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Inorganic Chemistry

A Room Temperature Superconductor? Well. . .

Superconductivity is one of those places where chemistry and physics cross paths. That’s especially true as people search for higher-temperature materials, because that seems to involve more and more complex synthesis and characterization of the results. Very tiny changes in conditions or starting materials can make for huge differences in the behavior of the final products, and figuring out the atomic-level structures (not just unit cells, but defects, grain/domain sizes, interface effects, and so on) is a major analytical challenge.

A few weeks ago, a preprint showed up claiming room-temperature superconductivity in a mixture of gold and silver nanoparticles. That’s one out of deep left field, for sure, but so were the (by now well established) copper-oxide materials. This latest result really doesn’t seem likely at all, but you can’t quite rule anything out in this area. And the potential impacts of a room-temp superconductor are so gigantic (scientifically, economically, etc.) that even low-probability claims deserve a hearing.

 

That hearing they have gotten, and so far it doesn’t look good. Here’s Brian Skinner, a post-doc at MIT (and author of this physics blog) with a look at the original data. What he finds is disturbing: in a plot of magnetic susceptibility versus temperature, two completely separate runs of data (taken at different magnetic field strengths) appear to have exactly the same noise pattern. That is, whenever one of them zigs a bit up or down, so does the other. Every time. Perfectly in synch. It looks, in fact, as if someone copy-pasted one of the lines, changed the color of the points, and offset the new line a bit. Actually, it’s even worse than that: it looks like someone did that for just part of the figure – at the higher temperatures, the noise in the two runs are different.

This isn’t possible. Noise is noise, and it’s different every time you take a series of measurements. As Skinner delicately puts it, this behavior “has no obvious theoretical explanation”, but by gosh it has a very obvious practical one that is immediately obvious to even a casual observer. That is, someone copy-pasted one of the lines, changed the color of the points, and offset the new line a bit. If there were doubts about the validity of this report before this, they shrink into nothing compared to the doubts that people have now. Think about it: if you were about to report a world-changing result like a room-temperature superconductor, wouldn’t you want to make sure that everything about the paper was solid? Go over it a time or two? Make sure that a key figure didn’t include an obvious copy/paste that would call into question the veracity of the whole damn thing? The name “Jan Hendrik Schön” comes to mind, and that’s not something anyone wants to hear.

Here’s a Twitter thread from Skinner with some updates since his own note came out. The authors, he says, are sticking by their results, so it’s going to be something to watch. For my part, I certainly hope that an RT superconductor gets discovered. But this isn’t looking good.

Update: OK, this story is getting weirder, and a lot further from what should be happening if this were a real discovery. . .

94 comments on “A Room Temperature Superconductor? Well. . .”

  1. Anon says:

    There’s fraud, and there’s dumbass lazy fraud. Thankfully, the same personal traits that lead to fraud, usually lead to the dumbass lazy variety.

    1. Henry Clay says:

      Well aren’t we holier than thou? May those without sin cast the first anonymous comment. As if nobody here ever dragged the integration just a little extra to make sure the d.r. is JACS worthy, or left out that one pesky fluorimiter reading that dropped the r2 value below 0.99. Sheesh I didn’t work the leave early shift to publish in JOC

      1. Anon says:

        If they did, they shouldn’t have. If anybody is reading this, don’t do it. Be courageous and upstanding, not sleazy and insecure. It’s not always easy, but it’s always the right thing to do.

        Also, please do not contribute to making bad behavior socially acceptable, online or otherwise.

      2. I am holier than thou says:

        There’s a difference between showing your legit data in its best light and flat-out fabricating a set of data.

        1. The poster doth protest too much says:

          Is there? I’m not sure manipulating ‘above average’ data to make it ‘excellent’ is really as noble as you claim.

    2. loupgarous says:

      I like Derek’s term “deliriously incompetent fraud” (from “Crap, Courtesy of a Major Scientific Publisher” for cut n’ paste identical copies of different runs of stochastic data better. It sings.

    3. you don't need it says:

      And people wonder why there is so much skepticism over man made global warming. BTW, its important to differentiate between simple cyclic temperature changes of this planet, which should be thought of as akin to breathing, and man made global warming which can be thought of as having a temperature due to illness.
      Additionally, if global warming is made made then we have to figure out who the doctor is. Big government with big taxation plans is unlikely to serve that function.

  2. Sal says:

    Makes one worry how much fraudulent data gets passed on by people with the competence to not copy and paste a dataset from the same paper for their key result.

  3. Marc Piquette says:

    Well if you’re going to fake results (and MAYBE they didn’t…), you probably want to do it on something less important – something that isn’t going to garner high levels of scrutiny. Of course even if they had gotten away with it, what then? They won’t be able to (re)produce it for any sort of application. We’d probably end up with other groups wasting precious time and money trying to replicate the work. It’s just a mess.

    Still, I’m hopeful for the eventual prospect of a room temperature superconductor. Here’s hoping there’s something of merit in this study?

      1. Marc Piquette says:

        Looks interesting – thanks!

        1. loupgarous says:

          Just a cautionary note: The last time someone connected lots of organic molecules layered on thin metal substrates with exceptional properties, up to and including identical noise in test runs at different temperatures, it was the Schön scandal at Bell Labs.

          While I didn’t see the identical noise in different test runs in Kawashima-san‘s paper and sincerely hope he’s onto something, I hope his peer reviewers take the hint to re-read Schön’s library of bogus and suspect experimental reports, and examine this paper for troubling parallels. If it survives that, it’s great news.

    1. something something science says:

      The paper has now been updated.
      The scientists continue to stand by their results.
      I guess we will have to wait until others are able to reproduce the results now that they have shared more details of their experiments.

  4. b says:

    I’m not that familiar with nanoparticle synthesis, but it seems their description of material preparation is… lacking. Basically “we prepared silver nanoparticles using standard techniques, then incorporated them into into a gold matrix”. One would think that with such claims, more care would be put into the description of preparation (as we gripe about in organic synthesis all the time). There’s not much of an experimental at all.

    1. tt says:

      Yep. Clear warning sign in that they give absolutely zero information on synthesis. Impossible to actually replicate this work to confirm/disprove the author’s claims. Extraordinary claims require extraordinary evidence. This reminds me of the cold fusion fiasco, except that this is much more obvious and sloppy.

      1. dave w says:

        I’m not sure that cold fusion is actually a complete fraud. There’s clearly a lot of wishful thinking in some of the reported results, but I suspect that: a) there is an effect; and: b) that it’s a weak signal, and its observation has involved a certain amount of luck, since the conditions for reproducing it are not actually well understood.

    2. VR says:

      Even though their preparation methods may have been published earlier (it’s “standard”), the whole caracterization is lacking.
      They say the material is “structured”, but how ? Are the silver nanoparticles randomly dispersed in gold ? Is there an organization, some kind of cristalline structure as in an opal ? What about the relative amounts of materials ? Is the effect homogenuous or is there a preferred direction. So many questions…
      Two TEM pictures are really not enough, especially since what is important is understanding th mechanism of the supraconduction.

    3. something something science says:

      The paper has now been updated.
      The scientists continue to stand by their results.
      I guess we will have to wait until others are able to reproduce the results now that they have shared more details of their experiments.

  5. M Welinder says:

    All that’s needed for room temperature superconductivity is a sufficiently flexible interpretation of “room temperature”.

  6. Chad Irby says:

    The non-fraud explanation could be “the grad student who made this chart screwed up and put in the wrong data for one of those runs.”

    That doesn’t speak too well for their quality control, but I’ve seen much, much worse in publicly-prepared data slides in well-received presentations over the years.

  7. Semichemist says:

    Hey Derek, both of your Brian Skinner hyperlinks go to the same place – the physics blog homepage

    1. Derek Lowe says:

      Arg, fixed. Thanks!

  8. Hap says:

    If you fake something like this, you can’t be really smart, because lots of someones are going to be checking this quickly, and if it doesn’t work then it ought to be clear shortly thereafter, and if it works then that ought to be clear as well. In addition, the benefits one hopes to gain from the work are long-term reputation and money and grants, and a lot of that seems to unravel if it’s based on deception. The people who run scams aren’t trying to get a lifetime sinecure with their marks, after all.

  9. SP123 says:

    I’ve seen this type of mistake in a draft of a paper where it was not fraud but honest error. The way it happens is in Excel (yes, that’s the real problem right there) you set up a worksheet with a template to aggregate/normalize/plot the values. Then you copy the worksheet for the next sample and keep the same normalization formulae, and when you paste you mistakenly don’t cover the full range (usually because part of it is off the screen)- in the case I saw they replaced the control columns but forgot to replace the sample columns. The result was a reasonable looking curve on its own, but if you compared to another sample it was a perfect replicate of the curve shape, just shifted to reflect the different control data being used for normalization.
    Summary- yes it’s sloppy and requires a retraction, but don’t assume it’s outright fraud until you have more details or see the underlying data processing.

    1. Hap says:

      This would be the kind of thing you’d want to be pretty careful about, though, considering the importance of the finding and the size of the likely audience. Sloppiness at this level is bigger than normal sloppiness (though less than fraud would be).

      1. SP123 says:

        Oh, totally agree- the paper I was looking at was for J. Med. Chem. or the like about some project we had killed, if you’re going to publish groundbreaking claims you check every piece of data 10+ times going back to raw files. And it could be fraud, I’m just saying I can see how it could happen without the need to immediately toss out the name Schön. I mean, if you’re comparing activity plots of two compounds in a figure and your EC50s were all reproducible, do you examine the 5-10 inactive points at the bottom of the curves all with <1% activity to see if there's some mistake that those points were accidentally replicates?

        1. Isidore says:

          So far the authors of the paper have not acknowledged any errors, Excel of otherwise, and are sticking by their data and the plots, as per Brian Skinner’s Tweeter feed. Unfortunately (again as per the Tweeter feed) they have not agreed to share the numerical data either.

          1. SP123 says:

            Yeah that’s not a good sign and tips my priors more towards the fraud side. There’s clearly something amiss with the data and if they insist otherwise they’re hiding something.

    2. Curt F. says:

      As you allude to, this is a great reason not to use Excel and to use data analysis approaches where the data is cleanly separated from the analysis (e.g. Python or R scripts, maybe Graphpad or something like that too — I don’t use the latter so I’m not sure). It’s best if the raw data is in one file, your analysis routine in another, and the analyzed data winds up in a third. It’s far harder to make this kind of mistake, and as a bonus, what you actually did to the data will be more transparent to other observers too.

  10. Anon says:

    So we have one publication that reports a “proven” recipe for room temp semi-conductor, I wonder how that would affect what an AI algorithm would predict about other possible solutions.

  11. awkward_pickle says:

    Brian Skinner’s thread on twitter continues to evolve! Delightful lunch reading.

  12. Anonymous says:

    Bednorz and Mueller disclosed the first YBaCu High Tc superconducting ceramic materials in 1986 and then won the Nobel Prize in 1987. In subsequent stories, it was told that IBM tried to stop their work over and over again. They managed to keep the effort alive by incorporating it into other funded projects by representing it differently. (I forget the details, so I am making up examples: they knew that their goal was high Tc superconductivity but they had to claim that they were working on YBaCu for use in photocopier drums or as ceramic air filters or something else unrelated.) Bednorz and Mueller, Nobel Prize; IBM Management, Boob Prize.

