Absolutely disgraceful

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In 2005, the then NSW President of the Australian Medical Association, Dr John Gullotta (who is now Adjunct Associate Professor at the University of Sydney) was quoted in a magazine called ‘Australia Doctor’, saying that what IHRB was doing was ‘Absolutely disgraceful’. The magazine is a news and education source for Australian General Practitioners.

A story filed on the 3rd of August 2005 by reporter Bianca Nogrady, is headed ‘GPs warned on hair clinic scripts’. The story can be found here, and this is what it says:

A hair restoration clinic that requests external GPs prescribe specific medications for its patients has raised the ire of the AMA.

Dr John Gullotta, AMA NSW president, described the practice as “absolutely disgraceful”.

“What they’re doing … is making themselves not responsible but putting the blame on a third party,” said Dr Gullotta, who is also chairman of the federal AMA therapeutics committee.

Sydney GP Dr Paul Fitzgerald raised the issue after he received a letter from a patient who had attended the Institute of Hair Regrowth and Beauty asking him to prescribe two topical medications — minoxidil (Rogaine) and Retin-A — which are known to interact with each other.

Prescribing information for minoxidil warns of a possible interaction between it and topical retinoids, something the letter failed to mention.

Sydney dermatologist Dr Jo-Ann See said combining the two drugs was a cause for concern because both were potential irritants. Retin-A was also photosensitising.

Combining the drugs was unnecessary because it did not increase the efficacy of minoxidil, she said.

MIMS product information also cautions that there is a theoretical risk of systemic effects of minoxidil if absorption is increased.

Dr Gullotta said he had recently been approached to write a similar prescription, but refused, telling the patient the drug (Proscar) was not licensed in Australia for treatment of hair loss.

The hair loss clinic’s managing director, Mr Samuel Cohen, defended his clinic’s use of the combination, saying it had been used for many years internationally, with only the occasional instance of skin irritation.

As a non-medical clinic, the institute relied on external GPs to write prescriptions, which were then filled by a compounding chemist, Mr Cohen said.

A 12-month program with the institute costs patients up to $4700.

Mr David Brown, United Medical Protection’s general manager of legal services, said once a patient had consulted a doctor, “the doctor and patient are in a relationship that should be uninfluenced by a third party”.

Doctors should only prescribe medication on the basis that it was a medically recognised treatment for the condition and in the interests of the patient, he said.

Associate Professor John Gullotta with Her Excellency Professor Marie Bashir AC CVO

Professor John Gullotta pictured here with NSW Governor Marie Bashir, reacted strongly to Sam Cohen’s disgraceful conduct. Mr Cohen was very lucky that the then NSW President of the AMA did not know the full story. Imagine what the AMA would have said if it had known that Retin-A (which is a Schedule 4 medication which requires a doctor’s prescription) is mixed with Minoxidil and given to patients without a doctor’s prescription! What would the AMA have said about that piece of shocking news?

I walked into Sam’s office, paid $3,700 and walked out with a prescription drug, without a doctor’s prescription! There are strict laws around this type of thing. How can Sam Cohen dispense such drugs when he is not a doctor? More on this absolutely disgraceful conduct in another article. For now, let us examine the core topic, highlighted by ‘Australian Doctor’ magazine in 2005. It seems that by 2008, when I became a client whose treatment ended in September 2009, nothing had changed. Sam was up to his old tricks, as if he had received no warnings. He did not care what others thought of him and his methods.

No friends left

Sam Cohen is quick to boast about the fact that doctors hate him. He also told me that his competitors hate him. Why? Because, according to him, doctors don’t know anything about hair loss and baldness. He told me that doctors are clueless. If they knew anything, he would not have ‘thousands of customers’ who come to him. He also said that his competitors hate him because he exposes them and their misleading claims. He makes out that he is the only honest one amongst the lot of them, and he is the only one who knows how to treat hair loss. Let me back these up with some proof. First, in an email from Sam to me, dated Wednesday 29 April 2009, responding to my email wherein I updated Sam about why my GP and Specialist Dermatologist both refused his request that I obtain Loniten and Proscar, he wrote, ‘I did tell you that many doctors don’t like me & many doctors do not want to help me.’

The second example shows how Sam positions himself as the honest alternative in a ruthless industry filled with con-men and scams. In this advertorial (which he calls an editorial) Sam is quoted as saying, ‘In the years I worked for other organisations, I was disappointed with the way most people with hair loss were told untruths, treated with ineffective cosmetic products, machines and gadgets to produce a false visual image in order to take their money.’ Click here for a PDF of this editorial, given to me, and also found on his website. The editorial above by Bianca Nogrady shows why doctors do not like him. Sam is mixing products that the medical professionals say is unwise. And he is giving it to clients without a prescription, which is illegal.

