Click to play: YouTube and similar sites have more doctors getting ready for their close-ups

Loring Jacobs. MD , an internist from Las Vegas, wanted to find a more personal way to tell patients their routine test results, otherwise relayed through a phone call, an automated system or a nurse.

So Dr. Jacobs began making video e-mails, giving patients the results himself, and explaining them in more detail. If the news is bad, Dr. Jacobs sends a video requesting that the patient make an appointment.

Dr. Jacobs has been sending video e-mails for about seven months. He said he does it because his patients like it, not only because they can see him talk about their test results, but also because they like how tech-savvy the video e-mail makes him appear.

"They say, 'Thanks,' and then, 'How did you do that?' " Dr. Jacobs said.

That "how" question is one a small but growing number of physicians are trying to figure out, as they incorporate the use of Internet video into their practices.

Doctors are creating video blogs, or posting video of lectures or procedures, or as Dr. Jacobs is doing, adding video to e-mail. Some are posting video to their own Web sites, to YouTube or to doctor- or health-specific sites.

Creating Web video doesn't have to be expensive. Dr. Jacobs pays $9 per month for his video e-mail system and made a one-time purchase of a webcam, which can sit atop or near the computer and feed video straight into it. A webcam can cost as little as $25.

Nina Sossamon-Pogue, with BenefitFocus, a Charleston, S.C.-based health IT company that recently launched the open-source video site icyou.com, said video is a way to make things easier for patients to understand what the physician wants to convey.

[...] Copyright 2008 American Medical Association. All rights reserved.
RELATED CONTENT  You may also be interested in reading:
Capitalizing on a craze: Medicine on an MP3  June 4, 2007
Massachusetts considers requiring all surgeries to be videotaped  April 23/30, 2007
Podcasting primer: All you need is the Internet  May 8, 2006

Former United CEO settles in case charging stock backdating

UnitedHealth Group's former CEO and board chair has settled with the company and the Securities and Exchange Commission over allegations that he benefited from an illegal scheme to maximize what he earned in stock options. But legal troubles remain for both William McGuire, MD, and United.

On Dec. 5, 2007, Dr. McGuire settled with the Securities and Exchange Commission and with pension funds that had brought a lawsuit against him over backdating of stock options, which was alleged to have occurred from 1994 to 2005. The SEC settlement totaled $468 million, the largest ever resulting from options backdating.

Though Dr. McGuire admitted no wrongdoing, the size of the settlement "reflects the magnitude and scope of Dr. McGuire's misconduct," Linda Chatman Thomsen, director of the SEC's enforcement division, said in a prepared statement.

Of that total, $7 million was a civil fine paid to the SEC, another $12.7 million was a return of what the SEC called "ill-gotten gains," and the remainder was a forfeiture of options already issued. The SEC settlement also bars Dr. McGuire from serving as an officer or director in a public company for 10 years.

In the lawsuit settlement, Dr. McGuire agreed to reimburse United for $448 million in options and cash, on top of $200 million in options he gave back upon resigning from United in November 2006, after 15 years with the company. The SEC said the lawsuit settlement, which needs to be reviewed and approved by a U.S. District Court judge in Minnesota, was sufficient to cover the forfeiture it had ordered.

[...] Copyright 2008 American Medical Association. All rights reserved.
RELATED CONTENT  You may also be interested in reading:
Health plan earnings up, but United's woes continue  Feb. 26, 2007
SEC takes closer look at United's stock-option grants  Jan. 15, 2007
Stock option problems magnifying financial troubles for United  Nov. 27, 2006

Does Vitamin E Work as a Hair Loss Treatment?

Vitamin E (Tocopherol) as a Hair Loss Treatment 

There are a number of herbal supplements out there that claim to work as a treatment for hair loss.  Whereas there is no question that marketing is over-reaching at best in order to sell a product, the real question that any hair loss sufferer asks is: will this product help combat baldness or is there any chance that it will regrow hair?  To date however, it is important to understand that there is no hair loss cure, therefore realistic expectations must be kept when considering any hair restoration product.

