From gaslighting between peers to professional intimidation: A new trend in the medical community.
- jemmaquilleuse
- 8 sept. 2023
- 7 min de lecture
If anyone wonders WHY most Drs/Mds/surgeons and other medical specialists are so blasé about medicine and WHY many of them seem cautious to the point of having no opinion nor taking any kind of position (even during medical consults with patients)
I THINK I may have an idea why.
There seems to be some kind of vendetta against medical doctors who are not jumping onboard with ideas that small cliques are propagating as ''the truth'' (which truth as to be applied to patients)
If you do not rally to those cliques/minorities, you will be shamed and cast away.
And it happens in every specialty .
And some of those cliques have pushed the enveloped to what I will call colleague shaming.
Which is the absolute equivalent of medical gaslighting between peers.
But now, that peer shaming has been taken to another level:
And I will call it Professional intimidation.
Let me explain:
A few months ago I received an e-mail from a surgeon who sent me a communication he received from his professional association.
I have been growing a pleasant professional relationship with this particular surgeon. We both had everything to gain to entertain that open line of communication. Him being a well regarded member of the aesthetic and plastic surgery field in Canada and elsewhere in the world, me being an international advocate for patients harmed by breast implants.
And part of that was the regular exchange of the newest articles and studies being published surrounding that particular subject. Him being openly not on the side of women being sick from their implants (and making it publicly known) me being openly on the side of patients and in favour of total capsulectomies for patients wanting to remove their breast implants (And making it publicly known) even more lately now that more and more cases of Breast Implant associated cancers are being found in the scar tissue forming around the implants (BIA cancers BESIDE BIA-ALCL).
Of course our world are colliding but being respectful of each other is key.
That day in May 2023, a particular email came from this surgeon with a simple ''FYI".
The purpose was for me to read the attachment which was an official joint communication published by the ISAPS ( the International society of aesthetic plastic surgery) The ASERF (Aesthetic surgery education and research foundation)
And The Aesthetic society.
At that time (May 2023), if I understood correctly, the ISAPS made a communication in collaboration with ASERF (amongst others) in which communication they declare that surgeons should not
perform enbloc for Bii patients if the goal is to help them with their symptoms.
"As board-certified plastic surgeons, we should practice evidence-based medicine. The absolute indication for en bloc capsulectomy is removal of an implant and capsule in the presence of capsular malignancy. Relative indications for total capsulectomy are capsular contracture, rupture of a gel implant, and possibly with removal and exchange of textured implants. There is currently no good peer-reviewed evidence that capsulectomy is required for symptom improvement in the absence of other indications.
Patient preference may be considered with appropriate informed consent. Capsulectomy is a more invasive procedure, may be more expensive, and may carry higher risks.
Surgeons who state that en bloc capsulectomy is required for symptom improvement should not do so without the scientific data to support their claims and potentially violate ethical standards, as it could lead patients to undergo surgical procedures that may not be indicated.11
Surgeons promoting themselves as “explant experts” who have no additional training or other basis to deem them more of an expert than other board-certified plastic surgeons, should cease marketing themselves as such.
Surgeons should keep abreast of scientific knowledge (AMA Principles of Medical Ethics).
Surgeons should not falsely represent a skill set; The Aesthetic Society Code of Ethics Section 3.01, B.14.: Claiming superiority in skills or services, including superiority due to the member’s gender or ethnicity, which claims cannot be easily and factually substantiated by patients."
They do this by reminding surgeons of their code of conduct, Which amounts to surgeon shaming-Professional intimidation in my opinion.
“Surgeons who state that en bloc capsulectomy is required for symptom improvement should not do so without the scientific data to support their claims and potentially violate ethical standards, as it could lead patients to undergo surgical procedures that may not be indicated.11”
While focusing in particular on the data of a new study.
“What Is the Data?”
"The Aesthetic Surgery Journal has published four papers from an ASERF-funded study, “Systemic Symptoms in Women – Biospecimen Analysis Study.” This study, with Drs. Caroline Glicksman and Patricia McGuire as principal investigators"
This cited study was conducted by a group of surgeons (Dr. Caroline Glicksman, Dr. Pat McGuire, Dr. Bill Adam et Al. (see ref. 4-5-6-7 of the communication linked below)
Which say contributor,Caroline Glicksman is…the
new elected president of the ASERF.
And the ASERF is partnering for this communication. Referencing to say study.
And all this is while being sponsored (see the bottom of the communication) by?
Breast implant manufacturers.
See, silicone breast implants were reintroduced on the market in 2006 after a decade long ban, after hearings at the FDA during which?
The new president-elect of ASERF and co-author of the cited study, Caroline Glicksman, testified to their safety.
You have to know that, on top of being a plastic surgeon in private practice AND the newly elected President of the ASERF
Caroline Glicksman is ALSO
MEDICAL DIRECTOR OF MOTIVA (US clinical trial )
(A breast implant manufacturer)
AND
Medical director of Galaflex (US clinical trial)
(Galaflex is a surgical scaffold use breast reconstruction and also used in a surgery called internal bra )
And 5 of the 12 articles in the references of this joint communication are papers/study or articles in which either Dr. Caroline Glicksman or Dr. Pat McGuire have participated.
