JCPM2025.12.02

The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of December 2, 2025, with Charles Runels, MD.  

>-> The PDF transcript of this live journal club can be seen here (for CMA members only, can find in the membership sites) <-<

Topics Covered

• Pelvic floor pain and dyspareunia in young female athletes
• Trigger point injections with platelet-rich plasma vs. corticosteroids
• Using AI inside CMA membership sites for clinical questions
• Psychodermatology: integrating psychology with dermatologic platelet-rich plasma procedures
• Treating vitiligo with PRP and UVB phototherapy
• PRP for post-herpetic neuralgia and antiviral implications
• Primary care workload crisis and implications for procedural cash-based practice
• Business model positioning: the “sweet spot” between research-supported and non-insurance procedures
• Book highlight: How to Live on 24 Hours a Day (1910)
• Pre-written marketing emails for pelvic floor pain and vitiligo
• Q&A discussion with Robert Doyle: VA healthcare and socialized medicine
• Storytelling technique for patient-facing emails and marketing communication

• References
• Helpful Links

Charles Runels, MD
Author, researcher, and inventor of the Vampire Facelift®, Orchid Shot® (O-Shot®), Priapus Shot® (P-Shot®), Priapus Toxin®, Vampire Breast Lift®, and Vampire Wing Lift®, & Clitoxin® procedures.

Transcript

Welcome to our journal club. I have several papers that I think will be encouraging. The fun thing is that we hardly ever bump into a paper that says, “Oh, the stuff you’ve been doing is just awful; you’re harming people; it doesn’t work.”

There is a huge stack of research that comes out every week, and it is so encouraging that I have to choose just one out of the pages of references. I’m trying to bring you the papers that will be most helpful in a practical way.

The way I grade them is: Will this either encourage our patients to come have what we know how to do, or will it refine our technique, or encourage us in what we’re already doing?

So let’s run through them. As usual, I’ll try to arrive somewhere between 30 and 45 minutes, so you can get back to your family.

Pelvic Floor Pain and Dyspareunia in Young Female Athletes

Let’s start with this paper because it’s one of my pet peeves. There’s this idea—and this is another one, by the way, that I couldn’t buy, so I’m going to have to swap you over so you can see it online. I had this happen last week, where I’m trying to give someone money and I just can’t figure out how to get them to take it.

So I have the abstract, and I’ll put the link in your chat box right now.^[1]

There is this misconception that pelvic floor problems and sexual pain secondary to that—and incontinence secondary to that—happen only to women in perimenopause or later, or to postpartum women. But there is actually a really huge incidence within young female athletes, and I think it’s not widely recognized by our colleagues and certainly not understood by patients. They don’t know. They think something strange is going on.

In one study of women who were trampoline gymnasts, all of them had incontinence.^[2] Incontinence was defined as enough leakage of urine that it’s interfering with your hygiene or your social life—you’re either having to stop doing something, or you’re having to wear a pad or diaper to prevent accidents. By that definition, almost 100% of trampoline gymnasts were affected. But this isn’t limited to that group—it also appears in distance runners and other impact sports: basketball players, volleyball players, anyone jumping up and down.

I put a link to the paper in the chat box. If you can figure out how to buy it, let me know. It wouldn’t take my credit card. But it’s a high-impact journal, and you can still get the point of it from the abstract—the British Journal of Sports Medicine.^[3]

And at the end of today’s call, like we did last week, I’m going to give you word-for-word, two emails that you can send, and one of them relates directly to this topic.

Marketing and Ethical Framing: Educating Patients

The reason I like tying research to marketing is to remind you of something essential: when it comes to marketing, instead of being embarrassed by it, I think it’s our ethical duty to acknowledge that patients don’t know what we’re able to do.

It would be different if you were writing antibiotics for sore throats. They know you know how to do that. Immunizations—pharmacies now do that. You can even get a prescription for pharyngitis or ED meds via a $25 text visit on Amazon.

So to really stay relevant, we have to stay up-to-date and do things that people cannot find elsewhere. And those are exactly the things that patients will never know we can do unless we educate them.

A recent article that came out within the past week makes it “news.” That allows you to say:
“This just came out, and it relates to something I do.”
Now you’re not advertising—you’re curating the news.

Think of it as an educational endeavor, and as part of your ethical responsibility.

Incontinence Statistics and Clinical Approach

So, you say: “Oh, yes—you think you’re unusual and embarrassed because you have urinary incontinence at the age of 20. But the stats are that 5% of women in their 20s have incontinence.”

