Japan, Home of the Cute and Inbred Dog

Hidekazu Kawanabe for The New York Times

Chihuahuas are popular in Japan; this one was bred to have a blue hue.

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TOKYO, Dec. 27 — Care for a Chihuahua with a blue hue?

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Masafumi Yamamoto for The New York Times

Hirofumi Sasaki, a pet store owner in Hiroshima, has seen so many defective dogs that last year he converted an old bar into a hospice to care for them. So far he has taken in 32 dogs, though only 12 have survived.

Or how about a teacup poodle so tiny it will fit into a purse — the canine equivalent of a bonsai?

The Japanese sure do.

Rare dogs are highly prized here, and can set buyers back more than $10,000. But the real problem is what often arrives in the same litter: genetically defective sister and brother puppies born with missing paws or faces lacking eyes and a nose.

There have been dogs with brain disorders so severe that they spent all day running in circles, and others with bones so frail they dissolved in their bodies. Many carry hidden diseases that crop up years later, veterinarians and breeders say.

Kiyomi Miyauchi was heartbroken to discover this after one of two Boston terriers she bought years ago suddenly collapsed last year into spasms on the living room floor and died. In March, one of its puppies died the same way; another went blind.

Ms. Miyauchi stumbled across a widespread problem here that is only starting to get attention. Rampant inbreeding has given Japanese dogs some of the highest rates of genetic defects in the world, sometimes four times higher than in the United States and Europe.

These illnesses are the tragic consequences of the national penchant in Japan for turning things cute and cuddly into social status symbols. But they also reflect the fondness for piling onto fads in Japan, a nation that always seems caught in the grip of some trend or other.

“Japanese are maniacs for booms,” said Toshiaki Kageyama, a professor of veterinary medicine specializing in genetic defects at Azabu University in Sagamihara. “But people forget here that dogs aren’t just status symbols. They are living things.”

Dogs are just one current rage. Less consequential is the big boom in the color pink: pink digital cameras, pink portable game consoles and, yes, pink laptop computers have become must-haves for young women. Last year, it was “bug king,” a computer game with battling beetles.

A number of the booms in Japan, including Tamagotchi — basically a virtual pet that grew on a computer screen — and the fanciful cartoon characters of Pokémon, have made their way across the Pacific and swept up American children, too.

The affection for fads in Japan reflects its group-oriented culture, a product of the conformity taught in its grueling education system. But booms also take off because they are fueled by big business. Companies like Sony and Nintendo are constantly looking to create the next adorable hit, churning out cute new characters and devices. Booms help sustain an entire industrial complex, from software makers to marketers and distributors, that thrives off the pack mentality of consumers in Japan.

The same thing is happening in Japan’s fast-growing pet industry, estimated at more than $10 billion a year. Chihuahuas are the current hot breed, after one starred in the television ads of a finance company. In the early 1990s, a TV drama featuring a Siberian husky helped send annual sales rocketing from just a few hundred dogs to 60,000; sales fell when the fad cooled, according to the Japan Kennel Club. The breed took off despite being inappropriately large for cramped homes in Japan.

The United States also experiences surges in sales of certain breeds, and some states have confronted “puppy mills” that churn out popular breeds by enacting “puppy lemon laws” that prevent breeders from selling diseased animals.

But in Japan, the sales spikes are far more extreme, statistics show. The kennel club says unethical breeders try to cash in on the booms, churning out large volumes of puppies from a small number of parents. While many breeders have stuck to healthy mating practices, the lure of profits has attracted less scrupulous breeders and led to proliferation of puppy mills.

Some veterinarians and other experts cite another, less obvious factor behind widespread risky inbreeding in Japan’s dog industry — the nation’s declining birthrate.

As the number of childless women and couples in Japan has increased, so has the number of dogs, which are being coddled and doted upon in place of children, experts say. In the last decade, the number of pet dogs in Japan has doubled to 13 million last year — outnumbering children under 12 — according to Takashi Harada, president of Yaseisha, a publisher of pet industry magazines.

