Avoid a disease becoming political as with COVID-19. Note, I said this is not possible. COVID-19 first was a medical disease, and within days was political. Subsequently, it became a legal disease and now one of personal liberty. Crazy what non-medical people can do to complicate something.
As a part of my interview series about the things that should be done to improve the US educational system I had the pleasure to interview Lanny L. Johnson, MD of Frankfort, MI.
Dr. Lanny Johnson’s stated goal was to have a positive impact on the practice of orthopedic surgery when he graduated from his residency at Barnes Hospital in 1964. He embarked upon a career that included a Hand Fellowship with Dr. Boyes, military service as a Captain in the Air Force, followed by his clinical practice and teaching of orthopedic medicine from 1967 until his recent retirement. Today, he still continues his research activities.
His contributions are legendary and he remains an inspiration to us all. Dr. Johnson has proven to be a dedicated and hardworking professional, a teacher, a healer, an innovator and a pioneer. He was a pioneer in the development of arthroscopic surgical procedures of the knee, shoulder, elbow, hip and has touched the lives of many orthopedic surgeons as well as athletes, in a positive manner.
He has been a guest lecturer for numerous orthopedic conferences since 1977. In addition, Dr. Johnson has published various books, chapters and papers in a variety of peer-reviewed journals. He holds membership in over 10 professional associations and has served on a number of committees for AOSSM, AAOS, and AANA.
Some of Dr. Johnson’s prestigious honors have been receiving the Jack Breslin Lifetime Achievement Award in 1993 and the Community Health Care Service Award in 1990. He has developed a reputation which spans the globe, while at the same time raised a family, supported his Christian faith and changed the lives of certainly every orthopedist and quite probably, most athletes in the country.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?
I am a medical doctor, a specialist in orthopedic surgery, best known as one of the pioneers in arthroscopic surgery. In my career I have been awarded 79 US patents related to medicine and surgery. I have always had an interest in cartilage healing and or the treatment of arthritis. As such, I saw a newspaper article reporting that the dyes of cherries would cause the pancreas cells of rodents to produce the hormone insulin. I reasoned that perhaps this dye chemically called cyanidin-3-glucoside (C-3-G) would cause other tissues to produce an insulin-like hormone IGF-1 which is known to heal cartilage. I funded research at Scripps in La Jolla, California testing this dye on human joint lining that confirmed my hypothesis. This resulted in US patents. It was learned that the active reagent was not the parent dye, C-3-G, but the primary metabolite, protocatechuic acid (PCA). This launched further investigation into the potential health and wellness applications of PCA.
Can you share the most interesting story that happened to you since you began your career?
As a young orthopedic surgeon, I was interested in sports medicine, especially surgery of the knee for injured athletes. At national continuing education courses, the experts of the day presentations always contended they were 100% correct in their physical examination diagnoses. I was not. They were not either.
I even published a paper on 5,000 consecutive cases reporting how bad I was. MRI was not yet available in those days. I then saw a small arthroscope that allowed visualization inside the knee to assist in making the correct diagnosis. I reported my first 100 such cases in 1973.
Now the interesting story. I became one of the pioneers in arthroscopic surgery. There was great resistance to this procedure. Ironically those most against it were the sports medicine surgeons of that day. Today’s sports pages tell us the outcome of that opinion. The orthopedic surgeons in my community said I was doing an immoral and unethical procedure. If so, arthroscopy is the most common immoral and unethical operation of this day.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
I do not think there are any funny mistakes. One of the real tragedies are infections related to surgery. I recall the first patient of mine having such. It occurred when I was in the Air Force Medical Corp. I still know the patient’s name. He had a fracture of both bones of the forearm requiring internal fixation with rods and plates. A post-operative infection occurred. I took full responsibility for such, even though the many factors exceed those related to the surgeon. Since that time, I have been diligent in avoiding such. My interest in prevention continues to this day and lead to the discovery of PCA’s role in prevention and treatment of surgical site infections, now including several US patents.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Judge not least you be judged in like manner also.” Without personal recognition, being judgmental of others is psychologically really projection on the other person of one’s own weakness. I have come to realize that attention to my frailties is a full-time job. I do not need to spend time looking after other’s issues.
How would you define an “excellent healthcare provider”?
An excelling healthcare provider is one who has compassion for his/her/their patient. It is person who is doing for others what they would desire for themselves. This is captured in the “Golden Rule”.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I am a born-again Christian, because I am not perfect. I regularly recognize my weaknesses and continually need forgiveness. As such, I find the Psalms and Proverbs most helpful in keeping my motives pure. Better actions follow pure motives. Medically, the Journal of Bone and Joint Surgery has the highest educational standards.
Are you working on any exciting new projects now? How do you think that will help people?
I am regularly exploring the potential wider applications of PCA in collaboration with Dr J’s Natural and Jacqueline Nguyen, a Doctor of Pharmacy. This is a joining of my research with her knowledge of formulations, thereby producing excellent compounds for health and wellness.
The most exciting is the recent discovery that PCA will inactivate the virus causing COVID19. I was granted two US patents pertaining to such this year, 2021. One is for the treatment. The other is for the mitigation or control of such on the person or their clothes and environment.
Along the way I have discovered and patented PCA as broad-spectrum antibiotic, a biofilm destroyer, a way to disinfect skin against C. acnes and published two papers on such.
Jalali, Omid; Best, Molly; Wong, Alison; Schaeffer, Brett; Bauer, Brendon; Johnson, Lanny. Reduced Bacterial Burden of the Skin Surrounding the Shoulder Joint Following Topical Protocatechuic Acid Application Results of a Pilot Study. JBJS Open Access d 2020: e19.00078. http://dx.doi.org/10.2106/JBJS.OA.19.00078.
