact the weightless environment will have on the spine, and some answers have been derived mostly from earth based simulation la


The demise of interventional pain-The rise of minimally invasive spine surgery
The history of medicine is without question characterized by the constant of change, and none more so evidently than in the field of spine over the last two decades. Approximately twenty-five years ago physicians trained in the field of regional anesthesia started to branch out into the interventional-based management of chronic pain syndromes, moving away from traditional anesthesiologists. This innovative group of physicians saw an opportunity to expand their scope of pract


A boy with an African heart- The global impact of political corruption
1. For two years, you have been fighting the State of New Jersey and the Governor, Chris Christie. One of the things you have always maintained is that the Governor is a bully and is corrupt. What were the first signs you saw before making these allegations that have now become public knowledge? To answer the question I think it is important to provide a chronological and organisational context to my involvement with the New Jersey Medical Board and Chris Christie. The


When the media just cant get it right-A doctor, a mobile phone and a misguided journalist
Much has been written about various events in my rather short but action packed life, and quite often by journalists too busy climbing their own career path to actually concern themselves with the truth. There is one incident however that stands above all else, and which is so glaring in its factual inaccuracy that Sue Clough the journalist from the London Telegraph who wrote the article http://www.telegraph.co.uk/news/uknews/1319482/Mobile-phone-medic-blamed-for-death.html i