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My response to Sure34 and related "suspension".


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Pat ??“ This is in response to your recent remarks. I have located the patient (Sure 34)'s chart and will address that shortly.

 

As you know, I have not been a fan of your internet marketing and have refused to go to your learning center level. My only purpose in being listed on internet sites is to allow patients to find my address and phone number when they are looking for it, since many of them are not in the local Beverly Hills/Brentwood, Newport Beach, or San Francisco phone book areas.

 

It is nice that you post a few pictures of patients on the internet, but the pictures are not of good quality. When patients come to my office for a consultation, we show them vast numbers of before and after photos, taken from various angles, and shot on film so the quality is extremely good. I don't believe people can make an adequate judgment about what they are seeing on internet photos. We also have one or more actual patients who work in the office, so real results can be examined in person.

 

My practice is a referral practice, and virtually all patients come from referrals from other patients, other physicians, or from various hair salons who have our patients as clients. It is not important for me to "garner internet patients", as you suggest.

 

It is good that you take feedback from patients very seriously. However, unfortunately you are not a physician and cannot possibly evaluate a patient for that reason, and also because you do not have access to the patient's chart, know the history, and have the before and after pictures.

 

I would like you to visit our offices in California when you come in October, to see how we do these surgeries. However, I have no interest in being listed on your internet sites in the future.

 

Your outrageous assertion that there is something wrong with my surgical results is beyond imagination. You may recall that I have done the most hair transplant surgeries of anyone in the world over the last 30 years, and our offices were achieving superb results even in the days of plug transplants. In fact, in those days, I had special plugs developed of 1-mm and 1.5-mm diameter, with which we extracted single follicles for transplanting hairlines. Today this is known as the follicular unit extraction technique and is used by several individuals including ourselves, in certain cases where the donor requires it. I attach a photograph of my longtime 15-year patient coordinator, Mr. John Peters, where you can see the section of his hairline transplanted 15 years ago with 1-mm single hair plugs (green), and the other section transplanted in recent years using modern techniques (blue). I believe you can appreciate that there is very little difference, although the modern technique is better. The reason for that is that in the old days, we used a 1-mm round hole to receive the 1-mm round plug, rather than the micro blade incision that is currently used.

 

You have suggested that I ought to encourage some patients to get on line and post their experiences with photos. I have for the first time read your suggestions for that being done, but I am unclear as to the part about photos. Is a patient required to reveal their individual name or can they use some sort of web alias? Is the patient to send his photos in the same way that you suggest for physicians, namely to your man in Washington? Please advise specifically how patients are to proceed in sending their narrative and photos and to where. I will ask a few of my physician patients to do that, but only if their individual names and facial features can be protected. As mentioned, about one-fourth of my patients are physicians, so that is a very common type of patient for us, and also a type of patient who probably understands, in greater detail, all aspects of any surgery. Incidentally, your assertion that you have many times in the past emailed me instructions to invite patients to post on your forum is incorrect. I have never seen this information before. Perhaps you were emailing this to one of my employees.

 

The patient known as Sure34, and of course we cannot discuss his real identity, initially presented to us on 3/31/00, at which time he was a student. He stated, "I've got a big scar on my head and it has become increasingly visible as my hair has thinned. I want to see if hair can be transplanted to cover the scar."

 

The scar was apparently the result of an accident. In fact, there were three scars in a stellate pattern. The three scars connected at a point about 8-10 cm behind the patient's hairline in the center of the head. From that, one scar ran towards the hairline, intersecting at about the midpoint; one scar ran to left of the center of the hairline; and the third ran to the right, intersecting the hairline in the temporal corner. All three intersected the hairline.

 

As the patient requested, we transplanted his existing hairline in order to hide these scars. Initially we did only 718 grafts to fill in the area of the three scars and fill in his hairline. Obviously, it was necessary to fill in his hairline in order to hide the scars since they intersected the hairline at three points. We did not lower his hairline. We charged at the student rate of $4.00 per graft for 500 grafts, but actually did 718 grafts. This was done in January 2001, because we had asked the patient to wait until the previous year's scars had fully matured, before transplanting, for six months. This was also to wait and see if there was any hair shock related to the accident that would grow back.

