The Bosley Medical Group: 10 things you should know

Introduction, continued

5. SMAs (from medical board disciplinary action) Larry Lee Bosley has faced disciplined action for having his clinics use a principal sales device called the "Senior Medical Assistant" or SMA. They performed patient consultations at BMG clinics. SMAs were found to be merely salespeople dressed up in white lab coats. The SMA's uniform created the highly misleading illusion that they were medically trained personnel. According to state disciplinary records, the SMA's compensation included incentives based upon the procedures they sold. "Such compensation...which amounts to payment for referrals of patients, induces the selling of procedures based on profit motives rather than on attempting to obtain the best results for patients, and constitutes unprofessional conduct". Bosley Medical now calls their salespeople "Senior Counselors". Their nationwide ads for these positions have sought "sales professionals" with one-on-one presentation experience in such fields as real estate, franchise programs and high-end or luxury products.

6. Brazen attitude toward their patients (from court documents) An internal document from the early 1990's that surfaced during the DA's investigation entitled "BMG Operational Philosophy" stated that the group is in the "dealing with insecure people" business. Don Broder, head SMA until 1998, wrote an interoffice memo to BMG president John Ohanesian discussing the failure of a particular SMA to properly "saute" a prospective patient into obtaining a procedure. The "saute" involves low-balling the anticipated cost, often in conjunction with the "Yellow Brick Road". This was a system of assessing the worth of a potential patient so that recommendations for surgical procedures were based on income level - the wealthier the client, the more surgery to be done. A memo to SMA named Brent discussing one patient's complaint said: "The scar was real big and is still sensitive . . . Should we tick 'forget this one' or invite him back for some ice cream?" A response on the bottom of the page indicates that Brent should "send the form letter about we're sorry your (experience) etc.

7. Pain (from court documents) Bosley's employees have been directed to downplay discomfort associated with procedures and never to use the word "pain" or "pain killers" to potential customers. In truth, BMG is well aware from patient complaints on file that many patients experience excruciating pain. A 1996 memo addressed to all BMG management and doctors disclosed: "Today I treated a 48 year old patient . . He told me the following: . . The discomfort of being anesthetized was so severe that he seriously considered never returning to BMG. Post-operatively he also suffered considerable pain in the donor area for 2 to 3 weeks, to the degree that it was difficult to sleep".

8. Invasiveness of procedures. Bosley Medical has downplayed the seriousness of surgery that takes place at their clinics, having described it as "minor" or "superficial" in their advertisements. Many are surprised to learn how invasive these types of procedures can be. Donor area harvesting involves excising or cutting out sections of scalp containing layers of tissue, nerves, blood vessels and sweat glands. Each subsequent procedure removes more tissue. Some possible side effects from this type of surgery in general include effluvium, or shock fall-out of the existing hair caused by the effects of surgery, loss of sensation- or numb or "dead" spots, visible scarring, and unnatural and irregular appearance of the scalp (see the Procedures page).

9. Blood drawn as a sales tool (from medical board disciplinary action) Several medical boards have taken action against Bosley for deceptive blood tests based on the 1996 DA investigation. According to the investigation, it was a practice at Bosley Medical to take and charge a prospective patient for blood laboratory tests and proceed to surgery without waiting for the results. The DA said that the drawing of blood was not for medical necessity but was used as a marketing tool to get patients to commit to following through with the procedures. A former BMG physician confirmed that blood was drawn merely as a sales tool designed to make the patient feel "bonded" to BMG or committed to going through with the procedures.

10. Other options. Surgery can reduce the efficacy of drug and other therapies and limit options for future treatments (see the Procedures page). More effective and less invasive treatments (e.g., hair multiplication) are being researched and developed which could make the current methods obsolete.

On an ironic note, with years of deception on record Bosley Medical actually put a "consumer alert" section in their brochure - cautioning consumers to avoid outfits who have used misleading and fraudulent advertising.

Next: Bosley Medical Sales and Marketing Methods

How to protect yourself from a disreputable doctor:

Thousands of people call their state medical boards or the AMA each year for background information on their physicians. However, this can often be a frustrating experience with minimal results. Less than half of a percent of doctors are disciplined, thus limiting the odds of revealing any useful information about your doctor. Cooperation between state medical boards is still limited, and doctors who worked in a clinic that received formal discipline may receive no marks on their license. The following common sense suggestions may help protect you:

Be a sophisticated patient do your research and know the ins and outs of the procedure you will be undergoing.

Patient referrals find out how other patients have fared and what they are saying about that doctor .

Beware of advertising claims be skeptical of doctors who make fantastic claims or promises about results.

Don't sign consent forms unless you understand them. Don't sign them the first time they're presented to you. You have the right to have them reviewed. Have the doctor write down and sign a list all of the material risks involved. If he has made any promises regarding results make him put it in writing.

Get second opinions from multiple doctors regarding your procedure: its risks, complications and alternatives. Find out about the doctor's reputation and standing among his peers.

