Dr. Adam Schaffner

GLG News by Dr. Adam Schaffner, Assistant Professor of Clinical Plastic Surgery

Bold Contest for a Daunting Problem

October 27, 2008

Analysis of:WellPoint, X Prize launch $10M health care contest | news.yahoo.com

Most people agree that the healthcare system in the United States is in need of a complete overhaul.  Unfortunately, the many competing interests in the current system make such overhaul extremely challenging.  This contest certainly provides much incentive for the best and brightest to put forth their ideas on how to improve the system.  Overcoming the obstacles to implenting such ideas will potentially be the biggest challenge of all.  Therefore, I believe the answer to the question "Will it work?" will only come when the healthcare system reaches the same critical threshold that our financial markets recently met.

Evolence: Will this New "Advanced" Collagen Filler Take Hold?

July 8, 2008

Analysis of:FDA Approves EVOLENCE®, a New Generation Collagen-Based Facial Filler | www.investor.jnj.com

Evolence is an injectable filler material that is made by an "advanced collagen GLYMATRIX™ Technology."  Collagen has generally fallen out of favor amongst aesthetic physicians due to its short duration of action.  Evolence will have to demonstrate that it is superior to the plethora of other injectable filler materials currently available to gain market share.  To do so will not only require clinical efficacy, it will also require a tremendous marketing effort to penetrate a market where there is no shortage of injectable filler materials from which to choose.

Allergan and Aczone: Likely a Winning Combination

June 26, 2008

Analysis of:Allergan Aquisition of Aczone | agn360.client.shareholder.com

Allergan has a strong infrastructure to support dermatologic and aesthetic products.  Aczone, an aqueous topical gel containing 5% dapsone, will be a new product which will help treat patients with acne.  "The strength of topical dapsone gel appears to be its high efficacy against inflammatory acne lesions.  Both rapid onset of action and tolerability make this agent a potentially nice complement to traditional antimicrobial and comedolytic acne regimens." (Draelos ZD, Carter E, Maloney JM, et al, J Am Acad Dermatol. 2007;56:439.e1-e10.)  Based on the study results available, it appears Aczone will provide an additional treatment option which will benefit patients.  Given the number of patients afflicted with acne, I believe Allergan will ultimately view this as a favorable acquisition.

Obesity: Higher Healthcare Costs, Lower Productivity

June 26, 2008

Analysis of:Obesity costs employers $45 bil a year | www.nytimes.com

There is no revelation in stating that obese people move slower or have more health problems compared to skinny people.  High blood pressure and diabetes are commonly associated with obesity.  Morbidly obese people may have difficulty sitting in a single coach airplane seat, fitting through a doorway, or bending over to pick up an item.  Such obesity is associated with higher healthcare costs, more time away from work, and lower productivity when compared to people who are not obese.  In short, obese Americans need to lose weight to improve their waistline and the bottom line.

Hair Removal: An Expanding Market

June 23, 2008

Analysis of:Zapping Teenage Torment | www.nytimes.com

Hair used to be something we all accepted.  Now, unwanted hair is viewed as unacceptable.  The market for hair removal is almost endless.  Men want hair removed from the nostrils, neck, back, and chest.  Women want hair removed from the upper lip, chin, sideburns, arms, legs, and bikini area.  Treatment options are as varied as the types and colors of hair that exist.  Patients will subject themselves to many different treatments, including shaving, plucking, bleaching, waxing, threading, lasers, intense pulsed light, electrolysis, and medications.  Recently, lasers have become more popular due to their effectiveness in achieving the goal of permanent hair removal.  However, their use is not without risk.  Patients can get burned or lose skin pigment.  Therefore, such treatments should only be administered by licensed healthcare professionals with proper training and experience. 

Improving the "Tired Look" - How to Treat Dark Circles Under Eyes

June 23, 2008

Analysis of:Putting ‘You Look Tired’ to Rest | www.nytimes.com

Looking rested and refreshed is big business.  Dark circles can make one appear tired and old - even at the young age of 25.  Therefore, some people will stop at nothing to conceal these circles.  53% of 13,000 Clinique users cited dark under-eye circles and puffiness as their number one beauty concern.  Consequently, it is not surprising that sales of anti-aging skin care treatments, which includes products designed to get rid of dark circles under the eyes, increased from $588 million in 2001 to $1.08 billion in 2006.   The causes of such circles are multi-factorial, including heredity, genetics, skin pigmentation, and skin thickness.  As there is no single cause for this problem, there is no single cure.  Hence, it is not surprising that Sephora sells more than 50 products "designed to specifically treat under-eye circles."  With time, the demand and number of products to treat this problem will only continue to grow. 