 

The patient continued to lose more hair from male pattern hair loss and, so, required an additional transplant on 9/13/02, one year and eight months after his initial transplant. At that procedure, we did about 778 grafts, and we again charged him at the student rate of $4.00 per graft.

 

Note that the patient was 21 years old at the time of the second procedure and 19 at the time of the first procedure.

 

There is nothing wrong with beginning to transplant a person with scars on his head at age 19. It was my judgment that no amount of drug therapy could solve the problem with the scars.

 

We spent plenty of time with this patient and carefully explained everything, including the fact that he would need several transplants over several years because he had male pattern baldness superimposed on his scars from the accident.

 

My initial impression at the time of consultation was that he was likely to go to a 3V. His father was a 3V pattern , although both grandfathers and uncles were both 2s. There was no substantial and severe hair loss anywhere in the family.

 

Based on the information on the internet, it would appear that this patient has gone into a depression, although it is not likely related to his hair loss. We have photographs dated in 2004, showing a very effective hair transplant with only a total of 2900 grafts used so far. It looks like his pattern will go to a 4 or 5, but there is still a vast amount of donor hair available. Originally we estimated about 7000 grafts available in his donor area, so there is no shortage of donor to finish whatever he requires. Obviously, the patient should not part his hair in the middle until all transplanting is done. His unusual natural hair direction fans out in the center of the hairline.

 

In February 2004, the patient re-presented to the office with further male pattern hair loss, and we did a third transplant of about 1800 grafts. This has grown out nicely, although I have not seen pictures in 2006. It is likely that he has had additional hair loss since 2004, and needs probably one more large transplant to all areas.

 

Pat, you should not be playing on a young man's depressed situation. You are not a physician or a psychologist, and your only role here should be to refer the patient back to his physician for additional treatment. The classic description of a depressed man is a rich man who, when depressed, feels he is poor.

 

As we do occasionally in cases of depression, since our main objective as physicians is to make people look and feel good, we will be pleased to finish this case on a pro bono basis. Kindly refer the patient back to us for evaluation at this point in time. We will attempt to get his depression treated.

 

Incidentally, the hairline on this patient is no lower than my 57-year-old hairline is, which you can easily see on my website at elliotthair.com. We never do hairlines that are too low, but in California, we probably tend to put hairlines at a little more youthful level than is done in the eastern United States. This is because people in California like to look good, and a well-framed face is what makes men have a handsome appearance. There is nothing more distracting than an elevated hairline from the front. It has always been my opinion that it is better to properly transplant the front of the head and, if necessary, leave a spot in the back. However, with modern micro technology, there is usually enough hair to transplant the front well and at least a medium coat in the crown, which looks great when the hair is combed back. California patients generally don't want a completely bald spot in the back of their head, although I understand in the East, this is frequently acceptable.

 

Finally, Pat, your assertion that we do not have a consistent and proven tract record of excellent results may well end us in court. This is absolutely ridiculous. Of the more than 30,000 patients that I have done, there have only been a handful who were not completely satisfied, and each of those individuals was a revision case that had initially been transplanted somewhere else. Sometimes there is not enough donor hair left to get to the level we want. However, 100's of times I have gotten more donor out of people who had previously been decimated in their donor by another clinic.

In our office, we never give up on these types of cases, we never surrender.

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Dr. If I recall Fue was around in 2000 and if it was at first to cover scars from a accident he should have been refered to this type of surgery. 19 years old is to young to go in and start the hairtransplant treadmill. Second .You have diagnosed him with mpb and if it started that soon(19) he should have been put on propecia even after the first transplant and sent home. I hope all the best for this patient.

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Dr. Elliott,

 

I appreciate that you took the time to respond in detail to the concerns posted by your patient who posts as "Sure34". This patient chose to present his concerns on this forum and you chose to respond.

