Neil Pollock

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Neil Pollock displaying a Mogen clamp
Neil Pollock
Colleagues & Benefactors:
Murray Katz
Pierre Crouse
Edgar J. Schoen
Barbara Kay
David Patrick
Funding & Associations:
Mogen
Schusterman Foundation
Canadian Institutes of Health

Neil Pollock is a circumcised surgeon and certified mohel[1][2] from Vancouver, Canada, whose sole livelihood comes from performing non-therapeutic infant circumcision and vasectomy.[3] He is a prolific circumciser of infants, and according to his website, he has performed over 30,000 infant circumcisions,[3] he performs 2,500 annually,[3] and he is personally responsible for 2/3rds of all circumcisions in the entire Vancouver Lower Mainland.[3]

On his website, he references the late Edgar Schoen, another avid circumcision advocate.[4]

The Canadian Urological Association (2018) says "neonatal circumcision cannot be justified based on the current evidence available."[5]

Revenue

Neil Pollock charges $455.00 Canadian for circumcising children under 2 months of age.[6] If his website is correct, he performs 2,500 annually,[7] which means he grosses C$1,137,500 on infant circumcision alone.

Misleading information

On his website, Pollock sells circumcision as "virtually bloodless, virtually painless" and "taking only thirty seconds",[8] and he claims to be using a unique "new approach" that was developed by himself,[9] but this information is misleading, it conflicts with information provided on his own website, or it is simply not true.

"Virtually bloodless"

While his homepage promises a circumcision that is "virtually bloodless",[8] the FAQ page admits that "a small amount of bleeding is normal,"[10] and it gives advice on how to stop it.

"Virtually painless"

Pollock promises a "virtually painless" circumcision,[8] but this claim depends on a dubious premise; that the methods he boasts in using are actually effective. On his website, it says that the pain control methods used are Tylenol, sugar,[11][12] a topical cream,[13] and a local anaesthetic injection called a dorsal penile ring block.[14] The topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.[15][16] During the circumcision, the child is given sugar pacifiers to "reduce his pain perceptions",[17] but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.[18] Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed.

"30 Second Procedure"

Pollock promises a "30 second procedure,"[8][19] but this doesn't take into account the fact that the child must first have topical anaesthetic applied, and then be given the dorsal penile ring block for which there is a 10 minute waiting period for the injection to take effect.[20] In the FAQ page, it is admitted that "although the circumcision takes under 30 seconds, we require you to be in our office for one hour and fifteen minutes in total so that we can carefully review with you all post procedure care and answer any of your questions."[21]

"A New Approach"

On his website, Pollock sells his circumcision technique as "a new approach" that "has recently been developed."[22] Pollock claims to have created this "new method" with another serial circumciser, Murray Katz. [23] Pollock's website uses language that suggests that he uses state-of-the-art techniques and equipment that no other surgeon possesses, by warning against others who try to "emulate" him.[24]

Closer inspection reveals that Pollock isn't doing anything "new"; his website reveals that he uses the Mogen technique, which involves the Mogen clamp.[25] The Mogen clamp was invented in 1954,[26] but it is actually one of many successors to the much older, traditional barzel device.[27]

What Pollock may not tell parents about Mogen

The website insists that without experience, which it boasts Pollock for having, the methods and techniques he uses could be "potentially dangerous," however the Mogen clamp has been notorious for glans amputations, even among experienced conductors of circumcision.[28] Mogen went out of business[29] after losing a 10.8 million dollar law suit,[29] after a mohel[29] severed the end of a baby's glans[29] using one of their clamps. Mogen claimed that injury was impossible with its use.[29] The injury behind a prior lawsuit in Fulton County Superior Court had already put Mogen on notice about the danger of the device.[29]

In a different case, at South Fulton Medical Center, another law suit was won in 2009.[29]In that case, a child lost a third of his glans, and the plaintiffs were awarded 2.3 million dollars.[29]

"A New Approach" for children, teenagers and adults

According to the Jewish Independent, Pollock claims to "have developed a technique to do circumcision in this older age group under local anesthetic without using sutures and using, instead, a cyanocrylate skin glue that closes the wound." Pollock claims that this provides for a "simpler, easier, quicker, safer and improved cosmetic outcome for patients.", claims that have not been substantiated.[30]