“Households with few or no children are turning to dogs to fill the void,” he said. “For a dog to be part of the family, it has to be unique and have character, like a person.”

Indeed, many of these buyers want dogs they can show off like proud parents. They are willing to pay top yen, with rarer dogs fetching higher prices. Coveted traits like a blue-tinged coat are often the result of recessive genes, which can determine appearance only when combined with another recessive gene.

Inbreeding is a quick way to bring out recessive traits, as dogs carrying the gene are repeatedly mated with their own offspring, enhancing the trait over successive generations.

When done carefully, some types of inbreeding are safe. But in Japan, all too many breeders throw aside caution in search of a quick profit, experts in the business say. In these cases, for every dog born with prized colors, many more appear with defects, also the product of recessive genes.

“The demand is intense, and so is the temptation,” said Hidekazu Kawanabe, one of the country’s top Chihuahua breeders. “There are a lot of bad breeders out there who see dogs as nothing more than an industrial product to make quick money.”

Awareness is so recent that the only comprehensive survey of genetic defects came out two years ago, looking at malformed hips in Labrador retrievers. The results showed that nearly half of all Labradors suffered from the deformity — four times more than the United States, according to Professor Kageyama at Azabu University, who conducted the survey.

Hirofumi Sasaki, a pet store owner in the western city of Hiroshima, has seen so many defective dogs that last year he converted an old bar into a hospice to care for them. So far he has taken in 32 dogs, though only 12 have survived.

One is Keika, a deaf 1-year-old female dachshund with eyes that wander aimlessly. Her breeder was originally selling her for about $7,500 because she is half-white, a rare trait in dachshunds.

“That is an unnatural color, like a person with blue skin,” Mr. Sasaki said.

The breeder told Mr. Sasaki that he had bred a dog with three generations of offspring — in human terms, first with its daughter, then a granddaughter and then a great-granddaughter — until Keika was born. The other four puppies in the litter were so hideously deformed that they were killed right after birth.

Ms. Miyauchi, the Boston terrier owner and a resident of the western city of Kobe, said she was appalled to learn how common inbreeding was in Japan. After the death of her second Boston terrier, she said she went looking for the breeder, but the phone number she got from the pet shop was invalid.

“No one’s really monitoring the industry,” she said.

The government concedes that oversight is poor, and passed a law in June to revoke the licenses of breeders who use dogs with genetic defects for breeding. But the Environment Ministry, which has jurisdiction over pets, says it has just four officials to monitor all of 25,000 pet shops, kennels and breeders in Japan.

The Japan Kennel Club began adding results of DNA screening onto pedigree certificates in April. But that falls short of the American Kennel Club, which discourages risky inbreeding by listing acceptable colors for each breed.

“Japan is about 30 or 40 years behind in dealing with genetic defects,” said Takemi Nagamura, president of the Japan Kennel Club.

Ultimately, animal care professionals say, the solution is educating not just breeders but potential dog owners.

“If consumers didn’t buy these unnatural dogs,” said Chizuko Yamaguchi, a veterinarian at the Japan Animal Welfare Society, “breeders wouldn’t breed them.”

¶ Thursday, December 28, 2006 0 comments

Quick and Easy, for a Price

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YOU can tell it’s thicker the minute you open the can,” said Ernest Rezik, a contractor who has painted thousands of walls in Manhattan, Queens and Brooklyn.

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Evan Sung for The New York Times

THE COVER-UP To test claims about a new paint from Benjamin Moore, the author set his young sons to work decorating his living room walls.

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Photographs by Evan Sung for The New York Times

Then he brought in a professional painter, top, to cover different areas of the mural with a single coat of the new paint or of standard latex paint. When the mural was covered, the judges were ready to render their verdict.

