DR. MED. EDUARD CHEN

What is most important to you when interacting with your patients? 

Trust and respect. I’m aware that the moment patients walk into the office, there’s a certain power imbalance: on one side, the patient seeking help; on the other, the seemingly all-knowing and all-powerful demigod in white. This can lead to unrealistic expectations, fears, or hopes. That’s why it’s important to me to find common ground on a human level. This facilitates communication and integrates the patient into the treatment plan by involving them in decision-making and fostering a sense of personal responsibility. As a matter of principle, I never make a decision against a patient’s will.

What do your patients appreciate most about you? 

That’s a very difficult question for me to answer, because I’m often not even aware of how I come across to other people. I can say for myself that, in general, I’m a rather impatient person and like to get things done quickly. This often shows in the fact that I speak very quickly (or so I’m told), and the people I’m talking to can’t always keep up with my train of thought.

On the other hand, I’m also an attentive listener and make a point of jotting down important information. I’m also interested in the people sitting across from me. Questions about their profession, daily life, and hobbies help me get the full picture and allow me to establish a possible connection to their current medical issue. Marketing experts would call this a holistic approach, but for me, the primary goal is to build a foundation of trust for our entire collaborative medical process.

Some patients are likely inherently distrustful or hesitant due to their profession or personality; some therefore come across as rather arrogant. I tend to view this behavior as a learned self-protection mechanism and never take it personally. In these cases, I know to respond in kind by also holding back and limiting my communication to what is absolutely necessary. If the patient becomes convinced of the value of our work, there is often a 180-degree shift in behavior, which I interpret as a sign of trust.

As for myself, I would say that I have a positive and optimistic outlook on life, as well as a strong sense of humor.

How do you achieve such a high accuracy rate in diagnosing your patients? 

First and foremost, it’s important for me to understand the patient’s presenting symptoms in order to make the correct diagnosis. Once the correct diagnosis is established, it’s no longer so difficult to initiate the appropriate treatment steps. The patient helps me in the diagnostic process by explaining their medical history and what they believe might be the possible causes. Targeted questions on my part—for example, regarding pre-existing conditions or previous surgeries—help complete the picture. In the next step, I conduct targeted physical examinations to confirm or rule out working diagnoses. Unlike what is taught in medical school or described in standard textbooks, I almost never ask patients to undress almost completely or perform a comprehensive assessment of all organ systems. In practice, this is neither feasible nor helpful for identifying the problem. When necessary, however, modern imaging techniques are also used, or supplementary questions are answered through consultation with specialists from other disciplines.

However, there are complex, interdisciplinary clinical presentations where a clear cause is not so easy to identify, and where the answers are only obtained—in a sense, in hindsight—through various treatments. Examples of this include gait disturbances, tinnitus, and dizziness. It is also possible for parallel, independent conditions to exist, which are sometimes mistakenly treated as a single problem. I learn something new from these difficult cases every time and strive to avoid repeating past mistakes in the future.

What criteria do you use to determine which treatment is the right one in each individual case?

Generally speaking, there are usually several approaches that can achieve the desired outcome. My overarching principle is that the patient should regain their original physical abilities as quickly as possible and with the least possible risk and effort; however, in times of increasingly scarce resources, costs cannot be ignored. Using tennis elbow as an example, I can illustrate just how complex the decision-making process can be: Cortisone injection—inexpensive, takes effect quickly, often does not last long, and can potentially cause long-term damage to the tendons. Shockwave therapy/acupuncture—longer treatment duration, higher costs, more lasting effects.

In some cases, I recommend surgery when conservative treatment offers no realistic prospect of success. The only exception: particularly in the case of very ill or elderly patients, surgery—except in life-threatening situations—is not feasible; in such cases, I try to achieve the best possible outcome for the patient using the resources at my disposal. If, in the end, my gut feeling is the deciding factor, I will make the decision for my patients just as I would for my own family or friends.

What role does conservative treatment play in your practice? 

Most patients prefer non-surgical treatment as their first option. Since we do not perform surgical procedures, we are often the first point of contact for establishing a diagnosis and developing a conservative treatment plan. Our range of conservative and innovative treatments exceeds what is covered by public health insurance and even many private health insurance plans. Thanks to my many years of experience in this field, I can offer non-surgical treatment options for many orthopedic conditions that are both lower-risk and more cost-effective than surgery.

You’ve worked internationally and were active in the medical technology field. How does that experience influence your practice today? 

