Full-Body Scan Pioneer Is on the Outside Looking In

Dr. Harvey Eisenberg couldn’t have scripted it better himself.

There he was on “The Oprah Show,” seated next to popular talk show host Oprah Winfrey, a 3-D image of her heart projected on a large screen behind them. As Eisenberg gave a national audience a virtual tour of her heart and other organs from a body scan--taken days earlier at his Newport Beach center--Winfrey gushed.

She called the procedure “miraculous,” a cutting-edge test that “can reveal diseases and heart problems before they can become deadly.” Hers showed plaque on a coronary artery, an early sign of heart disease. “I haven’t touched a potato chip since I saw you,” she said to roaring laughter from the audience.

It was an exultant moment for the 62-year-old Eisenberg, who more than any physician is behind the mushrooming growth of the full-body computed tomography, or CT, exam. For years he has helped refine the technology and has been extolling the virtues of the controversial test, mostly to a skeptical medical establishment. The former Harvard and UCLA professor has had run-ins with academia, and his earlier medical imaging venture failed.

But his appearance on “The Oprah Show” last fall brought vindication--not to mention an instant boost to his business. HealthView Center for Preventive Medicine’s Web site received 200,000 hits the day after Winfrey’s program aired. Actors William Shatner and Robert Wagner, among others, came calling. HealthView was doing well even before the program, but today there is a 10-month waiting list for a full-body scan, which costs $895 on average.

Eisenberg, a tall, mustachioed man with a gruff demeanor, has big expansion plans. He’s trying to open five scanning centers around the country by year’s end, hoping to replicate the success of his Newport Beach center, which employs 10 doctors and, based on an estimated patient count of 30,000, could pull in at least $27 million this year.

Eisenberg, who drives a 20-year-old Mercedes and lives in a Newport Beach home he bought 24 years ago, refuses to talk about finances. He said he’s not motivated by money, as some of his critics contend.

“I want to change the way medicine is practiced,” he said.

If that means widespread use of full-body scans, Eisenberg is much closer to his goal than he may know. Dozens of scanning centers have popped up in recent years. Some are in shopping malls; one company in the South operates mobile scanning centers.

In California, they’ve sprung up in Tarzana, Brentwood, Irvine and La Jolla. At least 100 centers nationwide offer a combination of preventive heart, lung or full-body screenings, and the number easily could double by next year, said John Donahue, president of National Imaging Associates in San Bruno, Calif., a manager of radiology services for health-care plans.

Although health insurers generally don’t cover the procedure, Donahue thinks they will if full-body scans are proved to be clinically effective and if more doctors see the value in them. Demand from consumers is growing, especially among aging baby boomers. “If you look at the way other new imaging technologies like mammography have been adopted,” Donahue said, “it would not surprise me if preventive screenings really take off.”

But as scanning centers have proliferated, so has criticism of their aggressive marketing. Not uncommon are ads such as this one in a recent magazine: “What you don’t know might be killing you.”

George Annas, professor of health law at Boston University, calls such promotions deplorable. “They’re preying on people’s anxieties,” he said.

Eisenberg, too, condemns such marketing. He said he has avoided print, radio and television ads, although he didn’t rule them out in the future. And he knows he’ll have to be careful. In 1998, California regulators ordered him to include disclaimers in his brochures stating that scans are not replacements for mammograms. Eisenberg declined to discuss that incident, saying only that he had addressed the government order immediately.

A more pressing issue for Eisenberg and other operators of full-body scans is the medical community’s opposition to preventive screenings. In January, the American College of Radiology formally came out against the tests, saying there is no scientific evidence that mass screenings help people live longer.

Then about two months ago, Dr. Thomas B. Shope of the Food and Drug Administration’s Center for Devices and Radiological Health said full-body scans might be exposing thousands of Americans to unnecessary and potentially dangerous radiation that could increase the risk of cancer. Shope’s remarks prompted a flood of calls and cancellations at scanning clinics, including HealthView.

Radiation Exposure Is Subject of Debate

Eisenberg was vacationing in Paris when the FDA official’s comments were made public. By phone, he instructed his staff to tell patients that the screenings were safe, that they exposed people to minimal amounts of radiation and that they saved lives, not endangered them. Although that allayed most of his clients’ fears--business has since returned to normal--Eisenberg is grappling with questions about the tests.

Full-body scans deliver an average of 2 to 3 rads of radiation, up to 200 times more than the typical chest X-ray, said Dr. Fred Mettler, chairman of radiology at the University of New Mexico. For every 10 rads of radiation exposure, he said, the risk of developing cancer increases by 1%. (Eisenberg recommends that people should get repeat scans every one to three years.)

“I think if patients knew that one [full-body] scan equals 20 mammograms, they might jump off the table and flee,” said Mettler, who called preventive screening for the general population “dumb.”

Nonsense, said Eisenberg. “No patient has ever been shown to develop cancer from a full-body scan,” he said, adding that HealthView’s modified machines, on average, emit about half the radiation of other scanning equipment.

Eisenberg said he and his colleagues at HealthView have performed scans on about 18,500 people. The results of those tests, including the incidence of false positives and medical problems in various groups, are expected to be published this year.

Whether publication of those results will help Eisenberg’s crusade is unclear, especially given how he has alienated some physicians with his often blunt and forceful style.

