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Can QC Kinetix Reinvent Itself as a Legit Player Offering Orthobiologics? My Interview with Mitch Sheinkop – Regenexx

I wanted to get this one out the door before I left for my sailing sabbatical. If you read this blog, you know all about QC Kinetix, which has been bombing the national airwaves with ads for orthobiologics delivered by mid-levels in franchise clinics. Recently, I came across a press release naming Mitch Sheinkop, M.D., as the company’s CMO. Hence, I reached out to Mitch to see whether this changed any opinions I had previously held about the company.

What is QC Kinetix?

QC Kinetix is a company owned by a physician assistant that operates through a franchise model. They offer non-physician investors the opportunity to run a clinic staffed by mid-levels, often renting space part-time from another medical practice. The biggest expenditure in these clinics is advertising, which can cost tens of thousands of dollars per month. This type of broadcast radio advertising has a downside, as you attract many patients who can’t afford these therapies. This then leads to another lynchpin of the QC Kinetix business plan: the frequent use of patient financing. All of this, plus high prices for treatment, has led to a recent class action lawsuit against the company.

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Mitch Sheinkop, M.D.

Mitch is a retired orthopedic surgeon who was once part of the Regenexx network. Mitch learned about Orthobiologics from me and others in our network. Given his clinical trials experience in TKA devices, we worked with him on our RCT testing Regenexx BMC vs. exercise therapy (1). Mitch has experience using BMC, PRP, and MFat in joints.

Given that I knew Mitch and thought he had completely retired, I was surprised to see him sign on with QC Kinetix. Hence, I asked him if I could interview him for this blog. Below is what we discussed.

Can QC Kinetix Reinvent Itself?

First, I want to report that these are the notes that I took during my interview. Dr. Shienkop made it very clear multiple times that if QC Kinetix could not significantly change its clinical and business plan, he would no longer be working for them six months from now.

In general, Mitch knew little about QC Kinetix before he was hired. He didn’t understand the controversies many in the orthobiologics community have identified. He does now.

The Class Action

First, I asked Mitch about the class action. He felt this could have been one of the reasons he was hired as CMO. Again, he didn’t learn about this class action suit until after he was hired.

Handing Quality at Almost 200 Franchise Clinics without a Physician Owner

One of the things that sets QC apart is that they advertise in franchise magazines for non-physicians to purchase a franchise. To me, this creates many issues, as while the odd non-physician owner may understand what it takes to run a medical clinic, most businessmen purchasing a franchise would not. As a result, I would imagine that these franchise owners are promised a well-oiled cash-generating machine and are often at odds with what doctors need to practice high-quality healthcare.

On this topic, Mitch distinguished between the corporate-owned clinics (there are only six of them) and the franchise clinics. As of this writing, there are almost 200 clinics total, so only a tiny portion are “corporate.” He felt that the care at the six corporate locations is better because there are full-time physicians. At the franchise sites, most of the care is directed by mid-levels.

Mid-levels Performing BMAs?

I asked Mitch about mid-levels performing Bone Marrow Aspirations, as this has been a point of contention for many physicians. He agreed and said he would push for direct on-site physician supervision of all BMAs performed. However, this is one of many times he stated that if he couldn’t accomplish this, then he was out.

Professional Sales People Involved in Upselling

One area where the QC game plan deviates from the average medically run and owned orthobiologics clinic is professional salespeople who upsell. In the average medical clinic, the role of a physician is to outline the risks and benefits of various procedures and help the patient make a clinical decision. That patient may be turned over to a check-out/scheduler who might discuss cost, but this is not a professional salesperson.

The QC plan is very different. The patient is seen by the mid-level, who fills out a form, and then the patient is turned over to a professional salesperson. IMHO the goal of this employee is to get the patient to purchase as much as possible and to upsell them from less expensive care to higher proceed care. Mitch here was flabbergasted by the costs for QC procedures, especially given that the provider most often delivering the care is not a physician superspecialist but a midlevel. In addition, he mentioned that, in his opinion, this upsell is backfiring as many people walk out when they detect the hard sell and never come back. That happens up to half the time.

Distant Medical “Supervisors”

As physicians, we have seen some of our more mercenary colleagues get into the practice of renting out their medical licenses to midlevels. This is because in many states, mid-levels like physician’s assistants need to list a medical supervisor. This is because these providers were never meant to practice independently.

This phenomenon isn’t unique to QC, as many chiropractic clinics do the same. One of the unique things I documented before about QC was distant medical supervision. For example, one “Medical director” for a clinic was located a 4-hour drive from the clinic he was supervising. I asked Mitch about this; he has already placed a 2-hour maximum drive time on medical directors. While this is better, I’m personally not sure it changes the calculus of having generally unsupervised mid-levels practicing at clinics that are rarely visited by their physician supervisors. Mitch also brought up that the QC clinics have a hard time recruiting physicians, something he thinks is due to the company’s poor reputation, something he hopes to change.

Collecting Data?

Another significant criticism of QC is that the company was not collecting clinical registry data. Mitch stated that he has already changed this and implemented the use of the Data Biologics registry. He did admit that compliance with the registry thus far has been poor, but again, this is a sticking point that could see him leave QC sooner or later. He wants to see which treatments seem to be working and which are not.

Spine Training

I discussed with Mitch that I had seen several QC sites using mid-levels to offer simple spine treatments. Several also seemed to have non-spine-trained physicians performing things like epidurals. He agreed and placed a system-wide prohibition for any QC clinic performing spine procedures without an interventional spine-trained subspecialist.

Is The Owner on Board for the Drastic Changes?

How was the owner of QC Kinetix, physician assistant Tyler Vail, taking Mitch’s new game plan? I was shocked to hear that despite being with QC for 3 months, Mitch had yet to meet with Tyler. To me, this was a bad sign. For example, if Tyler were serious about changing QC, he would have personally hired Mitch and would meet with him frequently to see how they could thread the needle between what Mitch wanted and a successful business.

The upshot? I want to thank Mitch for his candor and wish him the best in turning the QC ship from a heavy profit-focused business model to a clinical one. I have serious doubts as to whether this will work, as when I heard that in three months, Mitch had yet to meet or speak with the company owner, Tyler Vail; my opinion and prediction is that Mitch won’t be at QC for very long. However, you never know; I could be wrong. Only time will tell.

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References:

(1) Centeno C, Sheinkop M, Dodson E, Stemper I, Williams C, Hyzy M, Ichim T, Freeman M. A specific protocol of autologous bone marrow concentrate and platelet products versus exercise therapy for symptomatic knee osteoarthritis: a randomized controlled trial with 2 year follow-up. J Transl Med. 2018 Dec 13;16(1):355. doi: 10.1186/s12967-018-1736-8. PMID: 30545387; PMCID: PMC6293635.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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