Sources: California State Attorney General, California State Medical Board, Maryland BPQA, Federation of State Medical Boards (FSMB), Los Angeles District Attorney's Office: Bureau of Special Operations - Consumer Protection Division, NBC News





	Introduction, continued 5. SMAs (from medical board disciplinary action) Larry Lee Bosley has faced disciplined action for having his clinics use a principal sales device called the "Senior Medical Assistant" or SMA. They performed patient consultations at BMG clinics. SMAs were found to be merely salespeople dressed up in white lab coats. The SMA's uniform created the highly misleading illusion that they were medically trained personnel. According to state disciplinary records, the SMA's compensation included incentives based upon the procedures they sold. "Such compensation...which amounts to payment for referrals of patients, induces the selling of procedures based on profit motives rather than on attempting to obtain the best results for patients, and constitutes unprofessional conduct". Bosley Medical now calls their salespeople "Senior Counselors". Their nationwide ads for these positions have sought "sales professionals" with one-on-one presentation experience in such fields as real estate, franchise programs and high-end or luxury products. 6. Brazen attitude toward their patients (from court documents) An internal document from the early 1990's that surfaced during the DA's investigation entitled "BMG Operational Philosophy" stated that the group is in the "dealing with insecure people" business. Don Broder, head SMA until 1998, wrote an interoffice memo to BMG president John Ohanesian discussing the failure of a particular SMA to properly "saute" a prospective patient into obtaining a procedure. The "saute" involves low-balling the anticipated cost, often in conjunction with the "Yellow Brick Road". This was a system of assessing the worth of a potential patient so that recommendations for surgical procedures were based on income level - the wealthier the client, the more surgery to be done. A memo to SMA named Brent discussing one patient's complaint said: "The scar was real big and is still sensitive . . . Should we tick 'forget this one' or invite him back for some ice cream?" A response on the bottom of the page indicates that Brent should "send the form letter about we're sorry your (experience) etc. 7. Pain (from court documents) Bosley's employees have been directed to downplay discomfort associated with procedures and never to use the word "pain" or "pain killers" to potential customers. In truth, BMG is well aware from patient complaints on file that many patients experience excruciating pain. A 1996 memo addressed to all BMG management and doctors disclosed: "Today I treated a 48 year old patient . . He told me the following: . . The discomfort of being anesthetized was so severe that he seriously considered never returning to BMG. Post-operatively he also suffered considerable pain in the donor area for 2 to 3 weeks, to the degree that it was difficult to sleep". 8. Invasiveness of procedures. Bosley Medical has downplayed the seriousness of surgery that takes place at their clinics, having described it as "minor" or "superficial" in their advertisements. Many are surprised to learn how invasive these types of procedures can be. Donor area harvesting involves excising or cutting out sections of scalp containing layers of tissue, nerves, blood vessels and sweat glands. Each subsequent procedure removes more tissue. Some possible side effects from this type of surgery in general include effluvium, or shock fall-out of the existing hair caused by the effects of surgery, loss of sensation- or numb or "dead" spots, visible scarring, and unnatural and irregular appearance of the scalp (see the Procedures page). 9. Blood drawn as a sales tool (from medical board disciplinary action) Several medical boards have taken action against Bosley for deceptive blood tests based on the 1996 DA investigation. According to the investigation, it was a practice at Bosley Medical to take and charge a prospective patient for blood laboratory tests and proceed to surgery without waiting for the results. The DA said that the drawing of blood was not for medical necessity but was used as a marketing tool to get patients to commit to following through with the procedures. A former BMG physician confirmed that blood was drawn merely as a sales tool designed to make the patient feel "bonded" to BMG or committed to going through with the procedures. 10. Other options. Surgery can reduce the efficacy of drug and other therapies and limit options for future treatments (see the Procedures page). More effective and less invasive treatments (e.g., hair multiplication) are being researched and developed which could make the current methods obsolete. On an ironic note, with years of deception on record Bosley Medical actually put a "consumer alert" section in their brochure - cautioning consumers to avoid outfits who have used misleading and fraudulent advertising. Next: Bosley Medical Sales and Marketing Methods		How to protect yourself from a disreputable doctor: Thousands of people call their state medical boards or the AMA each year for background information on their physicians. However, this can often be a frustrating experience with minimal results. Less than half of a percent of doctors are disciplined, thus limiting the odds of revealing any useful information about your doctor. Cooperation between state medical boards is still limited, and doctors who worked in a clinic that received formal discipline may receive no marks on their license. The following common sense suggestions may help protect you: *Be a sophisticated patient* do your research and know the ins and outs of the procedure you will be undergoing. Patient referrals find out how other patients have fared and what they are saying about that doctor . *Beware of advertising claims* be skeptical of doctors who make fantastic claims or promises about results. Don't sign consent forms unless you understand them. Don't sign them the first time they're presented to you. You have the right to have them reviewed. Have the doctor write down and sign a list all of the material risks involved. If he has made any promises regarding results make him put it in writing. *Get second opinions* from multiple doctors regarding your procedure: its risks, complications and alternatives. Find out about the doctor's reputation and standing among his peers.
	Sources: California State Attorney General, California State Medical Board, Maryland BPQA, Federation of State Medical Boards (FSMB), Los Angeles District Attorney's Office: Bureau of Special Operations - Consumer Protection Division, NBC News