What a total Toxic Conflict of interest from beginning to end!
The same kind of conflicts in which directors of major plastic surgery units in Quebec university hospitals (some specializing in post-mastectomy reconstruction) find themselves, being at the same time medical consultants for implant manufacturers at average salaries of $90,000/year all the while receiving a salary from the public healthcare system.
And some of those departments are unshamefully pushing their breast cancer survivors heading for mastectomies for immediate reconstruction with implants over any other options.
Are you going beyond the message that is forced through this communication without regard to the consequences for patients of course but also for those SURGEONS who are NOT riddled with conflict of interests and are dedicated to help their patients?
Because if we take it literally, it goes WAY beyond Enbloc Explantation/total capsulectomy surgery.
I would ask ANY surgeon taking this communication seriously:
Do you consider yourself an expert in your field?
( I myself believe lots of surgeons are experts in their field.)
How many (name of particular surgery) have you done so far?
A few what? Dozens? Hundreds?
Are you more of an expert in your field than a surgeon like Dr. Jae H. Chun (CA, USA) who has done thousands of enbloc capsulectomies for women who are-were sick because of their breast implants but shouldn't call himself an expert BECAUSE his field of expertise is…removing breast implants?
Is it’s possible that his expertise (and the expertise of a few explant surgeons) is treatening a 400 million $$$ industry?
An industry in which the current ASERF president is deeply involved in?
Is it possible that "Explant experts" are in their field as good and maybe better than other surgeons who are NOT as qualified and as experienced to performed some surgeries that they ARE performing but just NOT on such a regular basis as these men and women are doing explant?
And if we applied the code of ethics to the T… what would you be left with after applying article 50?
(The Quebec code of ethics of physicians:
ANY cosmetic procedure that are not MEDICALLY NECESSARY become illegal under this article.
And I bet there are similar dispositions in the US code of ethics.
Do you see Doctor, the limitations of such a release? For yourself? For your colleagues? Even for the breast implant industry?
Because don't fool yourself doctor: Breast implants are NOT a life-saving device. NO ONE will die if they are removed from the market.
BUT ALL PLASTIC AND AESTHETIC SURGEONS will loose TONS of money if articles of codes of ethics such as article 50 in the Qc code of ethics would suddenly be strictly applied.
Because breast implantation surgeries are NOT medically necessary in ANY cases.
Nor are MOST plastic surgeries done for aesthetic reasons.
And those surgeries are the bread and butter of the plastic surgeons and aesthetic surgeons in private practice.
It's interesting to see how the surgical community wants to control Bii and the narrative around explantation.
Yet no one told us about the science and scientific data when we wanted breast implants.
10-15 years ago, there were already published scientific articles that suggested potential links to systemic symptoms and problems (possible or proven) with BIA-ALCL…Let’s remember that the first cases are tracked back from 1996-1997.
In this quoted study, which I incidentally read as soon as it came out in May 2023, I saw no mention of the benefits of removing and testing the capsules for the purpose of identifying cancer and possibly reducing the risk of developing one in the future.
It seems strange to me that they want the reader to be informed about points raised in their research but not about these “other” critical factors.
Removing the scar capsule around the implants no longer just concerns systemic symptoms of Bii anymore but ALL cancers linked to all implants.
If there is no evidence of improvement in Bii symptoms with capsule removal, it should at least be ensured that patients are truly aware of other proven/possible benefits (of keeping the capsules in their bodies) like BIA-Cancers and that these patients can compare the risks to THEIR case taking into account THEIR health and according to the skills of THEIR choosen surgeon.
Ultimately, no one can take away a woman's right to have the scar tissue/implant capsule removed.
If she wants to remove her implants, capsulectomy or not, she should have no impedance other than the potential for increased risk factors related to individualized surgical procedures.
In the same way as currently, during implantation, informed consents are limited most of the time to the risk factors related to the surgical procedure and that all the risks related to breast implants, including Bii and cancers or the fact that implants have a limited lifespan (8-10 years max according to the Mentor Canada site) are rarely named, although these risks are now cited by the FDA.
Conflict of interest within those organisations is becoming a public health concerns.
Health care professionals involved at so many levels should probably be kept away from decisions making that could potentially harmed their colleagues and their patients.
Because they themselves are obviously riddled with conflict of interest.
All the while those colleagues are trying to do good by their patients.
Because there are trying to do no harm.
From beginning to end.
********************************************
Patient Safety Advisory - Breast Implant Removal and Capsulectomy | The Aesthetic Society
m-9, r. 17 - Code of ethics of physicians
Library:
Dr. Eric Swanson
Dr. Stephen C. Nicolaidis:
Dr. Eduardo Fleury:
Dr. Jan Willem Cohen Tervaert:
Dr. Henry Dijkman:
Dr. RM Kappel:
Dr. Ayush Arora
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