Below I decided to take a look at an herbal supplement that has been said to combat hair loss.  This product is an “active” ingredient in a few hair loss remedies such as HairMax MD.  Vitamin E is also sold as a stand alone product in nutritional stores. 

Vitamin E (Tocopherol)

Vitamin E consists of 8 molecules, four of which are known as tocopherols (one of the ingredients in HairMax MD), the other four known as tocotrienols. Both tocopherols and tocoltrienols consist structurally of a chromanol head and a phytyl side chain. The difference between these 2 types of molecules has to do with the phytyl side chain where tocopherols are fully saturated and tocotrienols are not. Tocotrienols contain three double bonds at the 3, 7, and 11 positions. Ultimately, these two types of molecules are distinct entities and not derivatives of one another. (Theriault et al, Clinical Biochemistry (1990) 32(5):309).

So why take the time to explain all this? From my research it seems that there may be clinical evidence to suggest that tocotrienols may be moderately beneficial for hair loss sufferers – but there is little evidence to suggest that tocopherols are, at least not by themselves.

Another interesting fact is that tocopherols, though mentioned in some patents of the so called hair regrowing agents, are not the major active ingredient but only act as an aid to the formula itself.

A clinical study was performed on 19 balding individuals (14 men and 5 women) ranging from the ages of 23 to 59 suffering from genetic hair loss who have not received any other type of hair loss medication including minoxodil, finasteride, or ketoconazole. 11 volunteers received a capsule orally containing tocotrienols and alpha-tocopherol while 8 volunteers received a placebo capsule. The results of the study transmitted that all hair loss sufferer volunteers who took the tocotrienol / alpha-tocopherol capsules had at least some increase in visible hairs over the 15 month study which indicates that a mixture of tocotrienol and alpha-tocopherol appears to increase the number of visible hairs in balding individuals. Additionally, out of the 8 volunteers in the placebo group, 2 also experienced hair regrowth. 2 experienced hair loss while the other 4 experienced no change.

To read more about this study, visit: http://www.patentstorm.us/patents/7211274-description.html

In my opinion, one problem with the study is that the study group was small and one could argue that the hair count increase was either coincidence or that hairs were growing back as part of the natural hair growth cycle.

Keep in mind also that this study shows the effect of a tocotrienol / alpha-tocopherol mixture taken orally, not topically (as some hair loss treatments suggest). Additionally, what part the tocopherol molecule played in the increase of visible hairs cannot be determined from this study.

Conclusions:

Though some nominal evidence exists for the potential benefit of Vitamin E taken orally for hair loss, I would argue that a larger clinical study needs to be performed to rule out coincidence or hair growing back as a result of the natural hair growth cycle. 

In my opinion, it would be better to stick to the hair loss drugs that have been proven: Propecia(finasteride), and Rogaine 5% (minoxodil). As an adjunct hair restoration treatment, Nizoral shampoo or Revita shampoo both containing active ingredient ketoconazole may also be helpful.

Bill Seemiller - aka Falceros
Associate Publisher of theHair Transplant Networkand theHair Loss Learning Center
View my Hair Loss Weblog

Hair Transplantation: How to Minimize the Risk of Donor Scar Stretching

I will be undergoing a donor scar revision in a few weeks.  How can I best care for my donor scar in the days following hair transplant surgery?  I really would like avoid scar stretching.

Caring for the donor scar after hair transplantation is relatively easy.  Your responsibility will be to keep the donor area clean by washing the area thoroughly but gently.  I find it helps to run my fingers with shampoo in the donor scar area in a circular motion in order to work off the dried blood that surrounds it.  Keep the sutures/staples in as long as your hair transplant clinic recommends and then after that just keep the area clean by washing.

