Dr. Frank Lagattuta grabs an ultrasound wand and squeezes a generous dollop of surgical lubricant onto its tip. He then positions it on top of my knee.
“There’s your patella, see?” he says as he points to the computer screen and continues squishing the wand against my now-
slippery skin.
I can barely make anything concrete out amid the snowy static and squiggly lines. He makes a minor adjustment and then—there it is—a floating triangle with rounded corners.
“Oh, I see it! That’s so cool!” I exclaim gleefully, like a child watching a magic trick.
Lagattuta is showing me one of the methods he uses to treat chronic pain at his practice, LAGS Spine and Sportscare, on West Carmen Lane. The office is one of 10 locations on the Central Coast. Among its main goals is to provide less invasive treatment for chronic pain at a lower cost.
“Of course, you can’t use [the ultrasound] on the spine, but it’s great for finding injection sites in joints,” Lagattuta says. “It’s also good for diagnosing and treating hamstring tears and torn rotator cuffs.”
And unlike X-rays, he adds, an ultrasound “only costs about $100, and you can do 90 percent of the things you can do with an X-ray.”
“The goal is to work smarter, not harder and more expensive,” the physiatrist says.
The cost of care
Lagattuta’s practice caters primarily to low-income patients on MediCal, providing them with holistic pain treatment and pain management. Methods of treatment include the ultrasound-
guided medication injections, epidurals, and sympathetic nervous blocks, as well as moderate prescription drug use, cognitive behavioral therapy, and exercise.
The goal is to limit patients’ reliance on prescription medication, costly surgeries, and emergency room visits.
As most people know from personal experience, the cost of health care has increased astronomically over the last dozen years or so.
“Costs are up—I think something like 12 percent—and they’re just going to get higher,”
Lagattuta told the Sun later in an interview. “Most doctors now are seen at the very end of the road.”
A lot of doctors, he said, have started selling their own pain, anti-inflammatory, and other medications, bringing in more than $100,000 a month.
“It’s a money grab,” he said bluntly. “Those doctors are looking at every dime they can make. I’m the opposite. I know [the system] is going broke. … We need to be the Walmart of medicine rather than the Macy’s, because we need to treat everybody.”
Like many other doctors—and their patients—Lagattuta is clearly frustrated with the current state of the country’s health-care system. It’s worth mentioning, however, that Lagattuta’s background is unlike that of many other doctors.
The Chicago native received his bachelor’s degree and doctorate from Loyola University. He went on to do his residency at Ohio State University. Over the years, he’s done plenty of volunteer work, held numerous high-profile positions, and received his share of prestigious awards. And in the mid-1990s, Lagatutta served as chief consultant to the six-time world champions Chicago Bulls.
Lagattuta is straightforward about his success: “I could easily set up a small practice and do hardly any work at all. But I want to help people.”
The lack of high-quality, affordable health care out there has him worried, as does the increasing prevalence of prescription drug use and addiction throughout the county and nation.
“People on MediCal usually have serious health problems,” he explained. “And, typically, they’re on tremendously high doses of narcotics.
“Pain patients want opiates for their pain and anxiety,” he continued. “All they want to talk about is their pain, but the real problem is their diabetes and other chronic diseases.
“The body is very similar to a car: It breaks down. It has to be kept up,” he said.
Medication, he explained, is a cheap way to mask problems. And soon enough, users are addicted.
Lagatutta estimated his practice treats about 2,000 to 3,000 people each month at its 10 locations. LAGS Spine and Sportscare physicians see patients twice a week at Community Healthcare Centers in Santa Maria and SLO, and once a week at American Indian Health Services in Santa Barbara. There are also private offices in Oxnard, Santa Barbara, Lompoc, Santa Maria, Arroyo Grande, SLO, and Templeton.
The practice has an agreement with CenCal (formerly the Santa Barbara Regional Health Authority) to provide treatment and other services at a capped rate of $200 per person.
“We take the burden off other doctors by handling the pain patients,” Lagattuta said.
Mireya Almeida, LAGS Spine and Sportscare’s office manager, said each patient agrees to a pain treatment contract that includes the judicious use of pain medication, as well as random urine tests, medication timeouts and holds, and an interdisciplinary pain program. The pain program includes 12 weeks of cognitive behavioral training and exercise, such as stretching, muscle strengthening, and aerobic activities.
“We help them so they won’t go to the ER or do the doctor shopping [for more medication],” Almeida said.
Lagattuta said most pain flare-ups occur when the patient is stressed: “Their mom is dying or they don’t have money for rent.
“We’re teaching people to cope with their pain. We can’t completely cure it, but we can teach them to deal with it,” he said. “The program is a bridge to take people to the next active level, depending on their lifestyles.”
Contact Managing Editor Amy Asman at aasman@santamariasun.com.
This article appears in Jun 9-16, 2011.
