Jay Buenafe

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Jay Buenafe

Jay Buenafe is a family physician who has recently expanded his practice to include non-therapeutic infant circumcision under the tutelage of Neil Pollock.[1][2][3]

The Canadian Urological Association (2018) says "neonatal circumcision cannot be justified based on the current evidence available."[4]

He has a website[5] that is nearly identical to that of Neil Pollock and Pierre Crouse on which he offers the same sales pitches and misinformation to parents, and he has announced in at least one magazine for parents.[6]

Contents

Conflicts of interest

Ethnic background

Jay Buenafe immigrated to Canada from the Philippines,[7] where circumcision is considered a right of passage, and 80% of Filipino males are circumcised, according to the WHO.[8] As a member of the Filipino community, Buenafe caters mainly to the Filipino community,[9] although he also extends his services to non-Filipinos.[10]

Financial gain

As with Neil Pollock, infant circumcision is Buenafe's main source of income.[11] Even before adopting the Mogen technique[12] from Neil Pollock (Buenafe started using it in April, 2012.),[13] Buenafe had already been performing circumcisions for a number of years among the Canadian Filipino community,[14] as well as for parents of other religious and ethnic backgrounds.[15] Buenafe charges C$299 per newborn circumcision.[16] (Source last checked on June 17, 2012)

The Manitoba Health Insurance Plan has not paid for non-therapeutic circumcision since 2006.[7] Circumcisions must be paid for by the patient or his representative.

Buenafe's website identical to those of Pollock and Crouse

Buenafe's website is a near mirror-image of that of Neil Pollock and Pierre Crouse. Some of the diagram images he uses are exactly the same, and some of the sales points are repeated verbatim. Buenafe praises the Mogen technique which he coins as "The Pollock Technique"[17] and he advertises it as "innovative, virtually painless," and taking "under 30 seconds",[18][19]

(An interesting note: As of April 2012, the Canadian Paediatric Society has not yet reviewed the so-called "Pollock" (AKA Mogen) method.[20])

Except for a few changes in wording, Buenafe's "Parents' Guide to Circumcision" page is nearly identical, to those of Neil Pollock and Pierre Crouse, advertizing the Mogen technique as taking less than a minute, and advertizing identical pain control methods of Tylenol, sugar, and a local anaesthetic injection.[21]

Pollock and Crouse's "Parents' Guide to Circumcision" pages can be viewed here and here. (Pages last viewed on June 16, 2012)

Misleading Information

Like Neil Pollock and Pierre Crouse, the information that Buenafe dispenses is misleading, it conflicts with information provided on his own website, or it is simply not true.

"Virtually Painless"

Like Neil Pollock and Pierre Crouse, Buenafe promises the "Pollock Technique" (AKA the Mogen technique), along with his pain control methods to be "painless," affirming his customers with the techniques he uses.[22][21][23] As Pollock, Pierre Crouse, Buenafe announces that the pain control methods used are Tylenol, sugar, a topical cream, and a local anaesthetic injection.[21] 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.[24][25] During the circumcision, the child is given sugar to "reduce his pain perceptions", 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.[26] Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed.

"Under one minute"

In a manner similar to Neil Pollock and Pierre Crouse, Buenafe promises a circumcision procedure that is "innovative, virtually painless," and taking "under 30 seconds",[27][28] 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.

"A New Technique"

As Neil Pollock and Pierre Crouse, Buenafe sells the Mogen circumcision technique, which he coins as "the Pollock technique," as a new and recent development.[29] Strangely enough, 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.[30] Closer inspection reveals that the so-called "Pollock technique" (AKA the Mogen technique) is not anything "new." The Mogen clamp was invented in 1954,[31] but it is actually one of many successors to the much older, traditional barzel device.[32]

What Buenafe may not tell parents about Mogen

Like, Pollock and Crouse, Buenafe peddles the Mogen technique (as the "Pollock technique on his website), but what he may not tell parents is that the Mogen clamp has been notorious for glans amputations, even among experienced conductors of circumcision.[33] Mogen went out of business[34] after losing a 10.8 million dollar law suit,[35] after a mohel[36] severed the end of a baby's glans[37] using one of their clamps. Mogen claimed that injury was impossible with its use.[38] The injury behind a prior lawsuit in Fulton County Superior Court had already put Mogen on notice about the danger of the device.[39] In a different case, at South Fulton Medical Center, another law suit was won in 2009.[40] In that case, a child lost a third of his glans, and the plaintiffs were awarded 2.3 million dollars.[41]

Buenafe admits CPS does not approve

Buenafe admits that the Canadian Paediatric Society does not endorse infant circumcision, as they ascertain that there is not enough evidence to do so.[42](The Canadian Paediatric Society has said there is no point to circumcision since 1982.[43])

In addition, as of April 2012, the Canadian Paediatric Society has not yet reviewed the so-called "Pollock" (AKA Mogen) method.[20]