    As submitted manuscripts from IBM, Chu (Houston), and elsewhere started to circulate (1986+), it was noted that many recipes didn’t seem to work. It came out that authors were deliberately submitting incorrect recipes because they had a sneaking suspicion that some reviewers would send their students into their own labs and try to copy the submitted work with the EVER SO POSSIBLE purpose of scooping the submitters or getting a leg up on the next obvious series of experiments for their own patent and career purposes. As far as I know, final recipes were corrected in final submissions or even as late as galley proofs before final publication.

    (A mentor, good friend, and great scientist helped to expose the Schoen fiasco. The kind of training he provided did not prepare me for what I encountered in chemistry in academia, biotech and Big Pharma.)

    1. Rhenium says:

      This is an awesome set on anecdotes. The stuff you’d never hear about in the “literature”.

      Thank you

      1. Anonymous says:

        A couple more: On another blog about this supercon topic, someone mentioned another series of fraudulent articles by physicist Adrian Maxim, ~2000-2008. Maxim made up data AND he made up fictitious co-authors. On at least one paper in a journal that publishes author bios WITH PHOTOS, he submitted photos of those fictitious co-authors. I will try to attach the link to my name.

        Depending on which biography you read (or choose to believe), Kamerlingh Onnes was not much of a scientist. He knew how to raise a huge amount of money for his world leading cryogenics labs at Leiden. He had an extraordinarily skilled staff who could design and build the machines to achieve high vac and low temp (which required a lot of money to do). It was staff scientists who designed and executed measurements of superconductivity in mercury at 4.2 K on their own (and that Onnes wasn’t even there at the time). Later, when told about the result, Onnes’ reaction was more of “Very good. Go find some more stuff to measure.” than “What a discovery!” He was a measurer. A sign above his door read, “Door meten tot weten.” which translates to “Science is measurement” or sometimes “Knowledge through measurement” (weten ~ science; kennis ~ knowledge). I hope that someone else can provide either balance to or corroboration of these anecdotes.

        1. Flying Dutchman says:

          Kamerlingh Onnes, as the story goes, was indeed an old school empiricist. Rather than proposing a hypothesis and attempting experimental verification, his style was “let’s do such and such and see what happens”.
          His motto, “door meten tot weten” is inscribed on the plinth of his bust that stands in front of the old Kamerlingh Onnes Laboratory, which presently houses the Leiden Law School – o tempora, o mores 😉

        2. Isidore says:

          William Thomson, First Baron Kelvin, said it before:
          “I often say that when you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind”

        3. Wavefunction says:

          Something similar can be said of Ernest Lawrence. He was a good albeit not great scientist but a great publicist; tremendously hard working and perspicacious when it came to securing financial support from rich philanthropists. Just like Onnes did, Lawrence had very talented physicists like Alvarez and Wilson working for him, along with theorists like Oppenheimer and Serber who interpreted his results.

          1. loupgarous says:

            Unfortunately, Lawrence forgot all about Oppenheimer’s invaluable help during Oppenheimer’s AEC security classification hearings, when Lawrence shivved him after Teller threw him under the bus.

  13. Uncle Al says:

    A conservative (yeah, well) ambient supercon would be a William Little exciton coax cable, polyacetylene core with chromophore cladding. Add monomer side chains for solubility.

    DOI:10.1126/science.aar8104, DOI:10.1103/PhysRev.134.A1416, DOI:10.1103/PhysRevB.13.4766

    http://www.mazepath.com/uncleal/pave1.png
    … Stereogram. H-atoms and pi-bonds omitted for clarity.

    The [=(Ar)C-C(Ar)=]n boojum might arrive as a polyacetylene living polymer synthesized from a benzil analog monomer via (Tebbe) bis-methyleneation then ADMET (Grubbs) → decorated polyacetylene + H2C=CH2↑ Electron or hole dope as required. Block copolymer (contrasted redox potenials) as a supercon diode. Terminate with sulfur for spontaneous gold connection.

    It doesn’t need to believable, only testable. Near everything that “should be” already is. Metal chain supercons were diddled by Coleman to no hinted success.

  14. Shalon Wood says:

    You know, this raises a question for me.

    You’re an up-and-coming brilliant scientist. You’ve found a high-temperature superconductor. You’re preparing your paper… and two of your graphs, taken at different field strengths, are _identical_.

    No one is going to accept this paper; it’s obviously fraudulent.

    You go back and repeat the measurements, repeatedly, with no change, except that you manage to actually _increase_ the temperature at which the material is superconducting, because of small changes in preparation, which fortunately you happened to note as you made them.

    What do you do? If you publish the actual data, you’ll be decried as a fraud — not only are the graphs identical, but when you repeated your impossible measurments, you made them _better_. If you don’t publish, the world misses out on the superconductor.

    To the best of my knowledge, this has never happened yet, but someday its moral equivalent will. It’d be nice for the poor scientist who ends up in that position to have some sort of consensus opinion to point to when defending their choice.

    1. Isidore says:

      I don’t understand this argument. If you are convinced, after repeating the experiment and double and triple checking your data and you interpretation that it is correct then you publish. You will be derided as a fraud, or at least as a sloppy and careless experimentalist, if nobody else can reproduce your “impossible measurements”. If they can you will be lauded and invited to give plenary lectures at important meetings. Isn’t this how science is supposed to work?

    2. SP123 says:

      That’s not how measurement noise works. The phenomenon you’re describing is of such vanishingly small probability that it’s more likely the scientist will die of asphyxiation because all the molecules of oxygen decided to randomly float to one corner of the room while (s)he was preparing the manuscript. Problem solved.

    3. Anonymous says:

      Shalon: “To the best of my knowledge, this has never happened yet.” And I doubt that it would because it sounds ridiculous. If someone has faith in their work and have double and triple checked it they will often call in colleagues from the department for a sanity check. If all goes well, they will sometimes ask an outside expert to pay a visit. If things still check out, submit. If the reviewers raise issues, address them in reply. If it is something REALLY big, invite them to visit your lab or to send them materials.

      There have been some controversial papers that were delayed for long periods in order to fact check. I think that Benveniste’s “memory water” submission was held up by Nature for a year or so while other labs checked out the claims. While working for NASA, Felisa Wolfe-Simon claimed to have discovered a strain of bacteria (GFAJ-1 wikipedia) that thrived on arsenic and used arsenate instead of phosphate in its DNA backbone. I think that was slowed down — but published — while referees went back and forth for quite a while. (Eventually, the claim was totally debunked and shown to be the result of sloppy and irresponsible research. Referees suggested that particular “killer” experiments be done. The referees were ignored and those experiments were not done.)

      Other examples: The N-Ray investigation took place post-publication, but it’s still a good story. Read about it at wikipedia (link in my name). Wood visited Blondlot’s lab to observe the experiment and — pfffft — game over.

      Pre-pub, I had a friend who was asked to visit a physics lab to help with a “sanity check” on an amazing result. After the usual amenities they went to the lab to look things over. My friend, quite modest about explaining his role, just asked the usual questions that he thought others would have asked (if not personally immersed in the whole thing for many months). “Are you using a Type A or a Type B framistan?” The guy freezes up; asks “please wait here” and rushes from the lab. He returns around 30 min later (it seems he was checking his old data against Type A and Type B) and he now realizes that he was measuring output from a part in the system and not a signal from the sample. END OF EXPERIMENT; NOT A GREAT DISCOVERY. He thanked my friend for saving him from public humiliation.

      I don’t have a real example from chemistry, but you can imagine some. An uninvolved outside observer might ask, “Did you distill your ether? Even a trace of BHT will probably affect your catalyst.”

      To repeat, I think what you propose will never happen.

      On the other hand, some people are extremely careful about what they publish and hold back. Following his death, it was found that Oosterhoff had many unpublished insights into the Conservation of Orbital Symmetry. He was just too careful about publishing a result before he was certain of it. Some think that had he published those papers that the field might have progressed faster and that he might have deserved a part of that Nobel Prize (except he died in 1974; Nobel for Orbital Symmetry was 1981.)

      Other chemists, physicists, mathematicians and others have held back papers (only discovered post mortem) but we only know of THOSE because they were famous or there was someone to go over their papers and not toss them in the dumpster.

      Fermat failed to publish the details of his proof of his theorem in 1637. Wiles published his proof of it in 1994.

      1. AlphaGamma says:

        AFAIK we still don’t know what Fermat’s proof was (it’s fairly unlikely that it was identical to Wiles’s, as the latter relies on methods that were not known in Fermat’s time). Or even if it was correct!

        1. anon says:

          That Fermat indeed had a correct proof of the theorem is about as likely as medieval alchemists actually having found the secret of transmutation.

          1. Li says:

            It was never clear to me whether the note in the margins was intended to be a joke…

      2. Isidore says:

        I recall a (peptide) chemistry example one of my graduate professors mentioned, but it was decades ago so I may not have it correctly; peptide chemists can correct or confirm. It had to do with using anhydrous Tfa to remove some protecting group, that had been reported to work very well in some Russian-language journal (this was the 1980s). American peptide chemists could not reproduce the results. It turned out that a little water was necessary for the deprotection to work and the anhydrous Tfa available in the US was truly anhydrous, but that available in Soviet Russia was not.

        1. milkshake says:

          probably ester sidechain on Asp or Glu. I remember ethyl ester comes off if you let it sit long enough in TFA that has some moisture – I remember a colleague in our lab wanted to keep the sidechain protected as Et ester while deprotecting benzyl and t-Bu groups elsewhere, he quickly found out about this problem

        2. AlphaGamma says:

          See also the “transition-metal-free” Suzuki coupling (actually catalysed by a 50 ppb palladium impurity in the sodium bicarbonate they used).

          Or the reaction that allegedly worked at room temperature- which turned out to need to be heated to 30C as the room in question was in Bangalore and not air conditioned.

    4. M Welinder says:

      This is a materials field. You can simply offer samples of your materials to the first five teams who wish to test. Surely a few labs can spare a graduate student to test such a claim.

      The synthesis, while interesting, is unimportant to the Big Question: is the material superconducting at high temperatures?

      1. b says:

        According to the Skinner Twitter thread, the authors are not making their samples available.

    5. Scott says:

      “You know, this raises a question for me.

      You’re an up-and-coming brilliant scientist. You’ve found a high-temperature superconductor. You’re preparing your paper… and two of your graphs, taken at different field strengths, are _identical_.”
      Your equipment is broken. Call the supplier, have them send a tech out, if you don’t know how to fix it yourself. Actually, you should probably have them send a tech out anyway, since if you managed to break it you obviously don’t know how to set it up.

      I’m an HR major, and I know this.

      But then, I’m also an enlisted (submarine) sailor, and your log data is *never* identical. And that’s for time lags between recordings measured in fractions of an hour, not fractions of a second. It’s even worse as the time between recordings decreases. Logs repeated set after set are only ever obtained by not actually taking the recordings. And that’s been determined by the sum of knowledge throughout naval history.