 

On this forum all patients and their experiences are welcome ??“ the good, the bad and the ugly. It is then up to the adults visiting this community to evaluate the merit of the information presented.

 

Fortunately, the vast majority of experiences posted in recent years have been positive since patients who are doing their research online are identifying and going to clinics that provide consistently high quality results. One need only use the "Find" feature to search for posts about leading hair transplant physicians to see this.

 

While it can be awkward to respond to patient complaints in a public forum, in the age of open information it is some times necessary. Physicians who are confident in their work and results are not threatened by this open forum since they benefit from a transparent environment in which actual results trump advertising hype.

 

You say that you are "not a fan of your internet marketing" and that your only purpose in being listed on internet sites is to allow patients to find your address and phone number. I think you are misunderstanding the value of this community, which serves both hair loss sufferers and outstanding clinics very well.

 

A lawsuit against me and this community is not going to enhance your reputation online. But genuine patients posting impressive results on this and other forums will. I suggest you embrace this transparent and open exchange of information rather than distain it.

 

This discussion forum is open to all physicians and patients, regardless of whether or not the physician is chosen for recommendation on this community. So feel free to invite your patients to join this forum and post their actual experiences and photos. They do not need to provide their real names. But they do need to have a genuine interest in participating on this forum.

 

No one person or even group of people can have definitive information about all physicians, clinics and techniques. But this community does strive to enable patients to get past advertising hype by comparing actual experiences and information. It also provides potential patients with suggestions for physicians who have a demonstrated track record of providing consistent high quality hair transplant results.

 

I have no doubt that you have many happy patients. And no physician bats 1000 all the time. But at this point, given the information I have now, I cannot confidently recommend you on this community. Perhaps after visiting your clinic in October and learning more about your patient results this may change.

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Finally, Pat, your assertion that we do not have a consistent and proven tract record of excellent results may well end us in court. This is absolutely ridiculous. Of the more than 30,000 patients that I have done, there have only been a handful who were not completely satisfied, and each of those individuals was a revision case that had initially been transplanted somewhere else. Sometimes there is not enough donor hair left to get to the level we want. However, 100's of times I have gotten more donor out of people who had previously been decimated in their donor by another clinic.

In our office, we never give up on these types of cases, we never surrender.

 

Dr Elliot I just want to say thanks for posting on this open forum and letting us all know your thoughts on how you have approached sure34's HT. Now that we have both sides of the story we can make up our own mind on whether or not your thoughts were justified.

 

You have to understand that Pat (and all of us) are justified in thinking that you may not produce consistent results if only patients that believe they have received a poor result post their experiences here. Having said that though I have spent countless hours on this forum and have read many other patients that have received a good experience from you. Letting us know about your experience (30000+ HT's) and hearing that you are using modern techniques will only be received positively here. You should encourage your patients to post their photos and experience here. Good results will raise your profile and give all of us here more confidence in your abilities.

 

But threatening court action will definately not be received well by people here. It does sound like you do not know about this forum as you were not aware about being able to post anonymously using aliases, etc. For this reason we can forgive your initial hostility towards this forum of open information. You like most of us should know that a HT is a life changing experience and that a bad HT can cause a patient severe depression. Before reading this forum I like everyone else new to HT's would have thought that any Plastic Surgeon can perform a HT and expect the same result. As you know this is not the case, not every surgeon doing HT's is sufficiently skilled, not everyone is doing FUT/FUE's, can perform the Tricho closure and a near undetectable scar, uses specialized equipment and can provide a truly natural result, etc. This forum is a life saver for many of us and also provides us an invaluable support group to give us confidence to actually go through with it in the first place.

 

Just to reiterate, this forum is a hell of a lot more than the promotion of surgeons in the Coalition, it is an invaluable resource to most of us here. It has provided us extensive knowledge about the entire HT process - how the entire operation is performed, how long it takes to heal, exactly what to expect after the HT (scabs, shockloss, 3+ months for signs of regrowth, etc). What results patients can expect in terms of grafts, density and coverage, etc. You have to agree that a well informed patient with realistic expectations is going to be a happier one.

