Q&A with Dr. Stephen Hollis: Ban online Botox, but make other drugs more accessible
People looking to blame someone for the shameful Botoxing of an 8-year-old girl have turned their guns on the Internet pharmacy where the girl's mother ordered the drugs. The doctors who work for these Internet pharmacies don't actually see patients. They just respond to online inquiries and prescribe the drugs.
I've written about a few of them over the years, including Dr. Stephen Hollis in March 2010. A year later, he commented on that post, multiple times, even leaving his phone number. I contacted him, in part just to know a little more about why someone in a profession that is focused entirely on patients would take a job where he has so little interaction with them.
I found Hollis to be likeable, excitable and a bit eccentric. As you will see, he makes some extraordinary claims that are impossible to prove or disprove, but, if he is to be believed, he has found a following with patients. The 64-year-old has been busy since graduating from Wake Forest University School of Medicine in 1973. He says he has done 118,000 eye surgeries to eliminate eyeglasses, most of them Lasik vision corrections.
Despite several run-ins with state and federal regulators, he has a backlog of people who want him to operate on their eyes, he says. His part-time Internet pharmacy work nearly cost him his medical license, but he sees his work there as part of a noble cause to save patients money and time. What follows is the first part of our conversation. It has been edited for space and clarity. The second and third parts will run Friday and Monday.
Q: Where did you do your training to become an ophthalmologist?
A: I stayed at Wake Forest for a year internship in general medicine, and then took three years of ophthalmology. I started the university at 18 and finished medical school, internship and three years of eye surgery residency at 30. Then I went and opened a practice in Columbus, Georgia, where I was born. But I was in Auburn, Alabama, when I was indicted by the federal government. They never even bothered to contact me. The way I found out was that I had people calling me telling me that both TV stations and the newspaper said that I had been arrested for being part of an illegal drug ring and that I was in jail.
Q: But you weren't in jail?
A: I wasn't in jail. I had to go to court the following Monday to find out that I had been indicted. The grand jury said I should be indicted, so I said I would like to see what lies the federal prosecutors told to the grand jury. My attorney said that was a sealed document that I couldn't look at. So there's no way to win. They indict me, and they won't tell me anything about the evidence. Listen to what the federal prosecutor said in the closing statement before the grand jury to one of the five doctors. He said "this doctor is nothing but a common dope dealer peddling dope."
Q: So you were able to see the case brought against you?
A: Not the evidence. But this is what he said in his statement, and what he said was a lie. You have to define dope. Viagra is not dope. Phentermine is not dope. I prescribed a few Phendimetrazine, another diet pill that is Schedule III, but not addictive. That's what I was prescribing. I wasn't prescribing dope on the Internet. I was helping people. I am a doctor, and I am allowed to prescribe these things. Why should I be able to prescribe them if a patient walks into my office but not if a patient sends in a request over the Internet or by phone?
Of course I wouldn't treat a heart attack on the phone, but there are a lot of things we could do less expensively and with little risk in this country over the phone and on the Internet. Prescribing Viagra for men with erectile dysfunction and phentermine for people who want to lose weight is easy and will not cause any problems.
Q: What about Botox? Should that be prescribed and sold online?
A: I have done Botox for years. I had it every four months for seven years for migraine headaches, and it was wonderful. But I do not believe Botox should be available online. Many doctors are not even comfortable with it. It takes skill to know where to give it, and one has to be prepared to handle a shock reaction to it. Put in the wrong place, it can be harmful.
Q: Why did you stop practicing ophthalmology and shift gears to work for an Internet pharmacy?
A: I was traveling to another clinic outside of Atlanta and was driving down a two-lane road where there are 118 crosses where people have died. It was rated one of the top five worst highways in America by Readers Digest. I ran off the road after hitting some water, took my foot off the accelerator and went into a crazy spin counterclockwise and hit two pine trees on the other side of the road and broke my neck.
I had to wear a halo around my neck, and so I couldn't drive. I couldn't even eat a hot dog because in order to eat a hot dog you have to raise your head and lower your chin, but I couldn't do either. So I was just sitting at home. When I did finally get to the point where I could drive, the vibrations from the car would make my neck hurt.
Q: So you ended up finding a job where you could work online?
A: I was told by a friend of mine that he had a friend who had this Internet company. He took me up to this place, and I met the guy who ran the company. I asked him, "What about the legality of all this?" Then I later met with their attorney, and he said there's nothing illegal about Internet medicine.
Q: It sounds like you had doubts about the legality of prescribing drugs online. What precautions did you take when you started working there to make sure that you didn't end up running afoul of federal drug laws?
A: I agreed I would not prescribe drugs for patients in Georgia or Alabama, because I have medical licenses there and knew it was going to be political, which it turned out to be. And I said I would not work in the four or five states where it is illegal to buy drugs on the Internet.
Q: How exactly did the online prescribing work?
A: I would just go all day long and check the computer to see if there were any orders for drugs. I averaged two to three hours a day, seven days a week. I did this from home. I did this from a hotel room in Florida, if was in Florida. After I got the halo off, I did it a few months after that, too. It took two seconds to prescribe the medication. Then the order was sent to six pharmacies across the country, and they mailed it out. These patients were able to get Viagra for the same price they could get locally but they saved the price of the doctor's visit, and time off work. Viagra costs you $22 a pill. That's just insane. Do you know how much it costs to order Viagra from India?
Q: No, I don't.
A: It costs 80 cents per pill. In countries where you don't have to have a prescription, the government can't stop that. And why doesn't the government stop people from buying drugs from India? They were against gambling on the Internet so they went after MasterCard and Visa and told them, "If you process these gambling transactions, we will get you." That shut those gambling operations down. They could do the same thing for these Internet pharmacies from abroad. Why not? Because you cannot prevent a country doing business under their laws.
Q: And I assume you aren't in favor of shutting down these Internet pharmacies from India?
A: No I'm not. I have never found a study that shows that we have more safety in America than most of the nations that don't have an FDA. The FDA is only there to slow new development down and make things more expensive. We had a thalidomide problem in this country that led to the creation of the FDA. Well, the answer to thalidomide causing birth defects is that is you don't take thalidomide if you are pregnant. How hard is that? It turns out that it was a very useful drug.
But instead of people being allowed to take it and benefit from it for all these years, instead we have an FDA to protect us and not a single study to show that we are safer because of the FDA. Now, 85% of all the drug costs in America are because of the FDA. A drug made in the U.S. sells in Mexico and Canada for $10, and in the U.S. it will be $80 because of the FDA. By selling drugs online, I saved society $10 million, and I saved people 100,000 hours sitting in doctor's offices.
Next: Hollis explains how he brought patients in by the thousands, earned millions
Related Posts:
Q&A with Dr. Stephen Hollis, Part 2: Government tries to "terrorize" doctors into submission
Q&A with Dr. Stephen Hollis, Part 3: Can't protect patients from their own stupidity
Doctors Behaving Badly: Eye doctor prescribed drugs to patients, sight unseen