Now, 5% may not seem like much, but it’s one in twenty. In a classroom of 20 young women, one of them is wearing a pad or has given up gymnastics or distance running due to incontinence. She may also be having hip or groin pain.

My wife, who’s a gynecologist, often tells me about someone—usually an elderly lady—with chronic hip pain, and she figures out that it’s actually their pelvic floor.

We have an answer for that, and you can review it.

Using CMA Membership Site AI for Clinical Support

If you log into any of our membership websites now, they have AI built into them. Of the millions of words we’ve generated doing these journal clubs over the past decade—and the feedback—and the 900+ videos—there is a huge reservoir of information, essentially a Wikipedia of our procedures.

You can search it using an AI that has read all of it. It will write out an answer and give you references.

If you go in there and type “pelvic pain” or “dyspareunia,” it will give you many references—more than what I’m giving you here.

The quick answer when you’re examining a woman with dyspareunia is:

• Look carefully at the anatomy
• Review a good Netter’s or online anatomical reference
• Palpate around the posterior vagina and laterally from about 3:00 PM to 6:00 PM to 9:00 PM

If, somewhere in that arc, you find a point that reproduces their pain, you probably found the source of their dyspareunia—and maybe even their hip or groin pain.

A trigger point injection there with platelet-rich plasma would be analogous to what sports medicine doctors now do. Hydrocortisone would be considered second-rate and could cause weakness.

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If you gave cortisone to an NFL player with a hurt muscle instead of PRP, you’d probably get fired.

Give your female patients the understanding that you know how to do this by referring to this paper. It’s stuff we already know, but it’s beautiful to see it discussed again.

Psychodermatology and Dermatologic PRP Applications

This next paper—I love this one. I love it so much that I also wrote an email you can send out about it.

Last week, we covered a paper that discussed the psychological component of dermatologic disease. They called it psychodermatology—combining psychotherapy with treating acne and other diseases like eczema and psoriasis that cause people to want to hide their faces. And I told you guys about my own experience as a teenager with horrible cystic acne.

Vitiligo is one of those conditions.

There have been trials with stem cells and lasers and all sorts of things, but the simplest approach—which also gets great support in this review article—is:

Platelet-rich plasma combined with light therapy.^[4]

Now, some have combined PRP with laser therapy. If you have a laser, go for it. But there’s a whole science behind using UVB phototherapy—just ultraviolet light.

So, basically, give them a tan on top of your PRP.

It’s the simplest little treatment. And it’s been shown to work. Their only criticism in the article was that there’s no standardized protocol.

Guess what? We have a standardized protocol.

Just do your Vampire Facial®—PRP, microneedling—and then tell them to use a sunlamp. You can buy UVB phototherapy lamps on Amazon. It’s inexpensive, practical, and research-supported.

So now you have a review article discussing:

• Emerging cell-based and cell-free therapeutic strategies
• PRP for repigmentation
• Phototherapy synergy

This paper is news, and you can talk about it. I wrote an article for you to send to your patients, bragging that you have an answer for something that probably makes some people in your town want to hide.

PRP for Post-Herpetic Neuralgia and Viral Pain Syndromes

Okay—this next one. I love this one because it’s about PRP helping with zoster pain.^[5] And of course that herpes virus shows up elsewhere.

We’ve had anecdotal reports—no one has done this formal study yet—but PRP is antibacterial and antiviral (though not exactly antiviral, it helps with healing and boosts the immune system).^{[6] [7] [8] [9] [10] [11]}

I’ve had anecdotal reports, including one from one of the first people I ever treated with PRP.

She was within the first ten patients I ever injected with PRP.

She had recurrent genital herpes and told me she didn’t take prophylactic acyclovir because she was celibate—she preferred not to be on it because of side effects.

She also had dyspareunia and anorgasmia, which were part of the reason she was celibate. She used a vibrator. I treated her.

She became more easily orgasmic with masturbation. And as a side effect, she noticed her recurrent genital herpes decreased in frequency and severity.

Was it because she was having orgasms again?
Or because of the O-Shot®?
I don’t know.

But now you have an article showing PRP helping with post-herpetic neuralgia.^[12] And this review paper is not just one small study—it summarizes multiple reports.

We all see patients with post-herpetic pain. It’s horrible. If you’ve ever had a patient or a grandmother with shingles, you’ve seen how devastating it is.

So now you have a new possible treatment.

Someone needs to do the study on recurrent genital herpes itself. That’s low-hanging fruit for any of you who want to publish.