Mr. Rezik was about to paint a wall in my apartment using Aura, a new paint from Benjamin Moore that the company claims can cover most surfaces in a single coat. The paint, which was introduced on the West Coast in September and will be available on the East Coast in late January, is also supposed to release fewer environment-damaging volatile organic compounds, or V.O.C.’s, than other paints.

To test the company’s claim that changing the color of a wall — even from black to white — can be accomplished with one coat of Aura (or at the most two, according to the company), I asked my 4-year-old sons, Aaron and Jacob, to paint a mural in a corner of my apartment. The result, reminiscent of the work of Paul Klee, was a mass of purple, brown and dark red blobs (or as Benjamin Moore calls them, Chambord, Carob and Moroccan Spice).

Two days later, Mr. Rezik arrived to repaint the wall white. First, he dipped a roller into a can of Benjamin Moore’s Regal, its most popular line of latex paint, which costs less than $30 a can in the New York area. It covered pretty well, but bits of my sons’ handiwork were still visible.

Then he tried the new paint, which lists for $55 a can, on another section of the wall. The dark colors disappeared immediately. When it was time to paint the baseboard, where remnants of my sons’ artwork had dripped, Mr. Rezik said he really noticed the difference. Because Aura is thicker than regular latex paint, he said, “you can control the amount of paint on the brush better” — meaning you can use more of it without worrying about drips. He was able to cover several purple spots easily in one go-over.

Aura also dries in minutes, which I confirmed with my own fingers, and is practically odor-free. Carl Minchew, the company’s director of product development, claims that some customers have painted their dining rooms and then had guests for dinner the same day.

At Benjamin Moore’s research center, in Flanders, N.J., Mr. Minchew showed me the results of various tests that, he said, demonstrated Aura’s durability, including one in which a blue enamel surface was painted white with Aura and then scrubbed at least 1,000 times, with little apparent damage. “Obviously, if we had flunked, I wouldn’t show you this,” he said cheerfully.

Mr. Minchew said an important impetus for developing the new paint came from an increase in governmental restrictions on V.O.C.’s, “especially in California, which has the most stringent regulations.” As with auto emissions, California took the lead in regulating V.O.C. emissions a few years ago. Among other things, the state restricted paint stores from ordering new supplies of many oil-based paints (which, although long prized by house painters for their appearance and durability, emit considerably more V.O.C.’s than latex paints), and more recently mid-Atlantic states, including New York, have followed suit.

Also important to the formulation of Aura, according to Mr. Minchew, was the problem of V.O.C.’s in colorants. Until the 1970s, he said, most paints in the United States were sold off the shelf in stock colors. But as consumers began to demand more color choice, the model shifted to one in which stores stocked cans of “paint base” and added tiny drops of colorants to create thousands of different hues.

Companies began producing colorants that would work with any paint base, oil or latex, adding a wide variety of chemical solvents to make the colorants adaptable. These solvents contained V.O.C.’s and “didn’t necessarily make the best paint,” said Barry Chadwick, Benjamin Moore’s vice president for product development.

Mr. Minchew said, “We realized that if we made a colorant that only has to go into latex base, and a latex base that only has to work with that colorant, we could make both of them better,” while using fewer V.O.C.-emitting compounds.

To sell Aura, Benjamin Moore will need the cooperation of retailers, who will have to decide whether to invest in new machines — which can cost $10,000 or more — that dispense the new paint. (Because Aura colorants dry so quickly, they harden before they can get through a conventional paint dispenser; Mr. Minchew’s team spent three years working with a Finnish company to create a new machine that uses water to keep its nozzles moist.)

Because it costs far more than a paint like Regal, which is already considered high-end, Aura has a marketing mountain to climb with consumers. Mr. Chadwick said it has been doing well on the West Coast.

Allen Blanson, the assistant manager of East Bay Paints in Albany, Calif., said Aura “has been flying off the shelves” at the store, an independent business that sells Benjamin Moore and Pratt & Lambert paints. But Benjamin Moore executives are waiting to see how East Coast consumers will react to the “super premium” pricing.