 

If you are a HT surgeon for the right reasons, i.e. to make a different in peoples lives and to give them back confidence and a happier outlook on life (as opposed to being purely motivated by profit) spend some time to research this forum you will soon find out that this forum strives to achieve this goal as well. I believe that if you refer your patients to this forum as part of your after care service they will be better off knowing that they are not alone and that there is an invaluable support group willing to provide invaluable information should they have any questions.

 

Dr Elliot, I wish you and your patients well in the future and look forward to your posts in future.

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i'm glad Dr Elliott spoke up as i think he is being unresonably attacked on this site, and any one saying they got good results from him is labelled a "shrill"..i have gotten great results from his clinic and was labeled a shrill. i think that many of his clients, being a clinic in Southern California demand a high level of privacy. i work in entertainment myself, so no one has ever known that i've had two procedures done, so i dont run to forums to post. my curiousity after my second procedure lead me to this site to see what other people have experienced, but it seems that some of you guys forget that after this procedure, some just want to get on with there lives. Also Dr. Elliott, i hope that you stay active on the internet and share information with your techniques and clinic from now on, so that people can see that you are indeed kind and care for your patients.

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I am grateful for this site and the amount of dedication that Pat, and previously Robert, have given to it.As I contemplated options to address my own hair loss, this site was an exceptionally valuable resource in educating myself on various options and protecting me from making an uninformed and potentially regrettable decision on who to seek out for my own hair transplant procedure.

 

I find the threats of lawsuits to be inflammatory, reactionary, unfortunate and unmerited.

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..... unreasonably attacked......

...Pat is not a physician, please refer these patients back to the doctor who caused some of the problems.......

 

Perhaps Dr. Elliot should spend some time on the internet to find out just how much information is out there. He would begin to realize that his being a doctor does not make him right all of the time, and a certain amount of guesswork goes into what he does on a daily basis. Many of us here spend time talking to each other or emailing each other, looking around and are able to form pretty solid opinions.

In this instance, I was less inclined to discard Dr. Elliot, except I felt he targeted this forum by reviving old threads in an attempt to bolster his reputation.

 

How about we settle for the fact that an unhappy patient voiced his concerns, and his doctor probably operated on him too early?

Obviously the patient was distraught over his scarring, so instead of treating him with medication and possibly FUE, the doctor went ahead and added another scar to the young mans head. In addition, the session sizes ensured that the patient would continue to come back for many additional surgeries.

"My initial impression at the time of consultation was that he was likely to go to a 3V." (now after 3 years it looks like a 4 or 5) So you were wrong Dr. Elliott, just like you were wrong to perform surgery on a 19 year old without looking at ALL available remedies, including NOT performing surgery. That is why all of the ETHICAL clinics treat young patients as if they will become a 6 or a 7, and act accordingly and ethically.

Lastly, I do not like the attitude presented by Dr. Elliott, that this forum and Pat are prone to rash acts of rebuttal against the misunderstood, misaligned, caring physician. That is pure vomit, just like threatening a lawsuit. What ever happened to education and sharing?

Dr. Elliott has been able to carve a nice living out for himself, so why not prove and share your results? No sir! I am a physician, who just stated that I misdiagnosed a patient, but do not want any layman questioning my judgement or skill.

 

BTW, I went to the website, and I am not impressed.

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Interesting thread. I do not know anything about Dr. True and take no position on whether he should or should not have operated on a nineteen year old, but I do know it is impossible for people on this forum from "afar" to judge whether what Dr. True did was reasonable under the cirumstances. There is no one size fits all category. Each case and circumstance must be judged on its own facts.