Complaints and investigation

In 2003 there were several complaints to the College of Physicians & Surgeons of British Columbia about Pollock Clinics' advertisements. The base for the complaints was that these advertisements present a very one-sided view of circumcision, referring to Edgar J. Schoen's website while failing to mention the position of the governing specialty college, the Canadian Paediatric Society, which recommends that circumcision of newborns should not be routinely performed.[31] The complaints also stated that Pollock's website states that "circumcision is regarded as one of the safest routine operations in practice today." No reference is given for this statement, which is by no means universally accepted. The complaint indicated that Pollock Clinics appeared to be in breach of the Rules under the Medical Practitioners Act, specifically Rule 98, which stipulates that doctors "must not exaggerate, be false, inaccurate, misleading or be reasonably capable of being misinterpreted."[32]

Infant circumcision evangelist

Rwanda

Pollock holding a child he circumcised in Africa in the name of HIV prevention.

On Feb 24, 2009, Pollock Clinics issued a press release stating that Neil Pollock was asked to go to Rwanda by the British Columbia Centere for Disease Control (BCCDC) and Family Health International (FHI),[33] as part of a team on a "fact finding mission." He was asked by David Patrick, then Head of Epidemiology at the BCCDC.[33] The mission was supposed to consult with the Rwandan healthcare system involved in the fight against AIDS,[33] but Pollock took advantage of the trip to promote infant circumcision specifically.[33] Upon being told that few parents were having their children circumcised because the procedures were being performed with scissors and stitches, without adequate anaesthetic and were taking around 30 minutes to complete,[33] he took the opportunity to promote the Mogen infant circumcision procedure under the guise of "HIV prevention."[33][34][35]

As in Canada, Pollock sold the Mogen technique as "bloodless, painless, and taking only 30 seconds."[36][37] He took advantage of the AIDS crisis, and the fact that the WHO/UNAIDS had endorsed circumcision as legitimate HIV prevention to promote specifically infant circumcision, and his "simple and painless procedure" (AKA, the Mogen technique).[38] Pollock admits that he hopes his "technique" would encourage more Rwandan parents to have their children circumcised, albeit for the pretext of HIV prevention.[39] With the help of his friends and family, he raised funds to buy Mogen clamps and other needed equipment to set up an infant circumcision clinic in Rwanda.[40] Pollock was largely instrumental in making infant circumcision a priority for the Rwandan Ministry of Health in the fight against AIDS. [41] The medical tour was covered by grant money from the Canadian Institutes of Health Research, and funding from the Shusterman Foundation.[42]

Pollock also took the opportunity to promote his vasectomy knowledge while he was in Rwanda.[43]

Haiti

In 2014, Pollock claimed he was contacted by Dr. Jeffrey Klausner, professor at [the University of California, Los Angeles] Medical School, asking to train surgeons in Port-Au-Prince. Pollock started a fundraiser hoping to raise $25,000 to cover a one week trip to Port-Au-Prince, to train two surgeons, who will in turn train more surgeons once he leaves. This with the premise that circumcision can help reduce the risk of males contracting HIV through heterosexual intercourse, a premise that has been subject to frequent criticism for lack of proven causal link and failure to show the intended results.

The ultimate intention of the training, Pollock said, is “to set up a national program accepted by the population, to introduce infant circumcision safely and effectively, and have it evolve to become a widespread practice throughout the country.” UCLA's Klausner and other researchers at UCLA seem to be very interested in introducing circumcision in the Caribbean and Latin America.

Pollock said. “It’s intended that Haiti will become a training centre for circumcision in the Caribbean. It is likely that my technique, once taught in Haiti, will soon be shared with multiple countries throughout the Caribbean, multiplying its effect to save lives throughout the entire region.[44]

Lack of third-party payment

Third-party payment for non-therapeutic circumcision is not available in Canada.

See also

  • Bias -- Motivations for circumcision bias.