Michael Pintchik, the president of the family-owned store in Brooklyn that bears his name, said that he was initially concerned that the price would discourage consumers, but now he thinks they may actually save money by using the paint, since one gallon may do the work of two. Mr. Minchew acknowledged that Benjamin Moore could end up selling less paint. “We’d like to think we’re going to get enough people buying our paint, instead of someone else’s, to make up the difference,” he said.

¶ Sunday, December 24, 2006 0 comments

New Rules Enable Healthy Savings

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WASHINGTON ( Reuters) - Health Savings Accounts are a great deal, and they are about to get even better. The 109th Congress, in one of its final acts, expanded the tax breaks that are linked to these accounts.

The new rules, which go into effect January 1, 2007, will make it easier for workers and their families to build a sizable

health-care nest egg to see them through the high-health-care consuming retirement years. But you have to know how to make the best of them.

An HSA is a tax-favored savings account that is paired with a traditional but high-deductible health insurance plan. The health plan may cover most of your medical costs, but you are responsible for the deductible and other co-pays.

To really appreciate these accounts, you need to adjust your attitude a little and accept that you will be paying more out of pocket right off the bat. HSAs have high deductibles: In 2007, the minimum deductible for a qualified plan is $1,100 for single coverage and $2,200 for family coverage. They've been criticized as unaffordable for folks who live at the financial edge and don't have the extra cash to meet their deductibles.

But if you can afford to set aside that deductible amount in an HSA savings account, you can save big. The premiums tend to be lower than they are in traditional insurance plans. And your contributions are tax deductible. The real savings come into play if you can afford to let your HSA build up without tapping it. If you can pay out-of-pocket costs from your regular checking account, you're really positioned to profit from these accounts and from the new provisions. Here's how.

-- Load it to the max. For 2007, you're allowed to put away as much as $2,850 for single coverage or $5,650 for family coverage in your HSA account, even if your policy's deductible is less than that. That's a new provision and worth taking advantage of. HSA holders 55 or older can stash an extra $800 in their accounts.

-- Invest it. Some banks and investment companies which offer HSA savings accounts offer companion investment accounts. Consider the amount you've put into your HSA as a long-term investment, and put it into stocks, bonds or mutual funds just as you would any other tax-advantaged retirement asset.-- Pay out of pocket for your health-care costs and don't use the HSA money unless you absolutely must. This will enable you to build that HSA nest egg for retirement -- a time when you'll need close to $300,000 for health care alone, according to the Employee Benefit Research Institute.

-- Push your employer a little. The new rules encourage employers to offer HSAs to workers by allowing them to offer their employees the option of moving money from existing Flexible Spending Account or Health Reimbursement Accounts into an HSA. Let your boss know about these rules and encourage the shift. Over the long term, you'll benefit more from an HSA than a flexible account you have to drain every year.

-- Make a full contribution in your first year. Old rules required you to pro-rate your first-year contribution to an HSA, based on when you got the policy. That seemed unfair, as deductibles are never pro-rated, even if you join part way through. The new law allows the full deduction even if you join late in the year.

-- Pass on the IRA transfer. The new law also allows individuals to seed their HSAs with money from their IRA accounts. It allows a one-time transfer from the IRA to an HSA, up to the maximum HSA contribution for that year. If you're close to retirement, that could be a good way to get some money out of your IRA without having to pay taxes on it. But basically, it's not netting you any new savings, and you'd be better off leaving your IRA intact and seeding your HSA account with extra money -- if you can afford to do it.

(Linda Stern is a freelance writer. Any opinions in the column are solely those of Ms. Stern. You can e-mail her at lindastern(at)aol.com.)

¶ Saturday, December 23, 2006 0 comments

How Not to Scare Off Buyers

Illustration by Gary Howland

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APARTMENT sellers might be forgiven their nostalgia for the last few holiday seasons, when everything seemed to sell quickly, even the dreaded ground-floor studio adjacent to a methadone clinic.