    6. loupgarous says:

      In a case like that, you may have discovered an entirely new physical effect. However, the law of parsimony requires you to check and then have someone else check your experimental setup, as it’s vastly more probable something’s wrong there.
      Saying the gods smiled on you, no one can find an issue, and you’ve made test runs with other stuff, so you get non-identical noise as usual, hmmm.
      You didn’t mention the instrument in question, and probably wouldn’t need to if i worked in high-temp superconductors. But then you and some physics guys need to mull the issue – some sort of polarization that affects your sensor in a way that polarizes the normal sources of noise (some weird off-shoot of Meissner effect, say).
      At this point, you’ve gone beyond high-temperature research into a potentially un-observed effect in physics. If you’re scrupulous in how you do things, you may be sharing a Nobel down the road. If you finagle your results, you lose. It just varies how badly.

  15. annonymous says:

    In the supplementary info of the original arXiv version, in Fig. S8(a) and (c), the few data points of resistance after the transition temperature also show striking similarity in trend, although they are from different samples and the values are different. The similarity is absent in another set of measurement, Fig. S8(b). It is well known that behavior near critical point is universal, the presence of similarity in two sets of different measurements and absence in another set is surprising, needs special attention and could have further implications.

  16. milkshake says:

    one thing that is worth considering – the shittiest research integrity standards are to be found in the nanoparticle subfield. Cherry-picking datapoints and EM images as representative is endemic in the nanoparticle literature. This is why especially in the therapeutic drug-loaded nanoparticle subfield there has been little progress. Research groups operate on wishful thinking, postdoc and grad students churn out papers without attention being paid to basic control experiments. Faulty papers are not retracted.

    1. Anonymous says:

      Amen!

  17. An Old Chemist says:

    R. B. Woodward, the legendary organic chemist of all times, was working on organic conducting materials, just before his death. The C&E News talked about it, when in 2011, more than 30 years after his death, his notes on this subject were unearthed, by Woodward’s son. The handwritten notes were neatly packed in a cardboard box. These notes of Woodward were published in Tetrahedron in 2011:

    https://cen.acs.org/articles/89/i22/Woodwards-Unfinished-Work.html

  18. The newly “discovered” Au-Ag nano particle composite superconductor may or may not be a true story, however the kind of scientific reaction the same has attracted is welcome. If, the discovery proves right will value the silence of the Inventors, if NOT than not only them but will be a lesson to the larger scientific community. The Science Mag. Blog and the plenty of reactions to the same are very interesting, worth a read again and again for any one.

    1. Anonymous says:

      Awana: “the kind of scientific reaction the same has attracted is welcome. If, the discovery proves right will value the silence of the Inventors, if NOT than not only them but will be a lesson to the larger scientific community.” A LESSON? The original authors seem to have missed out on many lessons, succinctly stated and restated as “Extraordinary claims require extraordinary proof.” – Carl Sagan, 1979.

      I think that this pub is not going to hold up and it is going to WASTE huge amounts of time and money and other resources as it is investigated. (Here I am, wasting my time posting about this happening all too often!) That consumes resources that could be put to better use elsewhere.

      Cold Fusion diverted dozens, even hundreds or more, of researchers away from better projects. From Skinner’s twitter, Andrew Rhyne posted about his effort to reproduce an important analytical chemistry result; it was a part time effort spanning four years and multiple labs. (I will add the link to my name.)

      A fraudulent lysergic acid synthesis (Org. Lett., 2004, 6 (1), pp 3–5,
      DOI: 10.1021/ol0354369, still not retracted) led to the waste of considerable time and effort by another group to make use of it before exposing it (Org. Lett., 2012, 14 (1), pp 296–298. DOI: 10.1021/ol203048q ).

      The original authors (Thapa and Pandey) should have checked their results VERY carefully and possibly called in others for verification before publication.

      1. tt says:

        I wonder how many hundreds of millions of dollars were wasted (as well as research time) investigating “Dr.” Wakefield’s fraud. False claims do cause damage, and the crime is even more egregious when willfully carried out, as opposed to an honest mistake.

        1. tt says:

          Oops…forgot to mention all of the kids who then died because of Wakefield’s fraud. This isn’t nearly the same level as that, but extraordinary false claims can have dire consequences across many dimensions.

  19. Conundrum says:

    Interesting notes here. Coincidentally I too might have found something (see earlier notes about graphite and alkanes) but at the time it looked like just a resistance *drop* not all the way to zero. I really need to test it again under better conditions because only some graphite samples showed the effect where others did not.

  20. harsh jain says:

    The comparison with Schohn is almost alleging that the data is Fabricated and ruling out the possibility that it could be a mistake. It’s also threatening to places developing in the field of science by big giants at science magazine.
    Not expected of scientists to jump to conclusions so irresponsibly.
    It’s a world changing result, but it’s a two member team in a country where science is grossly under-funded. It could be a mistake in data analysis.

    1. milkshake says:

      You are quite right, it could be the usual course of sloppy science and wishful thinking with extra dollop of chutzpah that is so commonly served in certain parts of your subcontinent…

      1. An Old Chemist says:

        milkshake, ” with extra dollop of chutzpah that is so commonly served in certain parts of your subcontinent…”. This statement is nothing with chutzpah from people of your part of our planet earth, which I have encountered so often. In countries where science is not well-funded and hence is not part of the culture such results get published. Philip Eaton told us in his class that the first ever synthesis of cubane was published in a Russian journal, but their reported melting point was tens of degrees off!!!

        1. milkshake says:

          I would disagree, up until 70s, CCCC (“Collections of Czechoslovak Chemical Comminications”) had impact factor higher than Helvetica, and definitely higher than Liebigs Annalen under Eastern Germany. The procedures were rock solid – I know this because I never had problem reproducing them. With respect to Russian journals, it is a mixed bag. The biggest issue there was a lack of high-field NMRs. This definitely hindered the natural product chemistry and total synthesis in Soviet Union.

          With respect to cubane, the melting points can be skewed easily because cubanes tend to be fairly high-melting solids that sublimate readily. So you need to do melting point the old fashioned way, and use a sealed capillary – if you use Kofler heated block microscopy apparatus that used to be popular in the Eastern Europe, with open slide, while your material sublimates, it is likely to be off by something like 20 degrees.

  21. DSTrasi says:

    The term ‘ resistance’ used for measurement should have been either surface resistivity or volume resistivity. If volume resistivity then the figure claimed in the range of 10^-4 is not low, since volume resistivity of copper at room temperature is 1.7 * 10^-6 Ohm cm

  22. MatthewTKK says:

    And now a piece in Scientific American by Shannon Hall (linked in my profile name) appears to have lifted the bulk of its content – paraphrased of course – from your presentation here Derek. Pretty disingenuous. Same narrative, same links presented in the same order, with some additional quotes.

    1. Derek Lowe says:

      I actually have no problem with that one – I think that’s how pretty much any article on this subject would come out. . .

      1. MatthewTKK says:

        I guess – but the similarity is uncanny. She did take the time to seek out comments and quotes though so I suppose it’s just fair-game journalism.

      2. Scott says:

        If she found your blog and then wrote that article, would have been nice (for values of “nice” including “required at my university”) if she had cited your blog. Though I realize that it’s pretty good odds that any article on the mess comprehensible by Joe Average is going to sound an awful lot like what you wrote.

  23. N.Adamopoulos says:

    Some years ago, during my PhD research in Type II superconductors, I had a series of results showing extremely hard superconductivity (trapped magnetization at very high external fields). It was a breaking result and send me to the moon. But I repeated the experiment three times and could not reproduce the results. I suppose everybody does the same and checks the reproducibility of the experiment extensively.

  24. jack hadley says:

    Well this is a fun one!

    The things about this that strike me as most interesting/significant I think while pondering “what if it were true” ?

    Keeping in mind that flieschmann & ponds were forced to publish early by a doe spy that had gotten a copy of their experimental setup/data, and that “low energy level nuclear reactions” involving paladium are now relatively well accepted theoretically and experimentally…. (scientists came to this position some time after flieschman and ponds were brutally discredited / maligned and laughed out of professional science )

    The legend around the campfire is that the doe/military/national secrecy state personally made sure that the “pure” paladium samples obtained by acedemic institutions following up on fleishmann ponds claims were doped with a trace impurity found to inhibit the effect. All of the institutions obtained their samples, doped to discredit cold fusion, from one supplier and reported loudly to the media that the experiments didn’t work and that flieschman ponds were frauds. Even though their claims have been replicated today, there is still a dark cloud of “bunk science”, fraud, and the general discrediting of “cold fusion” (renamed “low energy level nuclear reaction” by a scientist looking to study cold fusion and keep their funded job) associated with their names.

    It does seem somewhat likely that this gold/silver alloy is a fraud, but I can’t help but remember fliechmann ponds and think “what if it WAS true”? The fact is that if there were a possibility to make a room temperature superconductor from gold and silver the “ptb” would do everything in their power to make sure that didn’t become commonly known (much like cold fusion from palladium) They would go out of their way to prevent other teams from replicating or even attempting to replicate (due to the danger they may re-discover something even if the original team didn’t publish the required detail to reproduce the experiment) something like this…. Exactly the same as they did to flieshmann ponds, and for the same reasons (I suspect)

    If you haven’t watched Dr. Strangelove (or studied any modern american history with a working brain and a keen interest “between the lines”), you may not fully appreciate the pathological madness of the security state and those that dwell within it. These people are not monsters, but like horses, they are big, dumb and easily frightened. They do inhuman and truly demonic things in the holy name of “national security”, and have been caught with their dicks in the cookie jar so many times it is a fucking miracle anyone ever craves a cookie again. My point is, keeping scientific / strategic / industrial technology and innovation away from society is one of the primary functions of the military-industrial complex by design and they have cheated (and been caught cheating) repeatedly in the past (yes, they have cheated even more than, every year, the systemic theft of spending more than half of our nations wealth on technological/scientific advancement it does not share ,and conspires actively to do worse than that, with the people who’s money and lives has been spent on it). In general it is for “good reasons” (we tell ourselves, and they do the same) that these national security attrocities are routinely carried out in our name. Presumably the people that decided to discredit cold fusion did so because they were afraid of the instability that that could potentially introduce to the current world economy (imagine a world war over palladium, or gold and silver…. now that everyone in the world wants them desperately…..). The revolution will not be televised, and the advancements that will make life better for greater humanity (or could) will not be published for the exact same reason. Obfuscation makes this easy enough alone, and if someone discovers something that “shouldn’t be” based on their flawed but internalized worldview they will mostly be convinced by other scientists that it’s impossible and not publish anyway. The reason we are usng copper oxides now is because we don’t understand superconductivity. We expect our model’s and theoretical understandings to lead us to a solution, but that just isn’t how discovery typically works. We added lead to gas because we tried all the other elements first, and it was the one that best prevented the “knocking”… We should obviously be systematically brute forcing this problem with literally no regard for pre-existing theory, the fact that we are not most supports the view that we (industry, money) do not want to find this answer (like so many other possible technological advancements) and will not commit to do so in a substantial way.

