Physician Training Requirements

The ICMS asserts that all physicians involved in adult stem cell therapy must have a significant knowledge of the peer reviewed literature on the cell line used for treatment. This should include the possible outcomes and complications of treatment.

The peer reviewed literature as of the date of this guideline has demonstrated that many adult stem cell lines can’t be delivered with efficacy via a peripheral intravenous route due to a pulmonary first pass effect. This means that for the time being, effective stem cell therapy means delivery of cells to the intended target tissue. As a result, the physician should have the requisite training necessary to deliver the cell line to the intended target tissue. As an example, stem cells delivered via percutaneous means to the intervertebral disc should only be performed by a physician with formal training in disc access procedures and appropriate board certification (pain management, anesthesiology, interventional radiology, etc…). As another example, the delivery of stem cells to the pancreas should only be performed by a physician with formal training in interventional access to the GI system or surgical training to access the same site. This would include physicians boarded in interventional radiology, general surgery, or gastroenterology.

Complications of any procedure must be able to be reasonably managed by the physician performing the procedure. Physicians who can’t document formal training in the body system where stem cells are to be deployed should not be involved in treating that tissue. As an example, a physician without formal musculoskeletal training should not deploy cells in the musculoskeletal system just as a physician without formal cardiology training should not deploy cells into the heart or peripheral circulation.