Jalali, Omid; Best, Molly; Wong, Alison; Schaeffer, Brett; Bauer, Brendon; Johnson, Lanny. Protocatechuic Acid as a Topical Antimicrobial for Surgical Skin Antisepsis. Preclinical Investigations. JBJS Open Access: July-September 2020 — Volume 5 — Issue 3 — p e19.00079 doi: 10.2106/JBJS.OA.19.00079.
Thereby, we learned this is excellent treatment for facial acne. We learned that PCA is a fertilizer and have US patent pending upon such to increase the anti-predator benzoic acids in plants to increase their shelf life.
Besides the above, we learned by independent laboratory testing that PCA causes wound healing, promotes fracture healing and has wellness benefit to osteoporosis. All are based upon PCA having a property to cause increased expression of the local growth hormones at the cellular and tissue level.
There are applications in the food industry for reduction of contamination from manufacturing to the market. This is also protected by US patents.
Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
I purposely did not read the opinion of others you included in the correspondence. First and foremost, the system is not run by physicians who have actually practiced medicine. Practicing doctors are busy caring for patients and have allowed non-physician administrators to run the insurance and hospital industry. I published a paper in 1996 with purpose of showing benefits of a physician controlling cost of care including being granting a financial warranty.
Johnson, L. L., Becker, R. L.: An Alternative Health Care Reimbursement System-Application of Arthroscopy and Financial Warranty-Results of a Two-Year Pilot Study. Arthroscopy. 1994;10(4):462–470.
It was ignored but is now implemented and controlled by government and the insurance industry.
Healthcare in USA is a big business regulated by government. Physicians are now labor, not management. There is little opportunity for practicing physicians to give input to the system.
The FDA and EPA regulations are a huge barrier to advancement. This is most notable concerning antibiotics. There has been no new class of antibiotics in 35 years. The reason is simple, the regulation barrier is too high that no company can anticipate a return on investment. In my case, I have convincing evidence backed US patents for a broad-spectrum antibiotic that is a biofilm destroyer with potential to prevent and treat surgical infections. The mortality following a total joint infection is 25% at 5 years. This is worse than cancer of the prostate and or breast. No one but the patient cares! No orthopedic company is willing to take on the risk, due to the high bar of regulations.
I have an EPA PCA application in place now for 22 months without any action. The reagent was categorized as a biocide. It is found throughout nature, in ponds, rivers, all plants, trees, vegetables, and in the soil. It is common to the human diet. The bacteria in the human bowel manufacture small amount. The only question asked of me at 20 months was to produce my last four years of IRS tax returns. The purpose was to assume that I was an individual and not a company making such an application. I am an individual and not a company. A company has to pay the EPA a higher application fee. Hopefully, at some point they could decide that a few milligrams of PCA added to the already abundance in nature would be safe. Also note that the application took two years to complete all the preliminary work before submission.
As a “healthcare insider”, If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
First of all, none of these will happen.
- Practicing physicians to have a say and stake in the system.
- Make the salaries of hospital administrators and insurance executives similar to physicians. Presently, they make multiple millions per year, while the highest paid surgeons make on average in the hundreds of thousands.
- Have FDA rules determine and confirm safety of any new product or drug. This to be followed by the market determining effectiveness and value. At present, it is 10 years and one billion dollars for new drug and then only 15% pass. All fail in phase three when all the money has been spent.
- Avoid a disease becoming political as with COVID-19. Note, I said this is not possible. COVID-19 first was a medical disease, and within days was political. Subsequently, it became a legal disease and now one of personal liberty. Crazy what non-medical people can do to complicate something.
What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Nothing. It is too far gone. Physicians have forfeited. Big money and politics have taken over.
The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?
It is the old joke, but none the less true, maybe it would be better if the inmates are running the asylum. As I have outlined, the rule from the top is the rule of the day. Medicine is no longer a ministry, but big business. As outlined above, the physicians have forfeited and now are labor without a union. The supply chain needs correction from manufacture to the patient. Look at www.orthodirect.com what has worked for years to correct such.
The cost of delivery of product is such due to regulations and litigation. For instance, a total joint, sterile in box cost of goods is $300. The cost to the hospital has been as high as $10,000. Why so high? One factor is that the hospital is reimbursed by insurance based upon costs plus a percentage.
Another issue was the coding of COVID-19 granting the hospital $13,000 more for the diagnosis on admission and I think $27,000 more if on a ventilator. Why the surprise of so many COVID diagnoses even for gun-shot wounds.
How do you think we can address the problem of physician shortages?
I am not optimistic. The doctor is not in control. They best know how to deliver cost effective quality health care. It is not done by filling out the insurance company and government payment forms. At present, nurses spend more time filling our computer forms that attending to patients. Physician surveys regularly report they spend too much time on paperwork and not on patients.
How do you think we can address the issue of physician diversity?
This is another no-win situation. How is this done and maintain quality of candidates. It is a sociological problem, starting in the family unit. My father was a tenant farmer. He eventually had a low paying job in a factory. My parent’s goal was all focused on what could come through them, not to what had come to them. They committed themselves to my future and fortunately lived to see the product of their labors.
I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
This is outside my skill set.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
The movement was initiated centuries ago with the Judeo-Christian world view. That is what is under attack in USA today. As historically recorded, a small remnant of people will survive and make the change.
How can our readers further follow your work online?
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.