    1. Design Monkey says:

      hadley’s kooky fantasies about cold fusion hiding conspiracy are easily refutable. One of largest world palladium supplier is Russia. At times of cold fusion bubble – Soviet Union. If the evil CIA/NSA/DOE/FBI/ZOG were deliberately tainting Western world academics palladium to stop their research, then they were pretty much handing cold fusion over to soviets on a dainty china plate.

      Didn’t happen. There isn’t anything worth about cold fusion neither in West, nor in Russia.

      1. Scott says:

        Now, if you wanted to make a joke about the Soviets poisoning the Fusion power ideas well with their tokamak claims, *then* you might have something.

        1. Design Monkey says:

          scotty, this was about kooky claims of jack hayden about cold fusion.

          If you have kooky claims about hot fusion, that is a separate matter.

  25. Sxa says:

    A really large number of 1 ohm resistors in parallel makes the cheapest room temperature super conducter.

  26. XTPwpn0j41 says:

    Hi. I might have hit the proverbial jackpot here. Something that may have been missed is a so called narrow band re entrant HTSC at arounder 282K in a metal alloy. It is very narrow but the resistance drop is in the 10:1 ratio so worth investigating

  27. All too often the “bean counters” tend to be telling us how we are usually falling short.
    They come up with a few scheme to get us to see more patients than you can reasonably see or how you can “create” more procedures than are called for.

    This is bottom-line or practice-centered medicine and
    in my opinion is unethical as well as immoral. It is also outside of whatever you are called to
    do and is needless and counter to a healthy practice.
    What I believe builds a healthy practice and is just at the heart
    of doing what is right for patients, is the patient-centered seek the advice of.
    This type of consult is designed to get to the root of the patient’s concerns and do all one can because of help them
    achieve their health and aesthetic goals.

    In this regarding population-based medicine we have all
    already been told to do the bare minimum, but that doesn’t change the fact that our patients are concerned having optimal health and
    results. Olympic athletes do not win their contests by training to the minimum nor will all of our patients be served by giving the minimum.
    Let’s have a look at an example of how population-based medication is creeping into the test room in a way that is not fully understood by physicians nevertheless has great impact
    on the individual (many similar examples are visible medicine today):

    The drug corporations tell us that Plavix is mostly about
    30% better than aspirin. What they do not tell us is that it is fairly
    30% better. In definite terms it is about 1% better.
    What does this mean? Well, in a study on CVA the particular relative risk reduction has been quoted as 25% however the
    absolute reduction was 0. 9 for ASA as opposed to 1 .
    2 for Plavix or about 0. 3% (1). Now Plavix
    costs $5. 00 per supplement and ASA is about $0. 05 so to the individual
    over a fixed income is the total difference of 0. 3% worth $4.
    95 every day? Maybe, maybe not depending on quite a few
    factors. Certainly it may be worth it to society but community is
    not paying the bill… the affected person on a fixed income is
    actually. This is the confusion between inhabitants based and
    individual medicine. Some have even encouraged taxing or eliminating Functional
    procedures to reduce overall health charges in the US.
    This may help some number followed by economists however
    is it serving the individual who is interested in a specific goal?

    So what is the patient-centered consult? Medication is complex and in distinct, Aesthetic Medicine is intricate,
    yet it has been reduced to sound bites on TV. Tv ads ask the question “Is it better than Botox? inches or “Is
    it better than a Medical Peel? ” yet they do not give the reply or any real helpful information. Sufferers have, in general, no reasonable idea of what can and should not be done for them. The patient-centered consult is an educational knowledge for the patient that helps these individuals understand what is realistic and exactly is not.

    It starts having gaining a detailed understanding of the particular patient’s concerns are, certainly not what treatments they are thinking about. Most aesthetic patients come in thinking they know what they need. As an example many think they want an upper lid blepharoplasty but what they really need is really a brow lift. Other are available in asking about fillers nevertheless really need Botox or the other way round. The understanding of what they are concerned with is found not by questioning what they are interested in but rather, exactly what their concerns are. We all start in a conversational method. Most often a patient will start through saying something like “I think I need
    Botox right here. very well My answer is generally something similar to, “Well, that is certainly something we can easily do, but what is it generates you want Botox? ” The following
    several questions are inclined to helping the
    patient target the genuine issues behind the issues such as texture,
    tone, tightness, wrinkles, poor size, volume level etc .

    I use a consult tool I call often the $10, 000 mirror. We now have a simple hand mirror
    which has no magnification on one edge and 3 to 5
    times magnification on the other. I hand it to the patient with the magnified side facing them.
    Often the interesting thing is that most persons when given the mirror
    will start looking very intently at themselves and even start picking and brushing
    from things on their face. Then i have a checklist of items My partner and i ask them
    about. We go through the checklist item by product and discuss its impact on the overall appearance of the confront.
    Once this is completed, We formulate a plan of all that you can do for them, that will include things I can do
    but also things others may be able to do. For example, I do not do face lifts, but if the result
    these are after is best served with a face-lift, I put that on the plan. It is rare that we
    don’t do many of what they will benefit from.

  28. All too often the “bean counters” are usually telling us how we are usually falling short.

    They come up with a number of scheme to get us to find out more patients than you
    can reasonably see or the way to “create” more procedures when compared
    with are called for. This is bottom-line or practice-centered medicine including
    my opinion is unethical and immoral. It is also outside
    of anything you are called to do and is unnecessary
    and counter to a wholesome practice. What I believe generates a healthy practice and is easily at the heart of doing
    what is good for patients, is the patient-centered seek
    the advice of. This type of consult is designed to
    arrive at the root of the patient’s problems and do all one can do to help them achieve their health and aesthetic goals.

    In this associated with population-based medicine we have all been told to do
    the bare minimum, but that doesn’t change the undeniable
    fact that our patients are concerned using optimal health
    and results. Olympic athletes do not win their particular
    contests by training for the minimum nor will all of our patients be
    served by providing the minimum. Let’s examine
    an example of how population-based medication is creeping into the
    examination room in a way that is not fully understood by physicians yet has great impact on the affected person (many similar examples may be seen in medicine today):

    The drug corporations tell us that Plavix is approximately 30% better than aspirin.
    Them not tell us is that it is fairly 30% better.
    In total terms it is about 1% better. What does this mean? Well, in a single study on CVA
    the relative risk reduction had been quoted as 25% even so the
    absolute reduction was 0. 9 for ASA versus 1 .
    2 for Plavix or about 0. 3% (1). Now Plavix charges $5. 00 per capsule and ASA is about $0.

    05 so to the individual over a fixed income is
    the complete difference of 0. 3% worth $4. 95 each day?

    Maybe, maybe not depending on quite a few factors.

    Certainly it may be worth it to society but society is not paying the bill…
    the individual on a fixed income is. This is the confusion between population based and individual remedies.

    Some have even endorsed taxing or eliminating Aesthetic procedures to reduce overall health expenses in the US.
    This may help some number followed by economists however is it serving the individual who is interested in a specific goal?

    What exactly is the patient-centered consult? Remedies
    is complex and in certain, Aesthetic Medicine is sophisticated, yet it has been reduced to sound bites on TV.
    Ads ask the question “Is it better than Botox? inches or “Is it superior to a Medical Peel?
    ” yet they do not give the respond to or any real helpful information. Sufferers have, in general, no sensible idea of what can and are not done for them. The patient-centered consult is an educational encounter for the patient that helps all of them understand what is realistic and is not.

    It starts together with gaining a detailed understanding of what patient’s concerns are, not necessarily what treatments they are interested in. Most aesthetic patients also come in thinking they know what they need. As an example many think they need an upper lid blepharoplasty but what they really need is actually a brow lift. Other also come in asking about fillers however really need Botox or vice versa. The understanding of what they are focused on is found not by wondering what they are interested in but rather, precisely what their concerns are. Many of us start in a conversational manner. Most often a patient will start simply by saying something like “I believe I need Botox right here.
    inch My answer is generally something such as, “Well, that is certainly something we could do, but what is it that produces you want Botox? ” The next
    several questions are fond of helping the patient target the true issues behind the fears
    such as texture, tone, tightness, wrinkles, poor size, amount etc .

    I use a consult tool I call the actual $10, 000 mirror.
    Looking for a simple hand mirror containing no magnification on one
    part and 3 to 5 times addition on the other. I hand it to the patient with the
    amplified side facing them. Typically the interesting thing is that
    most men and women when given the looking glass will start looking very intently at themselves and even start off picking and brushing on things on their
    face. When i have a checklist of items I ask them about.
    We have the checklist item by merchandise and discuss
    its effect on the overall appearance of the deal with. Once this is completed,
    My spouse and i formulate a plan of all that
    can be done for them, that will include points I can do but
    also items others may be able to do. As one example, I do not do face lifts, but
    if the result these are after is best served by the face-lift, I put which on the plan. It is exceptional that
    we don’t do nearly all of what they will benefit from.

  29. Merely the “bean counters” tend to be telling us how we are usually falling short.
    They come up with some scheme to get us to determine more patients
    than we are able to reasonably see or tips on how to “create”
    more procedures compared to are called for. This is bottom-line or practice-centered medicine
    and my opinion is unethical as well as immoral.

    It is also outside of everything we are called to do and is needless and counter to a healthful practice.
    What I believe develops a healthy practice and is just at the heart of
    doing what is good for patients, is the patient-centered check with.
    This type of consult is designed to get to the root of the
    patient’s concerns and do all one can do to
    help them achieve their strengthening aesthetic goals.

    In this involving population-based medicine we have all also been told to do the minimum, but that
    doesn’t change the proven fact that our patients are concerned together with optimal health and results.
    Olympic athletes do not win all their contests by training to the minimum nor will the patients be served by
    providing the minimum. Let’s take a look at an example
    of how population-based drugs is creeping into the test room in a way that is not totally understood by physicians and
    yet has great impact on the affected person (many similar examples may be seen in medicine today):

    The drug firms tell us that Plavix is mostly about
    30% better than aspirin. Them not tell us is that it is comparatively 30% better.
    In definite terms it is about 1% better. What does this mean? Well,
    in one study on CVA the relative risk reduction ended up being quoted as 25% but the absolute reduction was zero.

    9 for ASA compared to 1 . 2 for Plavix or about 0.

    3% (1). Now Plavix charges $5. 00 per capsule and ASA is about $0.
    05 so to the individual over a fixed income is the absolute difference of 0.
    3% worth $4. 95 daily? Maybe, maybe not depending on many factors.

    Certainly it may be worth it to society but culture is not paying the bill…

    the individual on a fixed income is actually. This is the confusion between people based and individual drugs.
    Some have even recommended taxing or eliminating Functional procedures to reduce overall health
    expenses in the US. This may help several number followed by economists but is it serving the individual who will be interested in a
    specific goal?