I didn’t write you an email for this one, but it’s worth filing away—especially for:

• Patients with genital herpes
• Patients you are treating anyway with an O-Shot®, perhaps for incontinence or sexual dysfunction

Just tell them:
“Watch for decreased outbreaks. It might help.”

Primary Care Crisis, NEJM Article, and the Erosion of Traditional Practice Models

This one—honestly, it just hurt me. This paper was referenced by another article that came out in the New England Journal of Medicine.

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I find the NEJM to be… well, let’s just say that sometimes it feels like 30% politics, even in its scientific articles. Even 30 years ago, when I was in training, one of my attendings—the guy who memorized Harrison’s and could diagnose across the room—told me:

“Charles, I remember when you could count on what’s in the journals. Now a lot of it is just made-up trash.”

I don’t know if it’s truly that bad, but it’s not my favorite journal. I still read it because patients and other physicians consider it high impact and believable.

But here’s what made this interesting:

This left-leaning journal cited another paper showing that for a primary care physician to do everything required of them in a day—including documentation and preventive care—they would need 27 hours a day.

Let me say that again:

27 hours per day.

That was the conclusion of this paper: Time Needed to Provide Primary Adult Care.

We included the links in the handout.

Patients don’t believe this. They think if a doctor is broke, it’s because he’s drinking, gambling, or stupid with money. They don’t see the mathematics.

You simply can’t be a primary care physician without a physician extender and expect to prosper. It’s almost impossible now.

My dad always said:

“People want their lawyer to be rich and their doctor to be poor.”

Maybe that’s true. Maybe we should take vows of poverty. I don’t know. But the reality is that traditional primary care is collapsing under its own administrative weight.

And this NEJM paper confirms that—even from a viewpoint that is not business-friendly.

Strategic Implication: Why CMA Procedures Fit Today’s Medical Landscape

What this confirms for me is:

It’s not going back to the old way.

There are now 27 states where an RN can:

1. Get an online nurse practitioner degree
2. Practice without physician supervision

This is the landscape now.

So how do you deal with that?

You do the things that:

• Are well supported by research
• Require your hands
• Are procedural
• Are safe
• Are not yet covered by insurance

That’s the sweet spot.

If it’s covered by insurance, you must be paid by the middleman—what I call “the pimp.”
If it’s not covered yet—but backed by research—you can practice medicine the way it was meant to be practiced.

An O-Shot® is worth two nights in a nice hotel if it restores sexual function or cures incontinence.

Compared to a copay, sure, it sounds expensive. But if you take it out of the “medicine box” and compare it to the cost of:

• Renting a jet ski for two hours
• Buying a set of tires

It’s in the same price range.

Book Highlight: How to Live on 24 Hours a Day (1910)

Before I give you the marketing packet, I want to mention a book I was rereading this week. I keep a small shelf of books that I try to read at least once a year—many of them I’ve had for decades. These are the books that actually changed my life.

One of them—How to Live on 24 Hours a Day^[13]—was written over 100 years ago, in 1910. You can probably read it in an hour; the audio version is less than two hours.

Here’s what it looks like.
(Visual shown on camera during webinar.)

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You can buy a used hardback copy for around $12 on eBay. The paperback version on Amazon is about $5. The Audible version is narrated in a British accent, using terms like “pounds” and “shillings,” which I enjoy.

This book is profound, simple, and powerful.

If you want to:

• Write your book
• Do your research
• Write your autobiography
• Study the 5-Notes Expert System
• Dive deeper into the science behind our procedures
• Prepare yourself to conduct your own study

This is the book.

I almost don’t want to give you the punchline, because it’s like revealing the end of a movie—you might undervalue it if you hear it too soon. But practicing what this man teaches—simple, unique, old-fashioned—can literally change your life.

Marketing Kit for the Week

Okay—now your marketing packet.

I wrote two emails for you this week. You can copy and paste them as-is. However, what I recommend is this:

Add yourself somewhere.

Anyone could send the email as it’s written. But there’s no picture of you, no anecdote from your office, no story about something you experienced. There’s no “you” in it.

You don’t have to go full Kardashian. You don’t have to show your abs or cleavage or dance in the email. (Although we have providers in our group who do that very well—they’re beautiful, bright, funny, brilliant.)

But you don’t need that.

Just put yourself in it somewhere.

Add:

• A picture of yourself
• A brief personal note
• A story that happened in your practice
• Something you observed
• Something a patient taught you

And, of course, add your contact information.

The email already has the link embedded to the study it references. You can take it, personalize it, and send it out today.

If you can, tell a story—because stories are the best way to make content compelling.