 

Some of you have come down on Dr. True for threatening a lawsuit. Maybe I am biased because I am one of those "trial lawyers" who our wonderful President is so fond of bashing, but the fact is that it is probably not pleasant to have your professional reputation bashed on a public forum. Free speech does not circumvent the tort of libel and slander and defamation can be devastating to one's reputation and ability to earn a living. The sharing of information is important, but so to is the necessity of discretion by the moderator to ensure the legal rights of people are not violated. Face it, this is a public forum. There are a large number of disgruntled people in the world and certainly it is easy for any of them to come on a public forum such as this where they can trash the reputation of a professional, justified or not. Should they be able to do so with impunity? Does a moderator have any responsibility for what goes on in his public forum? I don't think the answers are so clear.

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Sorry Pat, I got the wrong doctor but the principal is the same. To what extent can professionals be defamed in public forums? Your forum provides a great public service. The problem I have is that it (and any other public forum of course) leaves open the possibility any person, maybe a manic depressive, can write in, trash a professional's reputation, blame that professional for all of their problems, and to some extent gain credibility on a forum such as this. There may well be lots of professionals out there who deserve a poor reputation. But it is simply too easy for anybody to trash anyone these days and there has to be some sort of accountability when that happens, imho.

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Hoping,

 

Free speech, like democracy, is not always pleasant. But it sure beats relying solely on paid advertising, which is more like the equivalent of a top down dictatorship.

 

On an open forum, claims can be refuted by those who don't agree with them. Then those reading them can make their own determinations.

 

Would anyone really claim that denying patients the ability to share their real experiences would improve things?

 

In cases were seriously allegations are made I typically investigate the claims to at least validate the authenticity of the parties involved. I find that the fairly infrequent complaints that are posted on this forum are almost always genuine and not motivated by malicious intent.

 

Having moderated this forum now for over five years, I trust in the process of people sharing and debating ideas and forming their own opinions. We are all subject to being critiqued on this forum and I've endured my share of grillings. But like others, I've always had the option of rebutting any claims I didn't agree with.

 

I've found that physicians who do high quality hair transplantation typically appreciate and support the need for a forum like this. These physicians also freely welcome me and others to visit their clinics to see them and their staff in action. These physicians have nothing to hide and operate in a transparent environment.

 

This accountability is expressed in the Coalition Membership Standards.

 

On the other hand, I find far too many physicians who bad mouth this and other hair loss forums. They consider forums in which patients openly discuss and critique treatments and physicians as blasphemous and heretical.

 

The ISHRS actually has an "Internet Monitoring" committee and has even sponsored closed door meetings (closed to lay web publishers) in which forums like this one have been hotly debated. Many physicians have not yet come to terms with the new power that patients have gained thanks to the Internet.

 

Yet, despite the best efforts of some very prominent physicians, the Internet and its forums are not going away. That genie is long out of the bottle and physicians need to operate in a world in which yesterdays patient may be tomorrows vocal poster.

 

Those physicians whose actual results do not meet high technical and ethical standards will not be recommended on this site. Given the life long consequences of hair transplantation, I think it is better to error on the side of being conservative in who is recommended on this site. After all, there are plenty of proven clinics already recommended on this community.

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Hoping, the claims of poor workmanship and shoddy technical skills are easily dissuaded with before and after photos. Attacking a professional? There is very little legal recourse for cosmetic surgery patients, defined under the reasonable expectations statute. In this particular instance a Dr. was removed from our membership at the discretion of Pat who determines the validity of these types of claims. The issue was not really an issue until several undercover posters attempted to revive 2 and 3 year old threads in a obvious manner to support Dr. Elliot. Again, a few of us mentioned this, but not a big issue. Once these efforts continued and these posters were called out, the workmanship of Dr. Elliot was called into question. Neither one of these "non-affiliated" posters could show us their results, or refused to. Then Dr. Elliot himself finally makes an appearance, chastising Pat for not being a physician, and for having the nerve to hold physicians accountable for their actions. One of the main reasons for disliking the internet is just this very situation. Instead of this patient working out a deal with Dr. Elliot-- this patient let everyone know he was dissatisfied, and justifiably so, from the way things have played out. Additionally, Dr. Elliot could have come forward with photos or his handling of the situation, but as we can see, that is beneath a person of his standing.