    Just what exactly is the patient-centered consult? Medicine is complex and in certain, Aesthetic Medicine is complicated, yet it has been reduced for you to sound
    bites on TV. Advertisements ask the question “Is it better than Botox? very well or “Is it a lot better than a Medical Peel?
    inch yet they do not give the answer or any real helpful information. Affected individuals have,
    in general, no reasonable idea of what can and can not be done for them.
    The patient-centered consult is an educational encounter for the patient that helps all of them understand what is realistic and what is
    not.

    It starts using gaining a detailed understanding of what patient’s concerns
    are, definitely not what treatments they are interested in. Most aesthetic patients also come in thinking they know what they demand.
    As an example many think they require an upper lid blepharoplasty but what
    they really need is often a brow lift. Other also come in asking about fillers yet really need Botox or the other way round.
    The understanding of what they are concerned about is found not by requesting what they
    are interested in but rather, precisely what their concerns are.
    We all start in a conversational approach.
    Most often a patient will start by simply saying something like “I feel I need Botox right here. very well My answer is generally something like, “Well, that is certainly something you
    can do, but what is it which makes you want Botox? ” Another several questions are provided to helping the patient target the real issues behind the issues such as texture, tone, rigidity, wrinkles, poor size, quantity etc .

    I use a consult tool I call typically the $10, 000 mirror. We certainly have a simple hand mirror which includes no magnification on one side and 3 to 5 times addition on the other. I hand that to the patient with the amplified side facing them. The particular interesting thing is that most persons when given the hand mirror will start looking very intently at themselves and even get started picking and brushing from things on their face. Then i have a checklist of items My spouse and i ask them about. We work their way through the checklist item by merchandise and discuss its affect on the overall appearance of the deal with. Once this is completed, I formulate a plan of all that can be done for them, that will include stuff I can do but also points others may be able to do. As one example, I do not do face lifts, but if the result these are after is best served by the face-lift, I put which on the plan. It is rare that we don’t do most of what they will benefit from.

  30. Claims the “bean counters” tend to be telling us how we
    are usually falling short. They come up with a
    few scheme to get us to determine more patients than you can reasonably see or tips
    on how to “create” more procedures when compared with are called for.
    This is bottom-line or practice-centered medicine and in my opinion is unethical along with immoral.

    It is also outside of whatever you are called to do and is unwanted and counter to a balanced practice.
    What I believe builds a healthy practice and is merely at
    the heart of doing what is right for patients, is the
    patient-centered consult. This type of consult is designed to reach the root of the patient’s concerns and do all one can do to
    help them achieve their into the aesthetic goals.

    In this associated with population-based medicine we have all already
    been told to do the minimum amount, but that doesn’t change the undeniable fact that our patients are concerned together
    with optimal health and results. Olympic athletes do not win their own contests by
    training towards the minimum nor will our patients be served by giving the
    minimum. Let’s examine an example of how population-based treatments is creeping
    into the quiz room in a way that is not entirely understood by
    physicians however has great impact on the individual (many similar examples are visible in medicine today):

    The drug firms tell us that Plavix is about 30% better than aspirin. Them not tell us is that it
    is comparatively 30% better. In total terms it is about 1% better.
    What does this mean? Well, in a study on CVA the actual
    relative risk reduction had been quoted as 25% nevertheless the absolute reduction was zero.
    9 for ASA versus 1 . 2 for Plavix or about 0. 3% (1).
    Now Plavix charges $5. 00 per tablet and ASA is about $0.
    05 so to the individual with a fixed income is the definite difference of
    0. 3% worth $4. 95 on a daily basis? Maybe, maybe not depending on quite a few factors.
    Certainly it may be worth the cost to society but community is not paying
    the bill… the affected person on a fixed income is usually.
    This is the confusion between people based and individual medication. Some have
    even strongly suggested taxing or eliminating Artistic procedures
    to reduce overall health charges in the US. This may help a number of number followed by economists yet is
    it serving the individual who may be interested in a specific goal?

    Precisely what is the patient-centered consult?

    Medicine is complex and in particular, Aesthetic Medicine is complex, yet it has been reduced to help sound bites on TV.

    Advertisements ask the question “Is it better than Botox? very well or “Is it greater than a Medical Peel?
    inches yet they do not give the response or any real helpful information. Individuals have,
    in general, no sensible idea of what can and can not be
    done for them. The patient-centered consult is an educational encounter for the patient
    that helps these individuals understand what is realistic and what is not.

    It starts using gaining a detailed understanding of
    what the patient’s concerns are, certainly not what treatments they are interested in. Most aesthetic patients also come in thinking they know
    what they really want. As an example many think they need
    an upper lid blepharoplasty but what they really need is
    often a brow lift. Other can be found in asking about fillers however really need Botox or the other way round.
    The understanding of what they are concerned with is found not by asking what they are interested in but rather,
    precisely what their concerns are. We start in a conversational method.
    Most often a patient will start simply by saying something like “I believe I need Botox right here. micron My answer is generally something similar to, “Well, that is certainly something we can do, but what is it which makes
    you want Botox? ” Another several questions are inclined to helping the patient target the important issues behind the problems such as texture, tone, constriction, wrinkles, poor size, quantity etc .

    I use a consult tool I call the $10, 000 mirror. We now have a simple hand mirror which has no magnification on one part and 3 to 5 times zoom on the other. I hand this to the patient with the amplified side facing them. The interesting thing is that most persons when given the reflection will start looking very intently at themselves and even start off picking and brushing from things on their face. When i have a checklist of items We ask them about. We work their way through the checklist item by product and discuss its affect the overall appearance of the encounter. Once this is completed, We formulate a plan of all that can be done for them, that will include stuff I can do but also things others may be able to do. As one example, I do not do experience lifts, but if the result they may be after is best served by just a face-lift, I put in which on the plan. It is exceptional that we don’t do nearly all of what they will benefit from.

  31. All too often the “bean counters” tend to be telling us how we are falling short.
    They come up with some scheme to get us to discover more patients
    than we can easily reasonably see or tips on how to “create” more procedures in comparison with are called
    for. This is bottom-line or practice-centered medicine since my opinion is unethical
    along with immoral. It is also outside of anything you are called to do and is pointless and counter to a
    wholesome practice. What I believe generates a healthy practice and is simply at
    the heart of doing what is good for patients, is the patient-centered seek the advice of.
    This type of consult is designed to be able to the
    root of the patient’s issues and do all one can because of
    help them achieve their strengthening aesthetic
    goals.

    In this regarding population-based medicine we have all already been told
    to do the minimum amount, but that doesn’t change the simple fact that our patients are concerned
    with optimal health and results. Olympic athletes
    do not win their contests by training towards the minimum
    nor will the patients be served by giving the minimum.
    Let’s check out an example of how population-based treatments is
    creeping into the exam room in a way that is not thoroughly understood by physicians however has great impact on the individual (many similar examples are visible in medicine today):

    The drug organizations tell us that Plavix is around 30% better than aspirin.
    What they do not tell us is that it is actually comparatively 30% better.

    In absolute terms it is about 1% better. What does
    this mean? Well, a single study on CVA the particular
    relative risk reduction was quoted as 25% even so the absolute reduction was 0.
    9 for ASA as opposed to 1 . 2 for Plavix or about 0. 3% (1).
    Now Plavix charges $5. 00 per tablet and ASA is about $0.
    05 so to the individual for a fixed income is the absolute difference of 0.
    3% worth $4. 95 per day? Maybe, maybe not depending on several factors.
    Certainly it may be more than worth it to society but contemporary society is not paying the bill…
    the person on a fixed income is. This is the confusion between people based and individual treatments.
    Some have even endorsed taxing or eliminating Cosmetic
    procedures to reduce overall health charges in the
    US. This may help a number of number followed by economists nevertheless
    is it serving the individual who is interested in a specific goal?

    So what is the patient-centered consult? Remedies is complex and in specific,
    Aesthetic Medicine is sophisticated, yet it has been reduced in order to
    sound bites on TV. Ads ask the question “Is it better than Botox? very well or “Is it better
    than a Medical Peel? ” yet they do not give the response or any real helpful information. People have, in general, no natural idea of what can and should not be done for them. The patient-centered consult is an educational experience for the patient that helps all of them understand what is realistic and what is not.

    It starts together with gaining a detailed understanding of the actual patient’s concerns are, not what treatments they are enthusiastic about. Most aesthetic patients appear in thinking they know what they really want. As an example many think they require an upper lid blepharoplasty but what they really need is really a brow lift. Other are available in asking about fillers nevertheless really need Botox or vice versa. The understanding of what they are concerned with is found not by requesting what they are interested in but rather, what their concerns are. We start in a conversational fashion. Most often a patient will start through saying something like “I assume I need Botox right here.
    very well My answer is generally similar to, “Well, that is certainly something we can easily do, but what is it that makes you want Botox? ” Another several questions are presented to helping the patient target the important issues behind the concerns
    such as texture, tone, rigidity, wrinkles, poor size, volume level etc .

    I use a consult tool I call the particular $10, 000 mirror.
    Looking for a simple hand mirror which has no magnification on one part and 3 to 5 times magnification on the other.
    I hand that to the patient with the zoomed side facing them.
    Often the interesting thing is that most people when given the reflect will start
    looking very intently at themselves and even get started picking and brushing at things on their
    face. I then have a checklist of items We ask them about.
    We feel the checklist item by piece and discuss its influence on the overall appearance of
    the deal with. Once this is completed, We formulate a plan of all
    you can do for them, that will include points
    I can do but also points others may be able to do. For example, I do not do face lifts, but if the result they
    are really after is best served by the face-lift, I put that will on the plan. It is hard to find
    that we don’t do most of what they will benefit from.

  32. Sometimes the “bean counters” are usually telling us how we are usually
    falling short. They come up with some scheme to
    get us to discover more patients than we can reasonably see or tips
    on how to “create” more procedures as compared to are called for.

    This is bottom-line or practice-centered medicine including my opinion is unethical and immoral.
    It is also outside of what we are called to do
    and is pointless and counter to a wholesome
    practice. What I believe generates a healthy practice and is basically at the heart of doing what is good for patients,
    is the patient-centered talk to. This type of consult
    is designed to are able to the root of the patient’s issues and do all one
    can because of help them achieve their into the aesthetic goals.

    In this associated with population-based medicine we have
    all recently been told to do the lowest, but that
    doesn’t change the simple fact that our patients are
    concerned along with optimal health and results.
    Olympic athletes do not win all their contests by training for the minimum nor will the patients be served by providing the minimum.
    Let’s examine an example of how population-based treatments is
    creeping into the assessment room in a way that is
    not completely understood by physicians however has great impact on the (many similar examples are visible in medicine today):

    The drug companies tell us that Plavix is about 30% better than aspirin. Them not tell us is that
    it is actually comparatively 30% better. In complete terms it is about 1% better.
    What does this mean? Well, in one study on CVA the particular relative risk
    reduction has been quoted as 25% however the absolute reduction was zero.
    9 for ASA vs 1 . 2 for Plavix or about 0. 3% (1).
    Now Plavix costs $5. 00 per supplement and ASA is about
    $0. 05 so to the individual for a fixed income
    is the overall difference of 0. 3% worth $4. 95 per day?
    Maybe, maybe not depending on a lot of factors.