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J. Emilio Flores for The New York Times

WAR STORIES Raphael Sbarge and Lisa Akey walked away from a deal for a brownstone in East Harlem after negotiating for months.

Christopher Porzio for The New York Times

Joan Sacks, a broker, tries to keep sellers from hovering when potential buyers come calling.

These days, Manhattan dwellings are spending 53 percent longer on the market than they did in the first quarter of 2004, which was the height of the market, according to the appraisal firm Miller Samuel. The slowness of sales requires a big change in attitude for sellers — but not all of them have gotten the message. The notion that it might be time to be more accommodating, even simply more friendly, is not one typically associated with Manhattan real estate.

“Buyers are shifting the balance of power and demanding a modicum of fair play, reciprocation and general good will,” said Julie Friedman, a senior associate broker at Bellmarc. “Sellers don’t have to be puppy dogs with wagging tails and drooling tongues, but given the variety and scope of good product on the market, the old Doberman attack-dog approach will ensure only hefty legal fees, not signed contracts.”

Sellers can sabotage themselves, she said, with “evil lawyers and twisted brokers.” They can also unwittingly alienate potential buyers by attending their own showings, restricting access too much, tussling over whether they’ll leave window treatments and light fixtures, and engaging in clumsy or high-handed negotiations.

Shuttle diplomacy performed by brokers can sometimes avert or heal a rift between buyer and seller. But some buyers, angered by something a seller has done, extract revenge by building mountains out of foothills, or even walking away. A seller who demands the right to take a $1,000 chandelier might vaporize a million-dollar deal.

Raphael Sbarge, a 42-year-old actor, exited stage left after playing a long, tortured scene opposite a seller.

Mr. Sbarge, who owns homes in New York and California with his wife, Lisa Akey, became enchanted last May by an East Harlem brownstone being renovated by its eccentric, artistic owner. The multifamily home was listed for nearly $2 million and had been on the market for six months.

The owner, Mr. Sbarge said, “had bought the house 10 years ago for about $60,000 and put his life and energy into it and basically assembled it into an art piece.”

But the man was detached from the reality of East Harlem real estate, Mr. Sbarge said, noting that nearby homes of similar size and condition were selling for around $1.2 million.

That was about what Mr. Sbarge and his wife first offered. When the seller did not respond, the couple increased their bid and were told that it had been accepted. They flew in from Los Angeles, where they currently live with their two young children, only to learn that their supposedly accepted offer wasn’t high enough. Three months of negotiations followed, during which the couple raised their offer twice.

They were, recalled Mr. Sbarge, belittled and stymied at nearly every turn by an owner who grew more hostile and erratic.

“Every time I made an offer, he got more and more surly,” Mr. Sbarge said. “In his mind, the house was a Taj Mahal.”

Mr. Sbarge estimated that he spent around $12,000 in travel and legal fees — and paid more steeply in lost sleep and domestic disharmony.

(“It’s kind of like dating,” he said, explaining why he persisted. “They say you fall in love in the first three seconds and the rest is denial.”)

In August, a deal was struck close to the original asking price. About to sign, Mr. Sbarge toured the brownstone only to discover that renovations supposedly taking place during the prior six weeks were simply not happening. The seller also announced he was keeping architectural salvage pieces that Mr. Sbarge had assumed were part of the deal.

“My knees started to shake, and my insides turned to jelly,” Mr. Sbarge said. “I just couldn’t believe that after everything we’d been through, this guy was so dismissive and rude. And I suddenly thought, not only can’t I trust this guy, but what’s hiding behind the walls that I don’t know about?”

Frustrated and embittered, Mr. Sbarge walked away from the deal. The dwelling remains on the market nearly a year after it went on.

The seller’s former broker confirmed the details of the story, but would not speak on the record, or identify the seller, because of her firm’s policy against speaking negatively about clients past or present.