My international training and research—particularly at Harvard Medical School in Boston, Mass. (USA)—and my work in high-tech medical devices in Toronto (CAN) have given me a very broad perspective on orthopedics. I’m familiar with many modern procedures from their very inception, and in some cases I’ve even invented and designed medical devices myself. This helps me evaluate innovations and select what truly makes sense for my patients and our practice—not what’s currently “in vogue.” In the past, however, I also offered medical technology in the practice that, in hindsight, turned into a financial fiasco due to insufficient utilization at our solo practice and resulted in losses in the six-figure range. These included a digital X-ray system and a DEXA bone density measurement system. The maintenance costs for these systems exceeded the revenue they generated, and selling them amounted to a total write-off of their high purchase prices. On the other hand, there are, of course, systems that consistently prove their worth in everyday practice, such as the Duolith shockwave system from Storz or the SpineMED decompression system, which we were the first practice in Germany to introduce in 2009.

What makes you personally feel like you've "done everything right"? 

This question can be answered very briefly and concisely.

I would consider treatment successful if, after therapy, the patient can resume their usual daily activities without pain. If a patient doesn’t return for follow-up after a treatment or series of treatments, there can be exactly two reasons. Either I did my job particularly well or particularly poorly.

In the first case, ideally, we’ll be recommended to others, and new patients will come to us (neighbors, coworkers, friends, relatives, etc.). We try to avoid the latter—as well as all negative outcomes—but it can happen, for example, that a patient visits other doctors after a single visit to our practice because their symptoms persisted. The new doctors may then have been able to identify and resolve the problem by ordering additional tests. Much later, I’m told through third parties that I failed to recognize or overlooked a problem. So you can see that, as a practitioner, it’s often difficult for me to get an overview of the success of my treatments.

Why are orthopedic conditions sometimes so difficult to treat?

Orthopedics is generally heavily influenced by biomechanics and physical forces. All parts of the musculoskeletal system must be stable and/or mobile in order to function properly. Much of this is visible, tangible, and measurable, which at first glance makes things seem simple. But for the body to perform all these functions, our nervous system must constantly and highly sensitively detect any changes. The patient immediately notices “when something is wrong” or, in extreme cases, complains of severe pain. Depending on which neurological region is affected, the dysfunction may also result in loss of strength, ringing in the ears, dizziness, or sensations of tingling or numbness. Since many organ systems in the human body are closely interconnected, it is possible that all the reported symptoms have a single underlying cause. However, it is also possible that several separate problems exist. These can both be of orthopedic origin, such as back pain accompanied by pain radiating down the leg in the case of a herniated disc. Alternatively, a herniated disc may be present, while the leg pain could stem from a vascular occlusion. Therefore, the expertise of physicians from various specialties is sometimes needed to arrive at a comprehensive diagnosis. In addition to external factors, normal degenerative aging processes are also playing an increasingly significant role as life expectancy rises. Nature may always win in the end, but we doctors can try to shift the curve slightly to the right on the timeline.

Have you also experienced setbacks in your more than 20 years of private practice?

Of course, where there is light, there is always shadow. The longer the symptoms have persisted, the more complicated the case, and the older the patient, the higher the expectations become. Instead of taking on only the simple cases, I clearly view difficult cases as a challenge. Of course, I can’t work magic, but it would also be wrong to reject gentle, conservative treatment from the outset simply because the outcome cannot be guaranteed. Since the negative consequences of surgery often far outweigh the time and financial costs of conservative treatment, there should be no hard feelings even if our treatment is unsuccessful. Living with the complications of a failed surgery, knowing it could have worked out without surgery, is unforgivable in the long run. In complicated cases, it is often the case that surgery is not an option at all. Either the patient’s overall condition does not permit elective surgery, or the underlying problem is so unclear that no surgeon is willing to take a risk in these ambiguous cases. As a result, I often become the last resort in these cases.

It goes without saying that the success rate isn’t 100%. However, I take every failure personally and analyze afterward whether I could have done something better. The best kind of failure for me—if one can even say that—is when the patient’s condition remains the same as it was before treatment, meaning our treatment did not cause it to worsen. Patients, on the other hand, focus primarily on the fact that, from their perspective, the time and—often—money they invested were wasted. Unfortunately, though, we all know that you can’t always win in life.

Why are private doctors so expensive, and why are many services also denied by some private health insurance companies?

As private practitioners, we are required to bill according to the German Scale of Medical Fees (GOÄ). However, both the scope of the service catalog and the medical fees have remained unchanged since 1996. On the other hand, patients today do not want to be treated according to the medical standards of 1996. For this reason, so-called “analog codes” were introduced to represent newer services that reflect a comparable level of effort. Over the past 30 years since the publication of the current edition of the GOÄ, the costs of real estate, energy, personnel, and—in particular—IT have multiplied. Once you realize that the physician’s fee covers these total costs—including my more than 30 years of professional experience—the cost arguments against us quickly vanish into thin air. From the perspective of private practitioners, treatment costs are not too expensive, but rather too low. Private health insurers have continuously raised their policyholders’ premium rates almost every year in recent years, yet they often strictly limit reimbursements to the 1996 GOÄ service level. Since the medical lobby has little political clout compared to the lobbyists representing the pharmaceutical and insurance industries, this comes as no surprise. Another reason for the hesitation to adjust private physicians’ fees (while adjustments to statutory health insurance (GKV) reimbursement do occur) is that, if physicians’ fees were to increase, the government would have to bear significantly higher costs through the financing of benefits provided to civil servants under the civil service allowance system. With government coffers remaining tight, no support for doctors can be expected from that quarter either.