    Certainly it may be more than worth it to society but modern society is not paying the bill…
    the person on a fixed income will be. This is the confusion between inhabitants based
    and individual medication. Some have even encouraged
    taxing or eliminating Cosmetic procedures to reduce overall health costs in the US.
    This may help some number followed by economists yet is it serving the individual
    who may be interested in a specific goal?

    So what on earth is the patient-centered consult? Medication is complex and in special,
    Aesthetic Medicine is sophisticated, yet it has been reduced to help sound bites on TV.
    Tv ads ask the question “Is it better than Botox? very well or “Is it much better than a Medical Peel?
    very well yet they do not give the response or any real helpful information. Individuals have, in general, no realistic idea of what
    can and is not done for them. The patient-centered consult is an educational practical experience for the
    patient that helps all of them understand what is realistic and
    exactly is not.

    It starts having gaining a detailed understanding of what patient’s concerns are,
    not necessarily what treatments they are enthusiastic about.
    Most aesthetic patients also come in thinking they know what they need.

    As an example many think needed an upper lid blepharoplasty but what they really need can be a brow lift.
    Other appear in asking about fillers nevertheless really
    need Botox or vice versa. The understanding of what they are concerned with is found not by questioning what they are
    interested in but rather, what exactly their concerns are.
    We start in a conversational way. Most often a patient will
    start simply by saying something like “I believe I need Botox right here. inch My answer is generally something such as, “Well, that is certainly something we are able to do, but what is it
    that makes you want Botox? ” The following several questions are presented to helping the patient target the true issues behind the concerns such as texture, tone, rigidity, wrinkles, poor size, level etc .

    I use a seek advice from tool I call the actual $10, 000 mirror. We now have a simple hand mirror containing no magnification on one part and 3 to 5 times zoom on the other. I hand that to the patient with the zoomed side facing them. The interesting thing is that most persons when given the reflect will start looking very intently at themselves and even start off picking and brushing in things on their face. When i have a checklist of items I actually ask them about. We have the checklist item by thing and discuss its effect on the overall appearance of the face. Once this is completed, We formulate a plan of all that can be done for them, that will include issues I can do but also stuff others may be able to do. As an example, I do not do experience lifts, but if the result they can be after is best served by way of a face-lift, I put which on the plan. It is hard to find that we don’t do nearly all of what they will benefit from.

  33. Too often the “bean counters” usually are telling us how we usually are falling short.
    They come up with a number of scheme to get us to find out
    more patients than we could reasonably see or how you can “create” more procedures when compared with are called for.
    This is bottom-line or practice-centered medicine and in my opinion is unethical and also immoral.
    It is also outside of whatever you are called to do and is unnecessary and counter to a healthy practice.
    What I believe forms a healthy practice and is basically at the heart of
    doing what is right for patients, is the patient-centered consult.
    This type of consult is designed to arrive at the root of the patient’s issues and do all one can because of help them achieve their health and aesthetic goals.

    In this regarding population-based medicine we have all
    been told to do the minimal, but that doesn’t change
    the fact that our patients are concerned along with optimal health and
    results. Olympic athletes do not win their own contests
    by training to the minimum nor will all of our patients be
    served by providing the minimum. Let’s check out an example
    of how population-based medication is creeping into the examination room
    in a way that is not thoroughly understood by physicians but has great
    impact on the person (many similar examples may be
    seen in medicine today):

    The drug firms tell us that Plavix is mostly about 30% better than aspirin. What they
    do not tell us is that it is comparatively 30% better.
    In total terms it is about 1% better. What does this mean? Well, in a
    single study on CVA often the relative risk reduction has been quoted as
    25% but the absolute reduction was zero. 9 for ASA against 1 .
    2 for Plavix or about 0. 3% (1). Now Plavix prices $5.
    00 per product and ASA is about $0. 05 so to the individual on a
    fixed income is the absolute difference of 0. 3% worth $4.
    95 every day? Maybe, maybe not depending on several factors.
    Certainly it may be worthwhile to society but community is not paying the bill…
    the person on a fixed income will be. This is the confusion between population based and individual remedies.
    Some have even endorsed taxing or eliminating
    Cosmetic procedures to reduce overall health costs in the US.
    This may help several number followed by economists nevertheless is it serving the
    individual that is interested in a specific goal?

    So what on earth is the patient-centered consult? Drugs is complex and in specific, Aesthetic Medicine is intricate, yet it has been reduced in order to sound bites on TV.
    Tv ads ask the question “Is it better than Botox? ” or “Is it superior to a Medical Peel? inch yet they do not give the respond to or any real helpful information. Affected individuals have, in general, no sensible idea of what can and are not done for them. The patient-centered consult is an educational encounter for the patient that helps these individuals understand what is realistic and is not.

    It starts with gaining a detailed understanding of the particular patient’s concerns are, certainly not what treatments they are enthusiastic about. Most aesthetic patients can be found in thinking they know what they really want. As an example many think needed an upper lid blepharoplasty but what they really need is really a brow lift. Other come in asking about fillers although really need Botox or the other way round. The understanding of what they are concerned with is found not by inquiring what they are interested in but rather, just what their concerns are. We all start in a conversational manner. Most often a patient will start by means of saying something like “I
    think I need Botox right here. inch My answer is generally something similar to,
    “Well, that is certainly something we could do, but what is it which makes you want Botox? ” The subsequent several
    questions are provided to helping the patient target the real issues behind the fears such as texture, tone, rigidity, wrinkles, poor size, volume etc .

    I use a seek advice from tool I call typically the $10, 000 mirror.
    We have a simple hand mirror containing no magnification on one aspect and 3
    to 5 times addition on the other. I hand this to the patient with the magnified side facing them.
    Typically the interesting thing is that most persons when given the hand mirror will start looking very intently at themselves and even commence picking and brushing on things on their face.
    Then i have a checklist of items My spouse and i ask them about.
    We go through the checklist item by merchandise and discuss
    its affect on the overall appearance of the encounter.
    Once this is completed, We formulate a plan of all which can be
    done for them, that will include stuff I can do but also items others may be able
    to do. For example, I do not do deal with lifts, but if the result these are after
    is best served by way of a face-lift, I put this on the plan.
    It is hard to find that we don’t do most of what they will benefit
    from.

  34. Sometimes the “bean counters” tend to be telling us how we are falling short.
    They come up with some scheme to get us to determine more patients than we could reasonably see or tips on how to
    “create” more procedures compared to are called for. This is bottom-line
    or practice-centered medicine since my opinion is unethical
    as well as immoral. It is also outside of everything we are called to do and is needless and counter to a wholesome practice.
    What I believe builds a healthy practice and is merely
    at the heart of doing what is a good choice for patients,
    is the patient-centered check with. This type of consult is
    designed to arrive at the root of the patient’s concerns
    and do all one can do to help them achieve their health and aesthetic goals.

    In this involving population-based medicine we have all been told to do the minimum amount,
    but that doesn’t change the proven fact that our patients are
    concerned together with optimal health and results. Olympic
    athletes do not win their very own contests by training towards
    the minimum nor will our patients be served by giving the minimum.
    Let’s look at an example of how population-based treatments
    is creeping into the examination room in a way that is not
    fully understood by physicians and yet has great impact
    on the person (many similar examples are visible in medicine today):

    The drug companies tell us that Plavix is approximately 30% better than aspirin. What they do not tell us is that
    it is actually comparatively 30% better. In absolute terms
    it is about 1% better. What does this mean? Well, in a single
    study on CVA the relative risk reduction had been quoted as 25% even so the absolute reduction was 0.

    9 for ASA compared to 1 . 2 for Plavix or about 0. 3% (1).
    Now Plavix prices $5. 00 per pill and ASA is about $0.

    05 so to the individual on a fixed income
    is the overall difference of 0. 3% worth $4. 95 daily?
    Maybe, maybe not depending on many factors. Certainly it may be worth
    every penny to society but modern society is not paying the bill…

    the individual on a fixed income is usually. This
    is the confusion between populace based and individual drugs.
    Some have even strongly suggested taxing or eliminating Functional procedures to reduce overall health fees in the US.

    This may help many number followed by economists yet is it serving the
    individual who is interested in a specific goal?

    Precisely what is the patient-centered consult?

    Remedies is complex and in certain, Aesthetic Medicine is complicated, yet it has
    been reduced for you to sound bites on TV. Tv ads ask the question “Is it better than Botox? very well or “Is it a lot
    better than a Medical Peel? inches yet they do not give the reply or any
    real helpful information. Sufferers have, in general, no reasonable idea of what can and should not be done
    for them. The patient-centered consult is an educational encounter for the patient that helps them understand what is realistic and what is not.

    It starts along with gaining a detailed understanding of the actual patient’s concerns
    are, certainly not what treatments they are thinking about.
    Most aesthetic patients come in thinking they know what they demand.

    As an example many think needed an upper lid blepharoplasty but what they really
    need is really a brow lift. Other come in asking about fillers although really need
    Botox or vice versa. The understanding of what they are focused on is found not by asking
    what they are interested in but rather, precisely what their concerns are.
    Most of us start in a conversational fashion. Most often a patient will start by simply saying something like “I consider I need Botox right here. micron My answer is generally similar to, “Well, that is certainly something we can do, but what is it that
    produces you want Botox? ” Another several questions are directed at helping the patient target the true issues behind the fears such as texture, tone, rigidity, wrinkles, poor size, level etc .

    I use a consult tool I call the particular $10, 000 mirror. Looking for a simple hand mirror that has no magnification on one side and 3 to 5 times zoom on the other. I hand the idea to the patient with the amplified side facing them. Typically the interesting thing is that most men and women when given the mirror will start looking very intently at themselves and even start picking and brushing with things on their face. When i have a checklist of items My partner and i ask them about. We use checklist item by product and discuss its impact on the overall appearance of the deal with. Once this is completed, My partner and i formulate a plan of all which can be done for them, that will include issues I can do but also things others may be able to do. To give an example, I do not do experience lifts, but if the result they can be after is best served by a face-lift, I put this on the plan. It is uncommon that we don’t do the majority of what they will benefit from.

  35. Claims the “bean counters” are usually telling us how we are
    generally falling short. They come up with some scheme to
    get us to discover more patients than we can reasonably see or
    the best way to “create” more procedures as compared to are called for.

    This is bottom-line or practice-centered medicine since my opinion is unethical along with immoral.
    It is also outside of what we should are called to do and
    is needless and counter to a healthy and balanced practice.

    What I believe creates a healthy practice
    and is basically at the heart of doing what is right for patients,
    is the patient-centered seek advice from. This type of consult is designed
    to reach the root of the patient’s difficulties and
    do all one can do to help them achieve their health insurance and aesthetic goals.