By the way, even if Sam were to say that he had been pulling our leg, and that he was lying about placing Retin-A, and that the letters he had written were false, and that he never gave patients Retin-A without a prescription, we can move onto the question of Minoxidil, which is a Schedule 2 medication which can only be purchased from a pharmacy. IHRB is not a pharmacy. Does Sam have a licence to sell a Schedule 2 product? I doubt it, but I would welcome proof if he does. I have written to the appropriate authority to query this, and I will let you know if we find that a licence had been issued to him.

Sam wanted me to go to my GP and obtain a prescription for a range of medications. I will outline these in another article. Anyway, my GP was dubious about this request because Sam was asking for medications that were not approved for treating hair loss. My GP sent me to a specialist dermatologist who is, in effect, a specialist doctor, who refused Sam’s request. So Sam suggested that I tell my doctors to go jump. He gave me a list of 227 doctors whom he said were fully behind his treatment and who would give me the prescription. I never went to those doctors. My GP is smart enough to advise me well. The dermatologist is qualified too. I did not want to risk my health (and there were significant health risks which I will outline in another article).

However, as part of this investigation, I asked one of my staff members to create a database for a mail-merge of these 227 doctors whom Sam said would gladly prescribe the risky medications, and I wrote to them. Many are no longer at that address or do not exist. And many wrote to say that they would have nothing to do with IHRB. If you want proof of this, just ring as many as you like on this list, and mention IHRB and see what they will say. Some will be noncommittal and ask you to go in and see them. No ethical and professional doctor will allow a non-medical person like Sam Cohen to call the shots. Doctors find it offensive and ludicrous that they should be used to write scripts. They have a duty of care. And the professional doctors know that it is unwise to be mixing drugs that are way off-label: completely off the radar as far as the drug’s purpose is concerned. Sam wanted me to obtain medications that the Australian Therapeutic Goods Administration (TGA) does not approve for hair loss treatment. One might say, oh well, who cares if the TGA does not approve them, they still work. Fine, go ahead and be brave, and ignore the TGA, but where are the clinical trial or studies to prove that they work? And which doctors will prescribe them and jeopardise their career and forfeit their insurance and give you a cocktail of medications to solve a problem that has never been studied or proved to work; using products that are designed for a specific condition which already comes with a long list of side-effects that are worse than losing one’s hair!  Click here to download the list of 227 doctors as given to me by Sam.

After a general search about hair loss scams, I found an article at Femail.com.au, written by registered nurse Tony Pearce, wherein he says:

‘For decades, consumers anxious about thinning hair or hair fall problems have had to tread the minefield of companies or individuals offering ‘guaranteed’ hair loss cures – at a price. To their collective shame governments, medical associations, & other regulatory bodies having done nothing to control the practices, claims, and charges of hair loss companies. Departments of Fair Trading – supposedly in place to protect the consumer – gutlessly hide behind the dictum of ‘Emptor caveat’ – “Let the buyer beware”.

‘I contend that the majority these hair loss companies – and the untrained salespeople they employ – are illegally practicing medicine. They tell prospective clients they have “genetic balding” or some other alopecia – is this not making a medical diagnosis? They suggest treatment such as laser therapy, Minoxidil, ‘special’ shampoos & nutritional supplements – is this not prescribing?

‘These unscrupulous charlatans possess little knowledge of the appropriateness of the treatments they sign clients up to – nor are they able to recognise potentially dangerous adverse effects of treatment when & if they arise.

‘Even more disturbing some operators produce their own untrialled & non-approved remedies, making outrageous claims to its efficacy. Still others openly tell prospective clients they add ‘special ingredients’ to prescription medication in order to make that medication more effective!

‘My client files are replete with stories of people having previously paid many thousands of dollars to hair loss salesmen when all that was required was some iron or other nutritional supplementation, a change of oral contraceptive, or in a number of cases – nothing but time – these individuals were experiencing a temporary & self-correcting condition.

‘The hair loss treatment industry is long overdue for regulation and the registration of qualified practitioners. No other area of health care tolerates untrained poseurs to masquerade as qualified specialists. I believe it’s only a matter of time before there are fatal consequences to an innocent consumer in allowing these unchecked practices to continue.’

Note that Tony Pearce says that ‘it is only a matter of time before there are fatal consequences’. How sad it would be to allow this to happen in a country that has so many rules and regulations. Why is IHRB slipping through the net? I developed a bad rash on my scalp, and I had to yet again go to the GP and take a course of antibiotics. I showed the photos to Sam Cohen, and I suggested that maybe the red sore rash was due to the topical solution, and Sam dismissed it. He just advised me to stop the topical solution and wait for my scalp to heal, and then to resume using it. He did not want to check the contents of the bottle. He said that all the bottles are the same.