Doctornauts: A Rapid Way to Reduce Health Care Costs
Stephen L. DeFelice, M.D.
Health care costs are accelerating, the 75 million baby boomers are
coming, and no solution is in sight! Doctornauts could be a significant
part of the answer of this critical national dilemma. The passage of
the Doctornaut Act as proposed by FIM (visitóDoctornaut Act Proposal on
the FIM website), is a wonderful, simple and straight forward
opportunity to reduce such costs. Though the concept is not complicated,
the dynamics behind the rational of the proposal require education on a
national level. This is best achieved by holding a Congressional
A doctornaut is a physician who has the right to volunteer for
clinical research with substantially fewer restraints than non-physician
volunteers, take greater risks and wave the right to sue. Current
technology alone, not to mention future technological advances, offers a
cornucopia of potential medical remedies that may either cure or
prevent disease — if they can be clinically tested! And this is where
the problem is. Formidable barriers, costs and risks, continue to block
clinical studies of many potential medical breakthroughs.
And this is exactly where the value of establishing a category of
doctornauts comes in; more therapies can be clinically evaluated,
accelerating the medical discovery of low cost remedies.
Many believe that doctornauts will lead to the discovery of high
cost therapies. Not true! One reason we have high costs therapies is due
to the high cost to discover and develop them. The later is exemplified
in the sudden drop of FDA approved drugs in 2005 and the recent attempt
by FDA to lower the barriers to early clinical research by permitting
the administration of very small, non- therapeutic doses of drugs to
determine whether they are absorbed and also arrive at their proper
targets in the body. The later is indeed a step in the right direction
but falls far, far short of what is needed.
Doctornauts will lead to the rapid discovery of both high and low
cost therapies which will compete with themselves in the health care
marketplace leading to a much desired goal and a reduction of the
prevalence of disease and its destructive consequences as well as health
Let's examine a potential low-cost therapy: There are more or less
14 million diagnosed diabetics in the United States that account for
approximately 135 billion dollars of annual health care costs. One huge
problem related to the devastating complications of diabetes is due to
the blockage of very small vessels which carry oxygenated blood to body
cells, robbing the latter of much needed oxygen. There is good reason to
believe that a low-cost nutraceutical (dietary supplements) combined
with a low-cost standard pharmaceutical will make these cells function
more normally, even when they are deprived of normal amounts of oxygen.
Let's assume that this medical approach results in lower costs of
thirty per cent. The annual savings would approximately 40 billion
dollars, a substantial amount for only one disease! If this could be
repeated with the other major diseases such as cardiovascular, mental
and malignant tumors, the reduction of total health care costs would be
On the other hand, it is fair to wonder whether the opposite would
occur. Yes, the short term costs would be reduced but this may lead to a
longer life span. In this situation the basic costs of diabetic care
would not only continue but these patients would be assaulted by other
disease such as Alzheimerís nullifying the original cost reduction.
The answer to this argument is that during the initial phase of
cost reduction, cures and other low-cost therapies will be discovered
for these diseases which will undoubtedly be discovered with the help of
The truth is that we cannot precisely know what impact doctornauts
will have on health care costs for future events will color the outcome.
I am reminded of the great Pericles. When the Spartans were approaching
Athens, a walled city by the water, he summoned the cityís citizens to
the main square to announce his war strategy. All of Athenians would
remain in the barricaded, walled city until the Spartans tired and
returned back home.
One of the anxious citizens asked, "Pericles, Pericles, are you
sure your strategy will work?" Pericles paused and replied, "How the
heck do I know? What I do know is that we must do something ñ soon!"
So also, we must do something to reduce health care costs as well
as help patients-soon. And doctornauts should rate high on the list.