    In this associated with population-based medicine we have all recently been told to do the minimum, but that doesn’t change the
    idea that our patients are concerned having optimal health
    and results. Olympic athletes do not win their own contests by
    training towards the minimum nor will our
    own patients be served by providing the minimum. Let’s take a
    look at an example of how population-based treatments is creeping into the
    assessment room in a way that is not fully understood by physicians
    yet has great impact on the person (many similar examples can be seen in medicine
    today):

    The drug businesses tell us that Plavix is around 30% better than aspirin. Them not tell us is that it is pretty 30% better.
    In overall terms it is about 1% better. What does this mean? Well, in one study on CVA the
    particular relative risk reduction ended up being quoted as 25% but the absolute reduction was 0.
    9 for ASA as opposed to 1 . 2 for Plavix or about 0.
    3% (1). Now Plavix expenses $5. 00 per supplement and ASA is about $0.
    05 so to the individual with a fixed income is the absolute difference of 0.
    3% worth $4. 95 per day? Maybe, maybe not depending on many factors.
    Certainly it may be worth every penny to society but community is not paying the bill…

    the on a fixed income is actually. This is the confusion between population based and individual
    remedies. Some have even recommended taxing or eliminating
    Artistic procedures to reduce overall health charges in the
    US. This may help a few number followed by economists nevertheless is it serving the individual who may be interested in a
    specific goal?

    What exactly is the patient-centered consult?
    Medication is complex and in special, Aesthetic Medicine is complicated, yet it has been reduced in order to sound bites on TV.
    Commercials ask the question “Is it better than Botox? micron or “Is it a lot better than a Medical Peel?
    very well yet they do not give the response or any real helpful information. Affected
    individuals have, in general, no realistic idea of what can and should not be done for them.
    The patient-centered consult is an educational knowledge for the
    patient that helps these understand what is realistic and is not.

    It starts with gaining a detailed understanding of exactly what the patient’s concerns are,
    not what treatments they are thinking about.
    Most aesthetic patients also come in thinking they know what they really want.
    As an example many think needed an upper lid blepharoplasty but what they
    really need can be a brow lift. Other appear in asking about fillers however really need Botox or vice
    versa. The understanding of what they are focused on is found not by wondering what they are
    interested in but rather, what their concerns are.

    Many of us start in a conversational approach. Most often a patient will start simply by saying something like
    “I assume I need Botox right here. micron My answer is generally like, “Well, that is certainly something we can easily do, but what is it generates you want Botox?
    ” The subsequent several questions are provided to helping the patient target the real issues behind the problems such as texture, tone, firmness, wrinkles, poor size, amount etc .

    I use a check with tool I call typically the $10, 000 mirror. We have a simple hand mirror that has no magnification on one aspect and 3 to 5 times magnifying on the other. I hand it to the patient with the zoomed side facing them. Often the interesting thing is that most folks when given the reflection will start looking very intently at themselves and even start picking and brushing at things on their face. Then i have a checklist of items I ask them about. We go through the checklist item by merchandise and discuss its effect on the overall appearance of the encounter. Once this is completed, I formulate a plan of all that can be done for them, that will include issues I can do but also issues others may be able to do. To give an example, I do not do encounter lifts, but if the result these are after is best served with a face-lift, I put which on the plan. It is uncommon that we don’t do most of what they will benefit from.

  36. Sometimes the “bean counters” usually are telling us how we are usually falling short.
    They come up with a few scheme to get us to
    view more patients than we are able to reasonably see or the best way to “create”
    more procedures in comparison with are called for. This is bottom-line or practice-centered medicine and in my
    opinion is unethical as well as immoral. It is also outside
    of everything we are called to do and is unnecessary and counter to a wholesome practice.
    What I believe creates a healthy practice and is simply at the heart of doing what is suitable for patients, is the patient-centered talk to.

    This type of consult is designed to be able to the root of the patient’s concerns and do all one can because of help them achieve their health and aesthetic goals.

    In this associated with population-based medicine we have all been told to do the bare minimum, but
    that doesn’t change the undeniable fact that our patients are concerned together with optimal health and results.
    Olympic athletes do not win all their contests by training to the minimum
    nor will each of our patients be served by
    giving the minimum. Let’s look at an example of how population-based medicine is creeping into the exam room in a way that is not entirely understood by physicians nevertheless has great impact on the client (many similar examples can be seen in medicine today):

    The drug firms tell us that Plavix is about 30% better than aspirin. Them
    not tell us is that it is fairly 30% better. In definite terms it is about 1% better.
    What does this mean? Well, in a study on CVA often the relative risk reduction had
    been quoted as 25% but the absolute reduction was 0. 9 for ASA versus 1 .
    2 for Plavix or about 0. 3% (1). Now Plavix charges $5.

    00 per capsule and ASA is about $0. 05 so to the individual for a fixed income is the
    overall difference of 0. 3% worth $4. 95 on a daily basis?

    Maybe, maybe not depending on numerous factors. Certainly
    it may be worth it to society but culture is not paying the bill…
    the client on a fixed income will be. This is the
    confusion between people based and individual medicine.
    Some have even strongly suggested taxing or eliminating Aesthetic
    procedures to reduce overall health costs in the US. This may help a few number followed by economists but is it serving the individual who will be interested in a specific goal?

    Precisely what is the patient-centered consult?
    Treatments is complex and in certain, Aesthetic Medicine is elaborate, yet it has been reduced to be
    able to sound bites on TV. Advertising ask the question “Is it better than Botox? ” or “Is it a lot better than a Medical Peel? very well yet they do not give the answer or any real helpful information. Patients have, in general, no reasonable idea of what can and are not done for them. The patient-centered consult is an educational encounter for the patient that helps them understand what is realistic and exactly is not.

    It starts with gaining a detailed understanding of exactly what the patient’s concerns are, definitely not what treatments they are enthusiastic about. Most aesthetic patients appear in thinking they know what they want. As an example many think they require an upper lid blepharoplasty but what they really need is really a brow lift. Other also come in asking about fillers although really need Botox or vice versa. The understanding of what they are interested in is found not by inquiring what they are interested in but rather, just what their concerns are. All of us start in a conversational approach. Most often a patient will start by saying something like “I feel I need Botox right here.

    ” My answer is generally something such as, “Well,
    that is certainly something we can do, but what is it which makes you want Botox?
    ” Another several questions are provided to helping the patient target the actual issues behind the problems such as texture, tone, firmness, wrinkles, poor size, volume level etc .

    I use a talk to tool I call the actual $10, 000 mirror. We certainly have a simple hand mirror containing no magnification on one area and 3 to 5 times addition on the other. I hand it to the patient with the amplified side facing them. The interesting thing is that most folks when given the looking glass will start looking very intently at themselves and even get started picking and brushing at things on their face. I then have a checklist of items My partner and i ask them about. We use checklist item by item and discuss its affect the overall appearance of the deal with. Once this is completed, I formulate a plan of all which can be done for them, that will include issues I can do but also things others may be able to do. As an example, I do not do face lifts, but if the result they are after is best served by a face-lift, I put that will on the plan. It is exceptional that we don’t do most of what they will benefit from.

  37. Sometimes the “bean counters” are generally telling us how we usually
    are falling short. They come up with a number of scheme
    to get us to discover more patients than we can reasonably see or how to “create” more procedures as compared to are called
    for. This is bottom-line or practice-centered
    medicine since my opinion is unethical as well as immoral.
    It is also outside of whatever you are called to do and is unnecessary and
    counter to a healthful practice. What I believe develops a healthy practice and is simply at
    the heart of doing what is good for patients, is the patient-centered talk to.
    This type of consult is designed to are able to the root of the
    patient’s difficulties and do all one can because of help them achieve their into
    the aesthetic goals.

    In this involving population-based medicine we have all been recently told to do the lowest, but that doesn’t change the proven fact that our patients are concerned together with
    optimal health and results. Olympic athletes do not win their contests by training for the minimum nor will our own patients be served
    by providing the minimum. Let’s have a look at an example of how population-based medication is
    creeping into the quiz room in a way that is not thoroughly understood by physicians but has great impact on the person (many similar examples
    can be seen in medicine today):

    The drug corporations tell us that Plavix is mostly about 30% better than aspirin. Them
    not tell us is that it is comparatively 30% better.

    In definite terms it is about 1% better. What does this mean? Well, in one study on CVA
    typically the relative risk reduction has been quoted as 25% though the absolute reduction was zero.
    9 for ASA against 1 . 2 for Plavix or about 0.
    3% (1). Now Plavix charges $5. 00 per capsule and ASA is about $0.
    05 so to the individual on the fixed income is the overall difference of 0.
    3% worth $4. 95 on a daily basis? Maybe, maybe not depending on many factors.
    Certainly it may be worthwhile to society but culture is not paying the bill…
    the client on a fixed income is. This is the confusion between human population based and individual remedies.
    Some have even recommended taxing or eliminating Functional
    procedures to reduce overall health expenses in the US.
    This may help a number of number followed by economists however
    is it serving the individual who may be interested
    in a specific goal?

    What exactly is the patient-centered consult?
    Treatments is complex and in particular, Aesthetic
    Medicine is sophisticated, yet it has been reduced to sound bites on TV.
    Tv ads ask the question “Is it better than Botox? micron or “Is it greater than a Medical
    Peel? inches yet they do not give the respond to
    or any real helpful information. Individuals have, in general,
    no natural idea of what can and can not be done for
    them. The patient-centered consult is an educational encounter for
    the patient that helps these people understand what is realistic
    and is not.

    It starts using gaining a detailed understanding of the particular patient’s concerns are, not really what treatments they are considering.
    Most aesthetic patients also come in thinking they
    know what they really want. As an example many think they require an upper lid
    blepharoplasty but what they really need can be a brow lift.
    Other also come in asking about fillers nevertheless really need Botox or vice versa.
    The understanding of what they are focused on is found
    not by questioning what they are interested in but rather, precisely what their
    concerns are. We all start in a conversational approach.
    Most often a patient will start by simply saying something
    like “I think I need Botox right here. inches My answer is generally like, “Well, that is certainly something we can easily do, but what
    is it that creates you want Botox? ” The next several questions are fond of helping the patient target the actual issues behind the problems such as texture, tone, rigidity, wrinkles, poor size, amount etc .

    I use a seek the advice of tool I call the $10, 000 mirror. We are a simple hand mirror that has no magnification on one aspect and 3 to 5 times addition on the other. I hand this to the patient with the amplified side facing them. Typically the interesting thing is that most individuals when given the mirror will start looking very intently at themselves and even get started picking and brushing with things on their face. I then have a checklist of items My spouse and i ask them about. We feel the checklist item by item and discuss its affect on the overall appearance of the deal with. Once this is completed, I actually formulate a plan of all that you can do for them, that will include items I can do but also stuff others may be able to do. As an example, I do not do encounter lifts, but if the result they can be after is best served by just a face-lift, I put that will on the plan. It is uncommon that we don’t do most of what they will benefit from.

  38. All too often the “bean counters” are generally telling us
    how we usually are falling short. They come up with some scheme to
    get us to discover more patients than you can reasonably see or how to “create” more procedures compared to are called for.
    This is bottom-line or practice-centered medicine as my opinion is unethical in addition to immoral.
    It is also outside of everything we are called to do and is unwanted and
    counter to a balanced practice. What I believe
    forms a healthy practice and is just at the heart of doing
    what is a good choice for patients, is the patient-centered
    seek the advice of. This type of consult is designed to get to the root of the patient’s difficulties
    and do all one can do to help them achieve their into the aesthetic goals.