While Mr. Sbarge contended with a seller he found particularly difficult, there are more innocent ways that owners can bumble a negotiation.

“If you’re not giving a buyer the feeling that they are in control or somehow in mutual discussions, you’re really putting them off,” said Stephen Klym, a senior managing director at Warburg Realty. A measured waltz of negotiation is “a longstanding tradition that is more important these days.”

As an example, Mr. Klym offered: “If you’re priced at $1 million and someone offers $925,000 for an apartment on the market for four months, that’s not a bad offer. If you come down to $995,000, you’re apt to get resistance from the buyer and they’re likely to go somewhere else if there’s something on the market.” Countering with $975,000 would be a better response, he suggested.

Ritualized give-and-take is less important if a property has multiple bids. Still, buyers can no longer be pitted against one another with insouciance.

“Sellers forget they can lose both bids if they don’t handle it properly,” cautioned Kirk Henckels, director of the luxury property firm Stribling Private Brokerage. He and his wife, who were recently selling their apartment on Central Park West near West 69th Street, fielded two asking-price bids from neighbors.

“We knew the parties well enough to know that they would have been offended had we gone to a sealed bid to get more money,” he said. Instead, he and his wife picked the more longstanding neighbors who, unlike their rivals, had no other avenue of expansion.

An accepted bid, of course, is not the same as a done deal. One inexperienced, grandstanding or lackadaisical lawyer can foul things up. Two can make life unbearable. A few months ago — through a long, hot August — two lawyers jousted over the sale of a Sutton Place two-bedroom listed for $1.375 million, even though the buyer and seller had already agreed on a price. “Literally from the moment these two attorneys made contact,” said Joan Sacks, an associate broker at Stribling & Associates, “there were sparks.”

The lawyers’ conflagration baffled and shocked Ms. Sacks, who was representing the seller.

“There were fiery e-mails shooting between attorneys that stopped short of saying, ‘You’re a moron.’ I was trying to step in as peacemaker and say: ‘Let’s keep the deal together, boys. Let’s stay on track, let’s stay focused.’ It got to the point where it wasn’t about the deal anymore. It was about who was going to win — who was going to make the other appear to be so dumb that they would come out with some banner on their back saying they were the smartest attorney in town.”

Before the contract could be signed, brokers for both sides swooped in and deposited their clients alone together in the Sutton Place apartment.

“When they finally spoke, the intensity was defused,” Ms. Sacks said. “I think the buyer and seller were very reasonable. It’s just that sticking points that shouldn’t have existed at all were intensified as issues by the attorneys.”

(Noting that the deal hasn’t closed, Ms. Sacks observed with trepidation that “we’re still going to have that moment where everyone is going to be in the same room. I’m going to make the assumption that these people can behave professionally.”)

But even congenial lawyers can wrench a deal by dragging things out.

“Time is the No. 1 killer of all deals,” said Jon Phillips, a vice president at Halstead Property, emphasizing the need to sustain momentum to stave off second thoughts. (This is true even in small ways: For instance, accepting a bid on a Friday may invite buyer’s remorse on the weekend.)

In Manhattan, the usual lapse between accepted bid and signed contract is a week to 10 days. But the timeline can go awry if a seller’s lawyer is inexperienced in local real estate.

“They can encounter unfamiliar practices or terms that seem much more alarming at first blush than they do once they’re properly understood in context,” Mr. Phillips said. “The main thing that can happen is that doubts or concerns can be conveyed to buyers. Especially in these nervous times, that can alienate a deal. Every experienced broker has seen deals crater because of attorneys not sufficiently grounded in New York issues.”

Long before lawyers get involved, however, sellers can undercut their own cause by simply refusing to leave their property during showings. It’s the surest way, say brokers, to cut a buyer’s interest off at the jugular.

“Once you lose a buyer’s focus, you can’t get it back,” said Rochelle Bass, an executive vice president at Bellmarc. “That’s why I never let sellers be home. It’s the kiss of death.”