In many cases, patients must therefore decide for themselves whether the loss of quality of life is worth the time and expense of modern therapy. On the other hand, frequent failures of our recommended treatments are also detrimental to our practice in the long term. For this reason, we have a strong vested interest in helping patients with the best possible, fastest, and most effective treatment, even if this occasionally means increased time and financial costs for the patient.

How did it come about that, in 2009, your practice became the first in Germany to introduce the SpineMED decompression treatment for disc disorders?

It was more of a coincidence than something I had planned. As is often the case, in early 2009 I received a promotional mailing from SpineMED GmbH in Munich introducing this innovative device. I had opened my private orthopedic practice in 2006, and because of its conservative approach, I also saw many patients with chronic back pain. Thanks to my training in chiropractic therapy, I can quickly and reliably resolve sporadic joint blockages in the spine—commonly known as “lumbago.” The challenge lies in structural anatomical changes, such as a herniated disc, which up until then I had only been able to treat with injections for acute pain and TCM acupuncture. My success rate with these methods was at most 50%, which was not ideal for my patients or for me.

In my view, the “SpineMED traction table” presented here also made sense as a way to release the nerves pinched between two vertebral bodies and the intervertebral disc. My own online research also revealed that the system had received strict approval from the U.S. Food and Drug Administration (FDA) in 2005. This meant that its medical efficacy and safety had been reliably tested. Furthermore, the experiences of patients treated with the SpineMED system in the U.S. and Canada were, for the most part, very positive. Numerous online patient forums provided me with a relatively easy way to learn about the treatment’s effects, side effects, and costs. Inspired by the fresh enthusiasm of having just opened my practice, I agreed to purchase the SpineMED system—financing it with the proceeds from the sale of my condominium—in the hope that the therapy would be as effective as it had been in the U.S. Fortunately, the success of the treatment justified my decision to invest at the time, and after nearly two decades of SpineMED therapy, we have helped many patients achieve lasting relief. We often combine this treatment method with injections, chiropractic therapy, and acupuncture to achieve maximum results during the 5-week treatment period.

Why did you introduce MBST magnetic field therapy in the summer of 2025, and for which conditions is this high-tech treatment method suitable?

Every week, we receive advertisements for medications, medical office equipment, and medical technology. Even patient waiting room magazines, such as Orthopress, are filled with success stories from local doctors and treatment centers and their use of the latest treatment methods. This always raises the question of whether existing treatment methods are good enough, or whether one should introduce a new procedure into the practice—with the risk of causing lasting damage not only to one’s bank account but also to one’s reputation. Because of my open-minded attitude toward technology and my curiosity, I stay informed on a regular basis and often agree to visits from sales representatives so I can learn more firsthand. I often decide against new products or procedures, especially when the benefits are not proportionate to the effort and cost involved. With so many offers coming my way, one can easily become a bit jaded. A more reliable source of information than manufacturer advertising is recommendations from fellow specialists who have personal experience with methods I’m unfamiliar with. That’s how I came to learn about MBST magnetic field therapy from my colleagues Drs. Wolf and Patzel from Gelnhausen at a local orthopedic meeting. My orthopedic colleagues from Gelnhausen had been using MBST for over 10 years and already had several systems installed. In fact, for years I had been hearing from my own patients that, following an MRI, the symptoms they had been complaining about had suddenly disappeared. My own anecdotal experience and the reports from my colleagues in Gelnhausen convinced me to purchase the MBST system for conditions for which I previously had few treatment options. This reminded me of the reasons behind my decision to purchase the SpineMED system.

Now, the areas of application for which the MBST magnetic field system was intended include osteoarthritis—particularly of the hands, knees, shoulders, and ankles—as well as injuries to ligaments, tendons, and muscles, along with bone fractures and nerve pain. After just under a year, the treatment outcomes with MBST have been exceptionally good. Fortunately, the expectations set by the manufacturer have been met almost entirely in this case as well. MBST also appears to work very well even in cases of very severe disease-related changes. We have observed these results in patients who, due to their very advanced age and for a wide variety of reasons, no longer have any alternative treatment options. In most cases, surgical solutions are not an option due to underlying medical conditions.