The other component in properly caring for your donor scar to help minimize the risk of scar stretching is to relax.  Do not put too much strain on the hair transplant scar.  Don’t do any intense weight lifting, stretching, or heavy aerobic exercises for the first several weeks.  Gradually increase your workout routine over the course of several months.  Common sense is the key.  If you feel a strain in the donor area, stop what you are doing.   See the following hair loss Q&A blog: Fitness/Sports After a Hair Transplant for more information.

Also avoid putting your chin on your chest as that will cause additional strain on the back of the scalp. 

You can also ask your hair transplant surgeon how your physiology plays a role in the risk of donor scar stretching.

Those with extremely elastic scalps may have “thin skin” (though this is not necessary true).  The lack of collagen puts these hair transplant patients at additional risk of donor scar stretching.  Keep in mind that donor laxity can be a really good thing and will help maximize the number of follicular unit grafts that can be excised.  But there is a possibility that too much laxity is a sign of a lack of supporting collagen in the skin.  Be sure to ask your hair transplant doctor about this.

I hope this helps.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

How Should I Wash My Hair After a Hair Transplant?

I am 7 days out from a hair transplant and want to know how gentle or aggressive I should be with the follicular unit grafts when washing my hair in order to work off the scabs.

Keep in mind that every hair transplant clinic has their own hair restoration postoperative instructions and they vary.  Therefore it is always best to get detailed postoperative hair washing instructions directly from the hair transplant surgeon.

That being said, I thought I’d share my personal experience with hair washing after hair transplant surgery that worked well for me.

Day 0: (day of hair restoration surgery): Just relax.  Do not wash your hair at all.

Day 1: If at all possible, visit your hair restoration clinic for a postoperative hair wash.  If not, fill a cup with water mixed with shampoo and pour it gently over your head several times.  Gently massage the shampoo into the donor area, cleaning the area around the scar. 

Day 2 and 3: Fill a cup with water mixed with shampoo and pour it gently over your head several times.  Gently massage the shampoo into the donor area, cleaning the area around the scar.  Wash donor area normally working around the scar with care to work off any dried blood.  Apply as much pressure as needed however, avoid using so much pressure that it causes pain. 

Day 4: Assuming that your shower pressure is reasonable and not too harsh - let the water from the shower head hit your head normally.  Massage shampoo in your hands until it lathers.  Gently touch the grafts with the shampoo in the palm of your hands and gently touch with your finger tips.  Avoid any massaging of the transplanted hair at this point.  Continue washing donor area normally from this point on paying extra attention around the scar as to work off any dried blood and keep the area clean.

Day 5: Repeat the instructions from day 4 however, add very gentle back and forth motions with your finger tips through the transplanted hair.  Avoid using your nails at all costs.

Day 6:  Resume normal hair washing but be extra gentle with the hair grafts.

Day 7+:  Begin showering twice a day normally however, use a little extra care of the follicuar unit grafts.  Spend 10 extra minutes in the shower both in the morning and evening massaging with shampoo the hair grafts in a circular motion with your fingertips in order to start working off the scabs.  Avoid using your fingernails at all costs.  Do not apply a lot of pressure.  The trick is to apply a constant circular motion to gradually work off the scabs rather than simply picking them off.  Picking the scabs should be avoided at all costs.  Whatever scabs don’t come off in the shower will come off after subsequent showers and circular massaging.  Additionally, when you come out of the shower and after looking in the mirror see some loose scabs, feel free to perform additional soft circular massaging over the scabs in front of the mirror to work off loose scabs.  Scabs still tightly secured to the scalp should not be worked too much.  These scabs will come off after subsequent showers in the coming days. Patience is important and don’t force anything off. 

I have found that by using the above method, scabs typically come off between 8-12 days.

Bill - aka Falceros
Associate Publisher of theHair Transplant Networkand theHair Loss Learning Center
View my Hair Loss Weblog