In 2009, hyperbaric oxygen therapy (HBOT) sat at the edge of medicine. That year, Amir Hadanny, then a medical student at Tel Aviv University, started working on clinical trials in the field.
That work grew into a 17-year body of research, including randomized trials in traumatic brain injury, stroke, post-concussion syndrome, fibromyalgia, PTSD and aging. Today, Dr. Hadanny is a neurosurgeon with a PhD in bioinformatics and more than 80 peer-reviewed papers to his name.
As chief medical officer of MD Hyperbaric, he’s focused on standardizing clinical protocols and bringing objective biomarkers into hyperbaric care. “Clinics vary widely in how patients are assessed, how outcomes are tracked and whether any evidence gets contributed back to the field,” he says.
Solving that problem is the focus of his work today. His career offers a look at what it takes to turn years of research into a standard clinics can share, and why he believes measurement is the key to earning patients’ trust.
Choosing the Slow Path
Hadanny’s interest started with patients who had been told they had reached their limit. “There were patients with brain injury and stroke who had been told they’d plateaued, with very little left to offer them,” he says. “The biology gave a plausible reason to think oxygen might help, and it was something we could test properly.”
The field’s early reputation shaped his approach. “A lot of what surrounded [hyperbaric oxygen therapy] was hype,” he says. “That pushed me toward doing it the slow way: controlled trials, clear outcomes and being willing to find out it didn’t work for some people.”
Seeing Brain Injury From Both Sides
His path to medicine began in the Israeli military, where he served as a fighter in a special unit. Hadanny later returned to that same unit in the reserves as its physician.
He trained in neurosurgery at Galilee Medical Center and began a PhD in bioinformatics at Bar-Ilan University partway through residency. After moving to the United States in 2021, he completed a fellowship in functional neurosurgery at Albany Medical Center and a fellowship at the brain modulation lab at Massachusetts General Hospital and Harvard.
Experience in both the operating room and neurorehabilitation shapes how he thinks about recovery. He notes, “In the OR you see injury as an event: acute, dramatic and often fixable. In rehab you see it as a long process, and you realize the event was only the beginning.”
Many patients, he says, leave the hospital “stable” but live with fatigue, memory problems and mood changes for years. “The brain keeps its capacity to change, and our job is to find what unlocks it.”
What the Research Shows
The conditions Hadanny has studied may look unrelated on the surface. But he sees common ground, stating, “Underneath, many share chronic tissue stress: impaired energy metabolism, reduced blood flow, low-grade inflammation and damaged connectivity.”
Oxygen delivered under pressure in repeated cycles appears to act on those shared mechanisms, he explains, including mitochondrial function, new blood vessel growth and neuroplasticity. Still, he’s careful about how far that goes. “A shared mechanism doesn’t mean it works equally well for everything. Each condition needs its own evidence.”
Across trials, he says, researchers have seen improvements in brain imaging alongside gains in cognition, symptoms and quality of life after a full protocol of dozens of sessions. One example is a 2022 randomized, double-blind trial Hadanny led in children with persistent post-concussion symptoms, published in Scientific Reports. “The signal is consistent enough to take seriously,” he says.
Open questions remain, however, including the ideal dose for each condition, how long benefits last and which patients respond best. “Larger, independently replicated, well-blinded trials are the priority.”
Why Limits Build Trust
Talking openly about HBOT’s limits is a priority for Hadanny. “Patients with chronic conditions are vulnerable, and hope is powerful,” he says. “If we oversell, people spend money and emotional energy on something that won’t help them, and the whole field loses credibility.”
“Saying ‘this may help some people, here’s how we’ll measure it and here’s when we’d stop’ isn’t weakness,” he adds. “It’s what makes the treatment trustworthy.”
Measurement Over Guesswork
Objective measurement can take the guesswork out of each decision, Hadanny says. “If we measure the same things the same way before treatment and again partway through, ‘should we continue?’ stops being a matter of hope or opinion.”
“Sometimes the numbers move, and we keep going,” he says. “Sometimes they don’t, and we have to be willing to say so, adjust, or stop.”
He also sees a bigger role for biomarkers in the years ahead. “Longer term, better biomarkers could help us predict who is likely to respond before they start, which would spare a lot of people time and money.”
Building a Standard That Scales
A consistent standard starts with a few basics, which, according to Hadanny, include proper medical screening, the same baseline measures for everyone, a defined protocol, reassessment partway through and at the end and clear criteria for when to stop. “Every patient gets the same process, no matter which location they walk into.”
“As a network grows, the pressure is to cut corners, so the process has to be built in,” he says. That means shared protocols, staff training, medical oversight and regular review of outcome data across sites.
Hadanny’s test for whether that standard holds up is simple. “Could another clinician look at our records and understand what we did and what happened?”
The Access Gap
Cost and reimbursement lead his list of barriers between research and everyday patients, since insurers want large, replicated trials. Hadanny also points to uneven quality across clinics and a shortage of trained clinicians and infrastructure.
Others have raised the same issue. In a recent Grit Daily interview, Dr. Kannan Rangaramanujam of Johns Hopkins noted that “identifying who will pay for the drug in the end and why is important.”
“Education matters too, because both patients and physicians need clear, honest information,” Hadanny states. “Closing the gap means generating strong evidence, standardizing care and showing real-world outcomes that payers can trust.”
Advice for Healthcare Founders
Hadanny believes founders and operators entering healthcare should earn trust before they chase scale, and let the evidence set the pace of their claims. That means measuring outcomes and publishing them, even when the results are imperfect. It also means building a team of people willing to tell them “no.”
“In healthcare, a single overpromise can undo years of credibility,” he adds. “Growth that comes from real patient results lasts longer.”
The Future of Hyperbaric Medicine
Over the next five to ten years, Hadanny hopes to see HBOT become “a precision tool: matched to the right patients, guided by biomarkers, with protocols refined by condition.” Getting there, he says, will take large randomized trials, shared data standards, regulatory clarity and collaboration between academia and clinical practice.
“If we stay rigorous, HBOT could move from the edge of medicine into a well-defined, evidence-based place within it.”