Saying "I'm Sorry" Will Decrease Medical Malpractice Premiums and Increase the Quality of Care

June 23, 2008

Analysis of:Doctors Say ‘I’m Sorry’ Before ‘See You in Court’ | www.nytimes.com

For years, doctors have been taught to deny medical errors and defend themselves to the end.  Such denial is contrary to the honesty doctors and patients desire in a patient-physician relationship.  However, the risk of medical malpractice has led physicians to pursue this practice.  With medical malpractice insurance premiums escalating at an alarming rate, physicians at prominent institutions like Johns Hopkins and Stanford are trying a new, "disarming" approach:  promptly disclosing errors, then offering an earnest apology and fair compensation for such errors.  The hope is to restore integrity in the patient-physician relationship, learn from such mistakes, and decrease the likelihood of other healthcare professionals making the same mistake in the future. 

Adolescent Acne - Many Treatments, Few Cures

June 23, 2008

Analysis of:What Skin Care Routines and Treatments Are Effective for Adolescent Acne? | www.medscape.com

Adolescent acne is a challenging problem to treat.  This is a medical problem that has social and psychological consequences.  Acne can affect one's self-esteem, psychological growth, and adversely impact one's educational and career development.  Therefore, it is of paramount importance that adolescent acne be treated effectively.  Unfortunately, there is no cure - only a plethora of treatments.  Determining which one is most effective in a given patient requires patience and perseverance. 

Patients Should Only Seek Care from Licensed Healthcare Professionals

June 23, 2008

Analysis of:Renal Failure Linked to Cosmetic Soft-Tissue Filler Injections | www.medscape.com

On December 27, 2007, the North Carolina Division of Public Health (NCDPH) was notified of three cases of renal failure occurring among women who had received cosmetic soft-tissue filler injections at a facility in North Carolina.  All injections were administered by a practitioner with no medical training or supervision.  The practioner was apparently trained as a radiology technician but had no other medical training or supervision.  Investigators were not able to identify the injected substances.  Although records indicated that the injections contained liquid silicone, this substance has not previously been associated with renal failure.  These findings underscore the risks posed by cosmetic injections administered by unlicensed practitioners.  Patients should only seek care from licensed healthcare professionals.  Such publicity will hopefully result in more patients doing their due diligence rather than avoiding such injections altogether.

Doctors need financial assistance to pay for Electronic Medical Records (EMR) systems

June 23, 2008

Analysis of:Most Doctors Aren’t Using Electronic Health Records | www.nytimes.com

Electronic medical records (EMR) have been shown to enable physicians and other healthcare professionals to provide higher quality and more efficient healthcare.  The problem is getting EMR systems implemented in healthcare facilities across the country.  Given the declining reimbursements from insurance companies, most doctors cannot afford to pay for the installation and upkeep of such systems.  Without financial assistance, use of such systems will not be widespread outside of large hospitals and medical groups.

Controlled Substances: Can be a Hot Commodity in the Wrong Hands

June 18, 2008

Analysis of:An Open Letter to Our Customers | www.cardinal.com

Controlled substances are invaluable in the attempt to control pain for many patients.  Unfortunately, some criminals attempt to obtain these substances for personal gain as they are a valuable commodity on the black market.  Therefore, it is of the utmost importance that industry and the DEA work closely together to strengthen and protect the integrity of the supply chain.  Strengthening all links of the supply chain may result in a stronger economy which benefits all Americans. 

Avoiding the Appearance of Improper Conduct in Research

June 12, 2008

Analysis of:Researchers Fail to Reveal Full Drug Pay | www.nytimes.com

Private companies have vast resources to underwrite the costs associated with research activities.  It is difficult to ensure that financial assistance and fees paid to researchers do not result in undue influence that may affect the results of research.  To avoid the appearance of any bias, all financial support should be reported.  Failure to do so may result in the appearance of improper conduct, whether or not such improper conduct occurred.