For example:

• Something about a patient (with identifying details removed)
• Something about your own life
• Something from your clinical experience
• Something your mentor once told you

Here is the first pre-written email.
(Shown on screen and provided in for CMA Members Only.)

Why Storytelling Works in Medical Marketing

Let me say a bit more about stories.

People do not want to be advertised to.
They love a good story.

I don’t talk about this often, but I have conservatively spent a couple million dollars on my marketing education over the past 20 years. When you don’t have a middleman—when you don’t have a payer system dictating things—you must learn to communicate directly with patients.

When I gave up Blue Cross Blue Shield, I had to learn how to speak to people far away.

The first thing I did was take an email-writing course. The coach charged me $3,500 for the course and then $1,000 per month for three years for one hour of coaching per month. And one of the most valuable things he taught me was:

“People don’t want more data.
They want meaning.”

And meaning comes through stories.

Stories have:

• A person
• A place
• A time
• Something that happens

They can be simple.

For example:

“This morning, when I opened my computer, I saw a new research paper showing that women in their 20s have pelvic floor pain at high rates…”

Now you’ve taken a piece of medical research and turned it into a story.

This is called the middle range:

• Straight statistics are too dry (newspaper reporting).
• Philosophy is too abstract (Spinoza, Kant, metaphysics).
• But stories—concrete experiences that connect to abstract meaning—hold attention.

It’s why children love fairy tales.
It’s why adults binge-watch Netflix.
It’s why your patients will read your emails.

Stories make science stick.

Adding Materials to the Handout Section

Now, let me upload the handouts.

(Shown live during the webinar.)

There’s the email (for CMA Members Only)
Next come the papers—PDF files.
The email is a Word document you can download, copy, paste, and modify.

Everything I put in the handout section is open source. If it’s not open source, I put a link instead. These items are yours to save to your laptop or desktop.

Q&A Segment: Discussion with Robert Doyle

Robert Doyle:
“Charles, that article from Medicine and Society was interesting. But we already have socialized medicine. It’s called the VA.”

Charles Runels:
“That’s true. Yes, it is.”

Robert Doyle:
“Everyone who says we’re ready for socialized medicine—I tell them: ‘We’ll be ready as soon as people are breaking down the doors to get into the VA. When veterans—who deserve the best care—are receiving such remarkable treatment compared to their local hospital.’”

Charles Runels:
“Yes, you’re right. My oldest son was 82nd Airborne. He bounced and wound up—well, he survived it and recouped—but it’s sad how we treat our soldiers. And old people and soldiers tend to get discarded. Gibran talked about it 100 years ago.”

“But here’s the good thing: if we’re all-cash, we can see them on the side. We’re not breaking anyone’s rules. Nobody can get mad at you.”

“When I was a PMD doctor for Blue Cross Blue Shield, if I saw someone for free, I had to at least charge them a copay. But when you’re all-cash, you can have a free clinic on the side. And many of our doctors do that.”

“I won’t name names because many people like to keep their good deeds secret, but many have clinics where they’re treating HIV patients or people in other countries—funded by the fruits of their all-cash practice.”

Follow-Up Discussion About Materials Access

Robert Doyle:
“One more thing—the psychodermatology article last week was amazing. And when you say you put the handouts in the materials section—where can I get those to store them on my laptop?”

Charles Runels:
“I should make it more obvious. When I put them in the handout section, maybe I’m closing the webinar too soon.”

Robert Doyle:
“In my panel it says, ‘No materials.’”

Charles Runels:
“Yes—I was late. Give me a second. Let me upload them now.”

(Uploads shown during webinar.)

Closing Remarks

The first prewritten email is now uploaded. Next come the PDFs.

The person who originally taught me how to write emails emphasized that people love a good story. And the same holds true today.

Use your stories.
Use your face.
Use your humanity.
Attach the research to something meaningful.

Take any excerpt from the emails and post them on social media with a link. Whatever fits your practice.

Seeing smart people show up every week always nourishes my soul. Thank you for being here.

Have a good night.

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References

Aggour, Reham L., and Lina Gamil. “Antimicrobial Effects of Platelet-Rich Plasma against Selected Oral and Periodontal Pathogens.” Polish Journal of Microbiology 66, no. 1 (2017): 31–37. https://doi.org/10.5604/17331331.1235227.