    In this involving population-based medicine we have all
    recently been told to do the bare minimum, but that doesn’t change the undeniable fact
    that our patients are concerned along with optimal health and results.
    Olympic athletes do not win their very own contests by training to
    the minimum nor will the patients be served by providing the minimum.
    Let’s check out an example of how population-based medicine is creeping into the examination room in a way that is not totally understood by physicians and yet has great impact on the
    individual (many similar examples can be seen in medicine today):

    The drug firms tell us that Plavix is mostly about 30% better than aspirin. Them
    not tell us is that it is actually comparatively 30% better.
    In complete terms it is about 1% better. What does this mean? Well, in a single
    study on CVA the relative risk reduction ended up being quoted as 25% however the absolute reduction was
    zero. 9 for ASA as opposed to 1 . 2 for Plavix or about 0.
    3% (1). Now Plavix charges $5. 00 per capsule and ASA is about $0.
    05 so to the individual over a fixed income is the overall difference of 0.
    3% worth $4. 95 each day? Maybe, maybe not depending on numerous factors.

    Certainly it may be worth the cost to society but community is not paying the bill…
    the person on a fixed income is actually. This is the confusion between populace based and
    individual drugs. Some have even encouraged taxing or eliminating Cosmetic procedures to reduce overall health prices in the US.

    This may help a few number followed by economists although is it serving the individual who may be interested in a
    specific goal?

    So what is the patient-centered consult? Medication is complex and in particular, Aesthetic Medicine
    is complex, yet it has been reduced to sound bites on TV.
    Commercials ask the question “Is it better than Botox? inch or “Is it greater than a Medical
    Peel? very well yet they do not give the respond to or any real helpful information. People have, in general, no reasonable idea of
    what can and are not done for them. The patient-centered consult is an educational encounter for the patient that helps
    them understand what is realistic and is not.

    It starts together with gaining a detailed understanding of exactly what the patient’s concerns are,
    definitely not what treatments they are interested in. Most aesthetic
    patients come in thinking they know what they really want.

    As an example many think they desire an upper lid blepharoplasty but what they really need is
    really a brow lift. Other also come in asking about fillers yet really need Botox or vice versa.
    The understanding of what they are concerned with is found not by questioning what they are interested in but rather, what exactly their concerns are.

    Most of us start in a conversational manner. Most often a patient will start by means of saying something like “I believe I need Botox right here. micron My answer is generally something similar to, “Well, that is certainly something we can do,
    but what is it that creates you want Botox? ” The next several questions are inclined to helping the patient target the real issues behind the issues such as texture, tone, rigidity, wrinkles, poor size, volume etc .

    I use a seek advice from tool I call typically the $10, 000 mirror. We have a simple hand mirror which has no magnification on one aspect and 3 to 5 times magnifying on the other. I hand it to the patient with the magnified side facing them. Typically the interesting thing is that most folks when given the reflect will start looking very intently at themselves and even commence picking and brushing from things on their face. I then have a checklist of items My partner and i ask them about. We have the checklist item by thing and discuss its effect on the overall appearance of the experience. Once this is completed, We formulate a plan of all you can do for them, that will include things I can do but also points others may be able to do. As one example, I do not do face lifts, but if the result these are after is best served by way of a face-lift, I put that on the plan. It is uncommon that we don’t do many of what they will benefit from.

  39. Sometimes the “bean counters” are generally telling us how we are falling short.

    They come up with many scheme to get us to discover more patients than we
    can easily reasonably see or how you can “create” more procedures compared to are called for.
    This is bottom-line or practice-centered medicine since
    my opinion is unethical and immoral. It is also outside of what we
    should are called to do and is unnecessary and
    counter to a healthy practice. What I believe builds a healthy practice and
    is basically at the heart of doing what is a good choice for patients, is the
    patient-centered seek advice from. This type of consult is designed to be able to the root of the patient’s difficulties and do all
    one can do to help them achieve their strengthening aesthetic goals.

    In this age of population-based medicine we have all
    recently been told to do the lowest, but that doesn’t change the simple fact that our patients are concerned
    having optimal health and results. Olympic athletes do not win their particular contests
    by training to the minimum nor will all of our
    patients be served by giving the minimum. Let’s
    examine an example of how population-based medication is creeping into the examination room in a way that is
    not totally understood by physicians nevertheless has great impact on the individual (many similar examples may be seen in medicine today):

    The drug companies tell us that Plavix is about 30% better than aspirin. Them
    not tell us is that it is comparatively 30% better. In overall terms it is
    about 1% better. What does this mean? Well, a single study on CVA the particular relative risk reduction had been quoted
    as 25% even so the absolute reduction was zero.

    9 for ASA vs 1 . 2 for Plavix or about 0. 3% (1).
    Now Plavix costs $5. 00 per supplement and ASA is about $0.
    05 so to the individual over a fixed income
    is the total difference of 0. 3% worth $4. 95 every day?
    Maybe, maybe not depending on many factors.

    Certainly it may be worth it to society but society is not paying the
    bill… the client on a fixed income will be.
    This is the confusion between people based and
    individual medicine. Some have even strongly suggested taxing or eliminating Aesthetic procedures to reduce overall health costs in the US.

    This may help some number followed by economists although is it serving the individual
    who will be interested in a specific goal?

    Just what exactly is the patient-centered consult?
    Treatments is complex and in certain, Aesthetic Medicine is
    complicated, yet it has been reduced for you to sound bites on TV.
    Commercials ask the question “Is it better than Botox? ” or “Is it a lot better than a Medical Peel? micron yet they do not give the solution or any real helpful information. Patients have, in general, no practical idea of what can and is not done for them. The patient-centered consult is an educational practical experience for the patient that helps all of them understand what is realistic and what is not.

    It starts along with gaining a detailed understanding of what patient’s concerns are, not really what treatments they are thinking about. Most aesthetic patients appear in thinking they know what they really want. As an example many think they require an upper lid blepharoplasty but what they really need is really a brow lift. Other come in asking about fillers but really need Botox or vice versa. The understanding of what they are interested in is found not by wondering what they are interested in but rather, what exactly their concerns are. Most of us start in a conversational fashion. Most often a patient will start through saying something like “I think
    I need Botox right here. inches My answer is generally
    something like, “Well, that is certainly something we can easily do, but what is it that produces you want Botox? ” The following
    several questions are provided to helping the patient target the true issues behind the fears such as texture,
    tone, rigidity, wrinkles, poor size, amount etc .

    I use a consult tool I call the actual $10, 000 mirror.
    We are a simple hand mirror which has no magnification on one aspect and 3 to 5 times zoom on the other.

    I hand it to the patient with the magnified side facing them.
    The actual interesting thing is that most people when given the mirror will start looking
    very intently at themselves and even begin picking and brushing at things on their face.
    When i have a checklist of items We ask them about.
    We feel the checklist item by thing and discuss its affect on the overall appearance of the encounter.

    Once this is completed, I formulate a plan of all which can be done for them, that will include
    issues I can do but also points others may be able to do.
    For example, I do not do face lifts, but if the result they can be after
    is best served by just a face-lift, I put in which on the plan. It is exceptional that we don’t do
    most of what they will benefit from.

  40. loupgarous says:

    Derek, hate to bother you, but aesthetic medicine here seems to have made the same point verbatim and in extenso 13 times.

  41. Too often the “bean counters” are generally telling us how we tend to
    be falling short. They come up with a few scheme to get us to discover more patients than we could reasonably see or the way to “create” more
    procedures in comparison with are called for. This is bottom-line or practice-centered medicine and my
    opinion is unethical and immoral. It is also outside of everything we are called to do and is unwanted and counter to a balanced practice.
    What I believe creates a healthy practice
    and is just at the heart of doing what is a good choice for patients, is the patient-centered seek advice from.
    This type of consult is designed to arrive at the root of the patient’s concerns and do all one can because of help them
    achieve their into the aesthetic goals.

    In this age of population-based medicine we have all been told to do the
    minimal, but that doesn’t change the idea that our patients are concerned using optimal health and results.

    Olympic athletes do not win their own contests by training
    into the minimum nor will our own patients be served by giving
    the minimum. Let’s look at an example of how population-based medication is creeping into the quiz room in a way
    that is not completely understood by physicians nevertheless has great
    impact on the (many similar examples are visible in medicine today):

    The drug companies tell us that Plavix is mostly about 30%
    better than aspirin. Them not tell us is that it is
    relatively 30% better. In definite terms it is about 1% better.
    What does this mean? Well, in one study on CVA often the relative risk reduction was quoted as 25% though
    the absolute reduction was 0. 9 for ASA against 1 .
    2 for Plavix or about 0. 3% (1). Now Plavix prices $5.
    00 per pill and ASA is about $0. 05 so to the individual with a fixed income is the definite difference of 0.
    3% worth $4. 95 on a daily basis? Maybe, maybe not depending
    on several factors. Certainly it may be worthwhile to society but
    society is not paying the bill… the affected person on a fixed income is.
    This is the confusion between human population based and individual drugs.
    Some have even encouraged taxing or eliminating Artistic procedures to reduce overall health fees in the US.
    This may help several number followed by economists although is it serving the individual that is interested in a
    specific goal?

    Just what exactly is the patient-centered consult?
    Treatments is complex and in certain, Aesthetic Medicine is complex, yet it has been reduced to sound bites
    on TV. Advertising ask the question “Is it better than Botox? inch or “Is it superior to a Medical Peel?
    very well yet they do not give the response or any real helpful information. Individuals have, in general, no sensible idea of what can and are not
    done for them. The patient-centered consult is an educational knowledge for the
    patient that helps these individuals understand what is realistic and exactly is not.

    It starts with gaining a detailed understanding of the actual patient’s concerns are, definitely
    not what treatments they are serious about.
    Most aesthetic patients can be found in thinking they know what they need.
    As an example many think they need an upper lid blepharoplasty but what they really need is often a brow lift.

    Other come in asking about fillers yet really need Botox or
    vice versa. The understanding of what they are worried about is found not by questioning what they are
    interested in but rather, precisely what their concerns are.
    We all start in a conversational method. Most often a patient will start simply by saying something like “I believe I need Botox right here. very well My answer is generally something like, “Well, that is certainly something we can easily
    do, but what is it that produces you want Botox? ” Another several questions are directed at helping the patient target the true issues behind the concerns such as texture, tone, rigidity, wrinkles, poor size, level etc .

    I use a seek advice from tool I call typically the $10, 000 mirror. We are a simple hand mirror that has no magnification on one side and 3 to 5 times magnification on the other. I hand it to the patient with the magnified side facing them. Often the interesting thing is that most persons when given the looking glass will start looking very intently at themselves and even commence picking and brushing at things on their face. I then have a checklist of items We ask them about. We feel the checklist item by product and discuss its affect on the overall appearance of the face. Once this is completed, My spouse and i formulate a plan of all you can do for them, that will include points I can do but also items others may be able to do. For example, I do not do experience lifts, but if the result they may be after is best served by the face-lift, I put that will on the plan. It is exceptional that we don’t do most of what they will benefit from.

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