Lessons Learned the Hard Way: Dangers of Using Non-Licensed Cosmetic Injectors

June 3, 2008

Analysis of:Renal Failure Linked to Cosmetic Soft-Tissue Filler Injections | www.medscape.com

Any publicized adverse events following the injection of filler materials or BOTOX Cosmetic will draw attention to risks inherent in such procedures.  This will likely have a temporary impact on the level of concern and possibly result in a transient decrease in use amongst patients.  To minimize the risk of developing complications, these injections should be performed by a well-trained, licensed medical professional who is experienced in administering such injections. 

Don't Get Sick After Hours: The Crisis to Improve Patient Care

June 3, 2008

Analysis of:Like Night and Day--Shedding Light on Off-Hours Care | content.nejm.org

On nights, weekends, and holidays, senior healthcare professionals are rarely found in the hospital.  Problems arise from (1) too few qualified personnel available to address the needs of patients, (2) inability to obtain physician coverage for some specialties, and (3) inability to obtain and/or service medical supplies/equipment.  Therefore, innovative and creative solutions need to be implemented to improve the morality, readmission, complication, and error rates.  Failure to provide such novel approaches will lead to stagnation and further decline in the quality of care which will adversely affect the bottom line and increase liability exposure of the institution and healthcare professionals.

Surgeons need to Protect Themselves and Their Patients

July 2, 2007

Analysis of:Study Finds Many Injuries to Surgeons Go Unreported | www.nytimes.com

All necessary precautions need to be taken to prevent injury or exposure to infectious fluids/materials.  It is of paramount importance that surgeons understand that failure to obtain proper diagnosis or treatment after suffering injury or infectious exposure not only places themselves at risk, it places their patients at risk as well.  Hence, despite the time and inconvenience incurred, it is vital for surgeons to report injuries/exposure to infectious materials, undergo the appropriate diagnostic tests, and, when indicated, be treated.

Unfortunate - but not shocking

June 22, 2007

Analysis of:Humana, UnitedHealth Suspend Some Health Plans After Complaints | www.bloomberg.com

The health insurance industry has, as its primary focus, making money - not taking care of patients.  Therefore, it is not suprising to learn that health insurance plans have misled individuals, most notably the elderly, into enrolling in plans which were not in their best interest.  It is likely that only minimal change will occur to address these acts which result in poor publicity for the insurance companies and attract the attention of government officials. 

Laser liposuction - not worth the risk...just yet

June 4, 2007

Analysis of:Cosmetic surgeons aim lasers to melt away fat | www.app.com

Laser liposuction is a new technology which has not, in my opinion, yet been proven to be superior to conventional liposuction.  The potential benefit of less bruising and swelling following "laser liposuction" is outweighed, in my opinion, by the risk of the patient incurring burns from the laser.  I am aware of cases in which patients of board certified plastic surgeons have suffered burns following the use of "laser liposuction."

Men Mandate Maintenance and Makeovers to Maintain Marketability

June 4, 2007

Analysis of:Men Fill Face, Modify Midsection with Cosmetic Plastic Surgery | www.plasticsurgery.org

Men are frequently taking advantage of advances in facial rejuvenation.  They desire to maintain a youth appearance to outwardly reflect an energy and cutting edge image that is vital to maintaining one's marketablility in a competitive workforce.  They frequently enjoy the benefits of BOTOX and injectable filler materials.  Some are also having aesthetic plastic surgery performed to reverse some of the signs of aging.

Non-Surgical Nosejob is not a Nosejob and not Risk-free

June 4, 2007

Analysis of:Nonsurgical wrinkle filler wins by a nose | www.shreveporttimes.com

Rarely, if ever, will a non-surgical modality be able to deliver the same results as a surgical procedure.  The use of an injectable filler material (e.g., Radiesse), is no different.  Without question, its use is not "risk free."

Patients Want Maximum Results with Minimum Downtime

June 4, 2007

Analysis of:New Survey Reveals Dramatic Rise in Non-Invasive Procedures in Facial Plastic Surgery | www.surgicenteronline.com

Patients want to minimize signs of aging, look natural, and minimize downtime while maximizing results.  Therefore, people are often choosing to have treatments such as BOTOX, injectable fillers, and mild skin resurfacing which require little downtime.

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