External links

References

  1. REFweb Owens, Anne Marie (22 January 2001). Like father, like son, The National Post. Retrieved 8 April 2011. Dr. Neil Pollock, a Vancouver-area physician who is also a trained mohel designated to perform ritual Jewish circumcisions...
  2. REFweb About Dr. Neil Pollock, MohelTraining.com. Retrieved 8 April 2011. Dr. Pollock has been certified by the Conservative and Reform Rabbinet of British Columbia to serve the community as a mohel.
  3. a b c d REFweb About Dr. Pollock. Retrieved 8 April 2011. Dr. Pollock limits his practice to only two surgical procedures. Non-therapeutic infant circumcision is one of these procedures. (No-Scalpel No-Needle Vasectomy is the other).
  4. REFweb Parents' Guide to Circumcision. Retrieved 8 April 2011. For detailed information about the medical benefits and risks of circumcision, please go to http://www.medicirc.org a website written by world renowned pediatrician - Dr.Edgar Schoen of San Francisco California, USA.
  5. REFjournal Dave, Sumit / Kourash Afshar / Luis Braga / Peter Anderson (February 2018): Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (full version), in: Can Urol Assoc J. 12 (2): E76-99, PMID, PMC, DOI. Retrieved 7 August 2020.
  6. REFweb Arranging a Circumcision. Retrieved 8 April 2011. The fee for babies younger than two months of age is $445.00 including all the aftercare supplies and taxes.
  7. REFweb About Dr. Pollock. Retrieved 8 April 2011. Currently he performs approximately 2,500 annually at his two private offices.
  8. a b c d REFweb (8 April 2011). Pollock Clinics Infant Circumcision. Retrieved 8 April 2011. 30 second, virtually bloodless, virtually painless procedure
  9. REFweb Parents' Guide to Circumcision. Retrieved 8 April 2011. A new approach has recently been developed that allows for a virtually painless and bloodless procedure to be safely performed in under 30 seconds. This technique was developed by Dr. Pollock and is used by few in the medical profession because it is relatively new and more difficult to learn.
  10. REFweb (8 April 2011). Frequently Asked Questions. Retrieved 8 April 2011. A small amount of bleeding is normal. Take some gauze with Vaseline on it and squeeze the bleeding area of the penis with your fingers for two minutes.
  11. REFweb Parents' Guide to Circumcision. Retrieved 8 April 2011. To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.
  12. REFweb (8 April 2011). Before the Circumcision. Retrieved 8 April 2011. During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.
  13. REFweb (8 April 2011). Before the Circumcision. Retrieved 8 April 2011. Then in our office, he will have topical anesthetic applied to his penis.
  14. REFweb Parents' Guide to Circumcision, Pollock Clinics. Retrieved 8 April 2011. We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.
  15. REFjournal Taeusch, H. William / Alma M. Martinez / J. Colin Partridge / Susan Sniderman / Jennifer Armstrong-Wells / Elena Fuentes-Afflick (April 2002): Pain During Mogen or Plastibell Circumcision, in: Journal of Perinatology. 22 (3): 214-218, PMID, DOI. Retrieved 8 April 2011. Quote: ...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.
  16. REFjournal Williamson, Paul S. / Nolan Donovan Evans (August 1986): Neonatal Cortisol Response to Circumcision with Anesthesia, in: Clinical Pediatrics. 25 (8): 412-416, PMID, DOI. Retrieved 7 August 2020. Quote: The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.
  17. REFweb (8 April 2011). Before the CircumcisionBefore the Circumcision. Retrieved 8 April 2011. During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.
  18. REFjournal Slater, Rebeccah / Laura Cornelissen / Lorenzo Fabrizi / Debbie Patten / Jan Yoxen / Alan Worley / Stewart Boyd / Judith Meek / Prof. Maria Fitzgerald (9 October 2010): Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial, in: The Lancet. 376 (9748): 1225-1232. Retrieved 8 April 2011. Quote: Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.
  19. REFweb Parents' Guide to Circumcision. Retrieved 8 April 2011. Our procedure takes under 30 seconds (10 times quicker than most hospital circumcisons).
  20. REFweb (8 April 2011). Before the Circumcision. Retrieved 8 April 2011. After 10 minutes, the penis is “frozen”, and the circumcision can be done.
  21. REFweb (8 April 2011). Before the Circumcision. Retrieved 8 April 2011.
  22. REFweb Parents' Guide to Circumcision. Retrieved 8 April 2011. A new approach has recently been developed that allows for a virtually painless and bloodless procedure to be safely performed in under 30 seconds. This technique was developed by Dr. Pollock and is used by few in the medical profession because it is relatively new and more difficult to learn.
  23. REFnews Owens, Anne Marie (22 January 2001)."Like father, like son There is so much evidence for and against circumcision that making a decision has become almost impossible. In the end, most parents use family tradition or simply trust their instincts", National Post. Retrieved 7 October 2012. "Dr. Neil Pollock, a Vancouver-area physician who is also a trained mohel designated to perform ritual Jewish circumcisions, has pioneered a technique with Dr. Murray Katz of Montreal using a four-step approach to pain relief and a piece of equipment that allows for a much quicker operation."