“Helicopter” sellers have their reasons for hovering. “To some people it’s a very personal experience,” Ms. Sacks said. “They want to show everything. They’re proud of what they’ve done, and they feel they can do a better job selling it than anyone else because they know it so well.”

But being asked to marvel over outdated, tacky or merely mundane improvements is too much for some purchasers.

“If someone says, ‘Wow, I just put in a new heater’ — does anybody care?” said Ellen S. Simon, a senior associate broker at Bellmarc, briefly evoking the lonely tree falling in the forest. “All they care is that it’s not cold. Either be nonchalant about it or use a broker to spin it and make it seem really great without overkill.”

Ms. Sacks noted: “It’s kind of like an overwhelming salesperson when you walk around the store. Even if you love it, you can’t stand being followed around and being told, ‘Look how wonderful my closets are.’ ”

Hanging around also interferes with the crucial mental leap that the buyer must make to imagine living in the property.

Innocent slips of a seller’s tongue can be equally deadly, said Marguerite Platt, a senior vice president at Halstead. Her seller inadvertently spooked a pair of buyers away from a nine-room apartment on Fifth Avenue overlooking Central Park. As the buyers ogled the view from the windows after their bid had been accepted, the owner agreed, “Well, it is nice, except when the parades go by.” The buyers promptly withdrew their offer.

Along with vacating their property during showings, today’s sellers may need to be more flexible about the hours in which they welcome apartment hunters.

“A couple of years ago, you could say, ‘I’m only showing the apartment from 10 to 5 o’clock, no evenings or weekends,’ and the apartment would sell,” said Matthew Mackay, a vice president at Corcoran. “Now with more inventory, sellers need to know that if a buyer is working all day and wants to see an apartment at 7 p.m., they have to be more accommodating.”

(Sellers beware: your own broker could be causing a bottleneck by clustering appointments together for his or her own convenience. Make sure your broker has a backup plan in the form of a colleague or assistant who can cover.)

Restricting access to a buyer who wants to make a repeat visit with a contractor, architect or decorator is another mistake. Sellers who perceive such intrusions as a put-down of their tastes and lifestyle ought to swallow their pride.

“In this market,” Mr. Mackay said, “we see so much money coming into the city and people paying so much for apartments for which sellers paid a tenth as much and can’t afford to do the modern finishes required by the buyer. Once it goes into contract, coming back one more time is perfectly standard.”

Even as they open their door wider, sellers should make sure they have hustled any skeletons out of the closet — preferably into the listing information. Any kind of surprise — including land-leases, upcoming maintenance increases or assessments, flip taxes, extra long or short closing dates, and plans for nearby construction — can reverberate unpleasantly.

“They can create a nasty negotiation,” said Richard Ferrari, a senior vice president at Prudential Douglas Elliman, “or one where a buyer will retract a bid and come in with a lower one, even if the facts don’t really impact the value of the apartment.”

Drapes, light fixtures and other accouterments are among the things a buyer might assume to be part of the deal. Claims staked after an accepted bid are particularly incendiary.

“Sellers always feel they’re selling for less than they could have gotten, and buyers feel like they’re paying more,” Mr. Henckels said. “So by the time you reach a deal, people are not in the mood to give a little.”

Fern Hammond, a senior vice president at Halstead, said: “I’ve had sellers ask for anywhere from $5,000 to $25,000 for curtains after there was an accepted offer. Normally a broker can straighten it out, but the purchaser may extract revenge either by pressing to close early or finding another way to give it back to the seller somehow.”

It can devolve into a game of chicken, played up until the very last second.

Some brokers end closing-room standoffs by digging into their own commissions for the comparatively few dollars it might take to leap over tall egos and conclude the deal. “Usually,” said Mr. Henckels, who has pitched in from time to time, “it comes down to the issue of ‘money talks and nobody walks.’ ”

¶ Sunday, December 17, 2006 0 comments

Study Questions Colonoscopy Effectiveness

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For years, patients and many doctors assumed that a colonoscopy was a colonoscopy. Patients who had one seldom questioned how well it was done. The expectation was that the doctor conducting the exam would find and cut out any polyps, which are the source of most colon cancer.