“Amazon.Com: How to Live on 24 Hours a Day: The Complete Original Edition (Audible Audio Edition): Bruce Kramer, Arnold Bennett, Joel Fotinos, Macmillan Audio: Books.” Accessed December 2, 2025. https://www.amazon.com/How-Live-24-Hours-Day/dp/B0845PJLZG/ref=sr_1_1?crid=1CV6V2CDUOLY3&dib=eyJ2IjoiMSJ9.Fb4fE7ffRRZod1n8nj_eZ2GimLRSYu3jWwOLf_44_Fn8hrrSQC0yD8M7YsvMmGyVFmHLhePFdjdAiHoHwL-yT2eI6XFSNFNjcYKZzsaMn_chZ1UAV1Al_uaDAGTiO3TLpvIoFUQz47Csp_2k9ikqe6FrlUtALrJn1Uz2xKE2j2_s9cje0YjlLArZSYoWgwR-jzLAXgvu2wxXUYVKw4hKlMWpXC-nAJ77wgjp7BPmSZA._IvYdVIBk7QQOOfAH9VaUdYa4D4z5rUMovaT8oxfRBQ&dib_tag=se&keywords=how+to+live+on+24+hours+a+day&nsdOptOutParam=true&qid=1764725266&sprefix=how+to+live+on+%2Caps%2C213&sr=8-1.

Chow, Reported CW, CC Koh, WYK Lam, et al. The Hong Kong Society of Dermatology & Venereology Annual Scientific Meeting. n.d.

Cooke, Rosalyn, Theodora Papadopoulou, Adam Weir, and Gráinne M. Donnelly. “Hiding in Plain Sight: The Pelvic Floor in Hip and Groin Pain.” Editorial. British Journal of Sports Medicine, ahead of print, BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, November 27, 2025. https://doi.org/10.1136/bjsports-2025-110028.

El Hoshy, Khaled, and Mona El-Kalioby. “Periorbital Dermatology and Oculoplasty.” In Oculoplastic Surgery, edited by Essam A. El Toukhy. Springer International Publishing, 2020. https://doi.org/10.1007/978-3-030-36934-7_32.

Gholijani, Nasser, Effat Noori, Zeinab Zarei-Behjani, et al. “Emerging Cell-Based and Cell-Free Therapeutic Strategies for Vitiligo.” Journal of Translational Autoimmunity 11 (December 2025): 100331. https://doi.org/10.1016/j.jtauto.2025.100331.

Kan, Hou-Ming, Hong-Yan Ni, Xiao-Tong Ding, and Zhi-Xiang Cheng. “The Effects of Platelet-Rich Plasma on Zoster-Associated Pain: A Scoping Review.” BMC Anesthesiology, ahead of print, December 1, 2025. https://doi.org/10.1186/s12871-025-03426-y.

Mokbel, Ramia, Alevtina Kodresko, Kefah Mokbel, Heba Ghazal, Jon Trembley, and Hussam Jouhara. “Cutaneous Cryosurgery in Dermatology: Evolving Principles and Clinical Applications for Benign, Premalignant, and Malignant Lesions.” In Vivo 39, no. 2 (2025): 577–612. https://doi.org/10.21873/invivo.13865.

Sethi, Dalip, Kimberly E. Martin, Sangeeta Shrotriya, and Bethany L. Brown. “Systematic Literature Review Evaluating Evidence and Mechanisms of Action for Platelet-Rich Plasma as an Antibacterial Agent.” Journal of Cardiothoracic Surgery 16, no. 1 (2021): 277. https://doi.org/10.1186/s13019-021-01652-2.

Zhang, Wenhai, Yue Guo, Mitchell Kuss, et al. “Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation.” Tissue Engineering. Part B, Reviews 25, no. 3 (2019): 225–36. https://doi.org/10.1089/ten.teb.2018.0309.

Tags

PRP, platelet-rich plasma, pelvic floor dysfunction, dyspareunia, urinary incontinence in athletes, trampoline incontinence, posterior vaginal wall trigger points, O-Shot, regenerative gynecology, sexual pain treatment, pelvic pain in young women, CMA clinical protocols, psychodermatology, acne-related distress, eczema and psoriasis psychological impact, vitiligo PRP therapy, UVB phototherapy, Vampire Facial, Vampire Facelift, zoster-associated pain, post-herpetic neuralgia, PRP antiviral effects, herpes recurrence anecdotal response, regenerative dermatology, regenerative pain medicine, CMA membership AI, clinical decision support AI, New England Journal of Medicine commentary, primary care workload crisis, time-to-care research, cash-based medicine model, physician autonomy, medical entrepreneurship, regenerative aesthetics marketing, patient education strategies, medical storytelling, marketing email templates for physicians, CMA Journal Club, transcript editing, practice growth strategies

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