  24. REFweb (8 April 2011). Pollock Clinics Infant Circumcision. Retrieved 8 April 2011. You may notice other local websites, desperately attempting to emulate Dr.Pollock both in name of website and content. Please be clear when researching your son's circumcision, that the methods and techniques for providing this surgery are only as meaningful as the operating physician's experience, without which, any method or technique is potentially dangerous.
  25. REFweb (8 April 2011). Parents' Guide to Circumcision. The technique used by Dr. Pollock is called the Mogen technique.
  26. REFweb Use of the Mogen clamp for neonatal circumcision. Retrieved 8 April 2011. The Mogen clamp was invented in 1954 by Rabbi Harry Bronstein, a Brooklyn mohel.
  27. REFweb (8 April 2011). Methods of circumcision, circumstitions.com. Retrieved 8 April 2011. The barzel (Hebrew for iron) also known as a mogen (Hebrew for shield) is a slotted shield to...
  28. REFjournal Taeusch, H William / Alma M. Martinez / J. Colin Partridge / Susan Sniderman / Jennifer Armstrong-Wells / Elena Fuentes-Afflick (April 2002): Pain During Mogen or Plastibell Circumcision, in: Journal of Perinatology. 22 (3): 214-218. Retrieved 8 April 2011. Quote: ...approximately 10% of the glans of a newborn was amputated (it was reattached surgically) during a Mogen circumcision carried out by two of our most experienced physicians.
  29. a b c d e f g h REFnews Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011. "The company is going out of business, according to a woman who answered the phone at its Brooklyn headquarters Monday."
  30. REFnews Laye, Baysa (4 April 2014)."Vancouver doctor will train physicians in Haiti in circumcision". Retrieved 11 July 2014.
  31. REFjournal Whitesides, Eugene W. (1996): Neonatal circumcision revisited, in: CMAJ. 154 (6): 769-80, PMID, PMC. Retrieved 17 March 2020. Quote: Circumcision of newborns should not be routinely performed.
  32. REFweb (24 February 2009). CPSBC re newborn circumcision. Retrieved 25 December 2012.
  33. a b c d e f REFnews Millman, N. Michael. "BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Dr. Pollock travelled as part of a team assembled by the BC Centre for Disease Control (BCCDC) and their partner in the project, Family Health International (FHI)."
  34. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Vancouver-based circumcision and vasectomy surgeon, Dr. Neil Pollock, recently returned from a 10 day mission to sub-Saharan Africa where he taught Rwandan doctors proper infant circumcision technique to help them stem the spread of AIDS in the region."
  35. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Dr. Pollock, who has performed what is arguably the world's oldest surgical procedure over 30,000 times, spent four days in December at the King Faisal Hospital in Kigali, teaching the hospital's chief surgeons his Mogen infant circumcision technique."
  36. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "I offered to go and teach them how to perform the procedure in a safer, quicker and less painful way and they happily took me up on the offer."
  37. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "The technique, named after the specialized tool used in the procedure, is a virtually painless and bloodless method which takes less than a minute to perform."
  38. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "When a relatively simple and painless procedure exists that can so dramatically reduce one's chances of contracting AIDS, it seemed tragic that the local doctors in Rwanda were not properly trained to use it..."
  39. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Pollock, whose research into infant circumcision has been published internationally, hopes that the proper technique will encourage more Rwandan parents to have their sons circumcised."
  40. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Dr. Pollock, through the support of friends and family, raised the funds required to purchase and deliver multiple sets of equipment and supplies that would allow Rwandan surgeons to set up and operate an infant circumcision clinic once he left."
  41. REFnews N. Michael, Millman (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "At the end of Dr. Pollock's visit, the Rwandan Ministry of Health announced they were making infant circumcision a priority in their fight against AIDS, as they found it to be more sustainable in the long run and ten times cheaper than adult circumcision(v)."
  42. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "...much of the trip's cost was covered by grant money from Canadian Institutes of Health Research and funding from the Shusterman Foundation..."
  43. REFnews Millman, N. Michael (24 February 2009)."BC Surgeon Joins Fight Against Sub-Saharan Aids", marketwire. Retrieved 10 April 2011. "Dr. Pollock also presented a talk to local vasectomy surgeons. He hopes to return with a team to the region on a second teaching mission to instruct local doctors on his No-Scalpel No-Needle vasectomy procedure, a virtually painless technique lasting less than six minutes, which he performs approximately 2,000 times a year in his Vancouver and New Westminster clinics."
  44. REFnews Laye, Baysa (4 April 2014)."Vancouver doctor will train physicians in Haiti in circumcisio". Retrieved 11 July 2014.