 

 

Let me just say this: Regardless of how many surgeries you have done, you still need to stay relevant. You also need to continue learning, because any industry will pass you by. We no longer accept shoddy workmanship or the attitude that a physician is always right. This situation here (using the good doctors recollection of the issue) is a perfect example of this.

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B-Spot, you continue to take stabs at me and my aparent agenda, but your's sir is crystal clear. you know nothing about me but you need to get a life. you are attacking this doctor without having the real facts and thats the only thing i will say about the matter, other then that, you could say what you will about me, but i could careless, because i dont have any respect for you and your dog like loyalty to Pat.

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something... you can say what you want about memebers here all you want, but don't stab Pat. He is here to help more than any of us. He is doing what is best for newbies and others. I'm glad you had a great experience... more power to you, but don't start throwing mud. Think about those that have had subpar results. Pat has seen more HT's than most of the docs recommended here. He's a class act trying to help the people that don't know any better find a great physician. If Pat says that a dr's ethics or practice are questionable than it's time to listen.

 

I can't help to think why your trying to defend a dr. so much... if he is that good he doesn't need your comments. B has been here a long time and he knows the drill and can spot a less than perfect treatment plan. Yes, perfect! If it isn't perfect for the patient than it's time that the doc isn't recommended. After all, it's all about the patient here not the doctor.

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forget the dr..really,i dont need to protect him, he can take care of himself. i just had a good experience with the guy, and thats the end of that. and i didn't mean anything offensive towards Pat. That i apoligize as well, but B-Spot keeps taking jabs at me for the limited time i have been here and i'm sick of them..

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Originally posted by something:

forget the dr..really,i dont need to protect him, he can take care of himself. i just had a good experience with the guy, and thats the end of that. and i didn't mean anything offensive towards Pat. That i apoligize as well, but B-Spot keeps taking jabs at me for the limited time i have been here and i'm sick of them..

 

Have thick skin, guy. Until someone comes and knocks at your door to yell "YOUR HAIR LOOKS AWFUL!", its just words on a screen. If someone does come to your door and do that, knock their teeth out.

 

If you're happy with your procedure then that's absolutely fabulous. I can't be happier for you. Apparently there have been quite a few posters on this forum that haven't been. Just do a search and you can see that for yourself. Do these posters have any more or less right to aire their side of the story? Of course not.

 

Guys, this isn't a court of law. This is an informational forum. Potential patients can read the facts and opinions brought forth by all parties and make their own decisions. That's the bottom line. The minute that arguing takes over a thread, though, is the minute an otherwise knowledgeable and useful poster can be viewed by someone knew to the site as nothing more than an internet tough guy that has nothing more to do with his time than to take jabs at others. Someone may have hundreds or thousands of posts that are filled with great information only to have it all compromised by a heated words.

 

Be all end all: play nice and stop arguing. A civilized discussion is what is needed here, not juvenile bickering.

 

-Robert

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Just an observation, but I think the internet has done more to educate consumers (i.e. patients) and to some extent challenge physicians than any other development in many years. The days of a patient just accepting the advice and opinion of a physician are long gone. Some physicians have embraced a better educated patient and some have been threatened by it. In the end the winner can and should be both. A better informed and educated patient will make better decisions for themselves and this is a good thing for both the doctor and the patient.

 

Just my opinion.

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Pat you do a great job here, and probably are a much better gate keeper than most in keeping out the trash. And I am not defending Dr. Elliott. His post was pretty condescending in his comparing California to the Easter US, an attitude which is pretty much what I have learned to expect from many members of the medical profession. Still, defamation is defamation. Not that you've done so or others on this board have done so, but it is a big problem on the internet.

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If a newbie may weigh in...

 

With respect to Dr. Elliot's perspective on internet "marketing," if I understood his words correctly, I would say emphatically that sites such as this one, and several others like it, are of immense value specifically because they provide a foil for "marketing," and allow people like me and others at the bottom of the hair-transplant learning curve to interact with people -- some, hundreds or thousands of miles away -- and see real results, and use this to make informed and intelligent decisions.

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