People at the Cooper Clinic in Dallas, where Eisenberg set up a scanning center in 1994, still remember how Eisenberg made waves by telling a group of cardiologists that a heart scan was indisputably better at detecting heart problems than a treadmill stress test--a widely accepted procedure that measures the heart’s functionality.

Eisenberg also has been criticized for claiming that he alone invented the full-body scanning procedure and that his equipment, which he says has been modified by a team of 65 engineers, computer scientists and physicists, is superior to his competitors’.

“He claims to have invented the world,” said Dr. Craig Bittner, a radiologist and chief executive at AmeriScan, which runs scanning centers in Scottsdale, Ariz., and San Jose.

Even so, Bittner and others credit Eisenberg with popularizing the body scan. And there’s little dispute about Eisenberg’s scientific abilities, which manifested at an early age.

He grew up with an older sister in a middle-class home in Philadelphia, but his childhood was tumultuous. When he was 8, his mother fell into a deep depression and became chronically ill, a condition later diagnosed as anorexia nervosa. To care for her, Eisenberg’s entrepreneurial father devised work near the home, doing everything from running restaurants to selling windows and siding.

Eisenberg Taught at Harvard, UCLA

The young Eisenberg apparently coped partly through his inventive adventures. “I was the guy in the street blowing up trash cans and making gun powder and everything else,” he said, noting that his mother’s poor health probably influenced his decision to go into medicine. “I wanted to fix problems like [hers].”

He graduated from the University of Pennsylvania and Jefferson Medical College in Philadelphia. “We’d spend lunchtime at the student union talking about new research in cell biology and DNA,” said Dr. Barton Blinder, a clinical professor of psychiatry at UC Irvine who attended high school and college with Eisenberg. “He was always on top of the new breakthroughs being discussed in medical journals.”

During his residency at Albert Einstein Medical Center in Philadelphia, Eisenberg said, he invented steering wires and coaxial catheter systems that are the basis for most angioplasty work. His research bent led him to academia. At 31, he became an instructor at Harvard Medical School and within three years was named associate professor.

In 1977, he took charge of the cardiac, vascular and interventional radiology department at UC Irvine. Two years later, he assumed the same position at UCLA. But that was as far as Eisenberg would go in academia. At UCLA, Eisenberg wanted to develop an electronic imaging medical center, but he left when he was not given seed money and the facility he said he was promised.

Eisenberg blamed UCLA’s change of heart on spending cuts resulting from the landmark Proposition 13 tax initiative. But he acknowledged that his independent streak didn’t help.

“I couldn’t get it done in academia,” said Eisenberg, who is married to an artist and has three adult children. . “Academics is a walled castle, where you have fiefdoms with heavy barriers between them. I wanted to control my own fate.”

In 1983, he struck out on his own, starting HealthCare Affiliates Inc., which eventually operated five medical imaging centers in Southern California and elsewhere. Although the company’s clinics were among the first in the nation to offer CT scans, his business closed in 1987 due to lack of funds.

A decade later, Eisenberg founded HealthView with major funding from two angel investors and $500,000 of his own money. Eisenberg remembered the pressures of that first winter of business in 1997. He was the sole doctor on staff. He had almost no money to promote his business, and he knew local doctors could undermine his fledgling enterprise by warning patients to stay away from the controversial procedure.

So Eisenberg took a gamble: He sent 2,000 letters to physicians offering them free scans. Thirty accepted, including Dr. Edward Zalta of Laguna Niguel. Like others, Zalta initially was skeptical. But he said the scan found blockages in his coronary arteries, prompting him to change his diet and increase his exercise. Zalta has since referred 40 people to HealthView.

“I believe Eisenberg has got the experience and software to save lives through early detection,” Zalta said.

About 400 physicians from around the country have dropped by to see or to be tested at HealthView. Not all have been happy with the results, but Eisenberg has won converts, who, along with some celebrities, have been spreading the word.

“I’m sending everybody I know,” said Shatner of “Star Trek” fame. The 70-year-old actor said he was given a clean bill of health, save for some degenerative vertebrae in his back and minute calcium deposits in his coronary arteries.

Dr. Ronald R. Blanck, a former Army surgeon general, said he is planning to help Eisenberg launch a scanning center in Texas. He first met Eisenberg seven years ago in Washington, and was later screened by him at the Cooper Clinic. As Eisenberg conducted the scan, Blanck said, he was taken by Eisenberg’s knowledge and intensity. Blanck was even more impressed when he watched Eisenberg spend 25 minutes excitedly screening a woman’s spine, showing him the view from the front, back and side--just as he did on “The Oprah Show.”

“I think it’s more than money that’s driving him,” Blanck said. “Like most innovators, Dr. Eisenberg wants to be vindicated, and, I suppose, he wants the acceptance of his technology and of his peers.”

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Inside View

In a full-body scan, a computed tomography, or CT, machine peers inside the body in search of hidden cancers, heart disease and other medical problems. The test takes 15 minutes and is noninvasive, but critics worry it needlessly exposes patients to high levels of radiation.

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Gun shoots beam of electrons, which is deflected off coil

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Beam hits tungsten ring and is reflected through patient

as X-ray.

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X-ray hits detector, which relays image to data collector

Source: HealthView Center for Preventive Medicine, Imatron Inc.

Graphic and Reporting by PAUL D. RODRIGUEZ / Los Angeles Times