Lack of third-party payment

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

References

  1.   About Dr. Buenafe. Retrieved 16 June 2012.
    Quote: He has now expanded his practice to include infant circumcision. He has studied and trained with Dr. Neil Pollock, a pioneer and foremost authority in North America on this procedure.
  2.   (16 June 2012)."Dr. Jay Buenafe brings Painless 30 Second Circumcision to Winnipeg", Winnipeg Parent. Retrieved 16 June 2012.
    Quote: Dr. Buenafe went to Vancouver and worked intensively with Dr. Pollock under his careful supervision.
  3.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: He went to Vancouver to learn Dr. Neil Pollock's circumcision technique...
  4.   Dave S, Afshar K, Braga L, Anderson P. Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (full version). Can Urol Assoc J. February 2018; 12(2): E76-99. PMID. PMC. DOI. Retrieved 7 July 2020.
  5.   Bunarafe, Jay. Circumcision & Vasectomy Clinic in Winnipeg. Retrieved 7 June 2020.
  6.   (16 June 2012)."Dr. Jay Buenafe brings Painless 30 Second Circumcision to Winnipeg", Winnipeg Parent. Retrieved 16 June 2012.
  7. a b   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: Buenafe, who came to Canada from the Philippines in 2002.
  8.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: In the Philippines, non-religious circumcision (Tuli) is routine and is performed on more than 80 per cent of baby boys, the World Health Organization reports.
  9.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: I'd been getting lots of demand from my patients, specifically in the Filipino community, said Dr. Jay Buenafe.
  10.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: "and people from different religious sectors and foreign countries who have this as a tradition, he said.
  11.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: This is the bulk of my practice.
  12.   Kaweblum Y, Press S, Kogan L, et al. Circumcision using the mogen clamp. Clin Pediatr (Phila.). December 1984; 23: 679-82. PMID. DOI. Retrieved 6 August 2020.
  13.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: ...Buenafe started using it at his Jefferson Avenue clinic this month.
  14.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: He's been performing circumcisions for a number of years for Filipino-Canadian patients' newborn boys...
  15.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: and people from different religious sectors and foreign countries who have this as a tradition, he said.
  16.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: <Buenafe charges $299 to perform the procedure on babies younger than two months.
  17.   FAQs, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: Buenafe Circumcision Clinic performs circumcisions using Pollock technique...
  18.   Buenafe Infant Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: A quick, safe, and virtually painless circumcision technique... A thirty second procedure with excellent cosmetic result.
  19.   Parents' Guides to Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: Our procedure takes under 30 seconds
  20. a b   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: A society spokesperson said Wednesday the Pollock method Buenafe performs hasn't been reviewed.
  21. a b c   Parents' Guides to Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.
  22.   The Process, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: All the following steps are taken to ensure your son has minimal discomfort during the procedure.
  23.   FAQs, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: A relatively new approach has recently been developed that allows for a virtually painless and bloodless procedures to be done safely in seconds.
  24.   Taeusch HW, Martinez AM, Partridge JC, Sniderman S, Armstrong-Wells J, Fuentes-Afflick E. Pain During Mogen or Plastibell Circumcision. Journal of Perinatology. April 2002; 22(3): 214-218. 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.
  25.   Williamson PS, Evans ND. Neonatal Cortisol Response to Circumcision with Anesthesia. Clinical Pediatrics. August 1986; 25(8): 412-416. Retrieved 8 April 2011.
    Quote: The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.
  26.   Slater R, Cornelissen L, Fabrizi L, Patten D, Yoxen J, Worley A, Boyd S, Meek J, Fitzgerald M. Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial. Lancet, The. 9 October 2010; 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.
  27.   Buenafe Infant Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: A quick, safe, and virtually painless circumcision technique... A thirty second procedure with excellent cosmetic result.
  28.   Parents' Guides to Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: Our procedure takes under 30 seconds
  29.   Buenafe Infant Circumcision, Buenafe Infant Circumcision. Retrieved 16 June 2012.
    Quote: Buenafe Clinic practices an innovative approach to circumcision that allows for a virtually painless procedure to be done safely in under a minute. This technique was developed by Dr. Neil Pollock...
  30.   (8 April 2011). Pollock Clinics Infant Circumcision. Retrieved 8 April 2011.
    Quote: 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.
  31.   Use of the Mogen clamp for neonatal circumcision. Retrieved 8 April 2011.
    Quote: The Mogen clamp was invented in 1954 by Rabbi Harry Bronstein, a Brooklyn mohel.
  32.   (8 April 2011). Methods of circumcision, circumstitions.com. Retrieved 8 April 2011.
    Quote: The barzel (Hebrew for iron) also known as a mogen (Hebrew for shield) is a slotted shield...
  33.   Taeusch HW, Martinez AM, Partridge JC, Sniderman S, Armstrong-Wells J, Fuentes-Afflick E. Pain During Mogen or Plastibell Circumcision. Journal of Perinatology. April 2002; 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.
  34.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: The company is going out of business, according to a woman who answered the phone at its Brooklyn headquarters Monday.
  35.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: after an infant lost a portion of his penis during an operation with the Mogen clamp, a judge awarded $10.8 million in damages against the company.
  36.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: In this case, a New York mohel, or Jewish ritual circumcisor, performed the operation in the baby's home
  37.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: The baby in the current case, identified in court documents only as L.G., lost the entire glans, or head, of his penis ...
  38.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: The maker of an instrument used in circumcisions claimed that injury was impossible with its use...
  39.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: Attorney David Llewellyn won a similar case in Atlanta last year and the injury behind that prior lawsuit in Fulton County Superior Court put the New York clamp manufacturer on notice about the danger of the device...
  40.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: Llewellyn won another circumcision case in 2009 over an operation at South Fulton Medical Center.
  41.   Tagami, Ty (19 July 2010)."Atlanta lawyer wins $11 million lawsuit for family in botched circumcision", The Atlanta Journal-Constitution. Retrieved 8 April 2011.
    Quote: The jury found that both the pediatrician and the physician who performed the circumcision were negligent, and awarded $2.3 million to the plaintiffs.
  42.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: The Canadian Pediatric Society still doesn't recommend it, he said.
  43.   Sanders, Carol (19 April 2012)."New circumcision method faster, safer: MD", Winnipeg Free Press. Retrieved 16 June 2012.
    Quote: Since 1982, the Canadian Pediatric Society...