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But a new study, published today in The New England Journal of Medicine, provides a graphic illustration of how wrong that assumption can be, gastroenterologists say. The study, of 12 highly experienced board-certified gastroenterologists in private practice, found some were 10 times better than others at finding adenomas, the polyps that can turn into cancer.

One factor distinguishing the physicians who found many adenomas from those who found few was the amount of time spent examining the colon, according to the study, in which the gastroenterologists kept track of the time for each exam and how many polyps they found.

They discovered that those who slowed down and took their time found more polyps.

“We were all experienced colonoscopists,” said Dr. Robert L. Barclay, a member of the group that participated in the study, Rockford Gastroenterology Associates in Rockford, Ill. “We had each done 3,000 or more colonoscopies before the study.”

Yet, Dr. Barclay added, “if our group is representative of an average group, you will see people who take 2 or 3 minutes and people who take 20 minutes” to examine a colon. Insurers pay doctors the same no matter how much time they spend. Gastroenterologists say colonoscopies can help prevent colon cancer, but warn that there is a pressing need for better quality control.

Still, the experts say, the onus remains on patients to ask for data on how proficient their doctors are.

“Patients assume that one colonoscopist is as good as another,” said Dr. Douglas K. Rex, a gastroenterologist and professor of medicine at Indiana University who did not take part in the study. “But these are dramatic differences.”

His own nine-member group, Dr. Rex says, has similar data showing a fourfold difference in detection rates. A paper on that data will be published in January in The American Journal of Gastroenterology.

The issue is of great concern to doctors and patients alike, said Dr. Robert E. Schoen, a gastroenterologist at the University of Pittsburgh Cancer Institute.

“We all agree that if you are doing a colonoscopy, you should do it well,” Dr. Schoen said. “It’s a huge commitment on the part of the patient, and it’s a huge dollar commitment,” costing as much as $2,000.

More than four million Americans a year have colonoscopies, hoping to protect themselves from colon cancer. The cancer, which kills about 55,000 Americans a year, is the second-leading cause of cancer death in the United States.

In a colonoscopy, a doctor pushes a flexible scope, called an endoscope, to the top of a patient’s colon, near the appendix, and slowly withdraws it, looking for adenomas. Though more than 90 percent of adenomas will never develop into cancer, the best precaution is to remove them. The exam is so effective, guidelines say, that if no polyps are found, the person can wait a decade before being examined again.

The Rockford study was preceded by other signs that colonoscopies are by no means foolproof. But as problems have been pointed out, they have all too often been met with disbelief among doctors, Dr. Rex said.

The first indication that colonoscopies were not as effective as widely believed came with two studies, one in 1991 and a larger one, in 1997, in which patients had two colonoscopies on the same day. Those studies showed that doctors were missing 15 to 27 percent of adenomas, including 6 percent of large adenomas.

Then, in the last few years, two studies of so-called virtual colonoscopies, which use a CT scan to view the colon, found that the rate of overlooked adenomas in traditional colonoscopies was even higher. Patients in those studies had traditional and virtual colonoscopy on the same day. Traditional colonoscopies missed 12 to 17 percent of the large adenomas detected in the virtual colonoscopies. But many doctors dismissed those findings, saying — if they believed them at all — that they applied to other doctors, not to themselves, Dr. Rex said.

Dr. Schoen, for one, said he was a believer. The conclusions of the adenoma detection studies were reinforced, he said, by studies finding that colonoscopies missed not just polyps but actual cancers.

That finding emerged from studies testing ideas about how to prevent polyps, like taking beta carotene or calcium pills or sticking to a low fat, high-fiber diet.

The patients in all the studies had at least one adenoma detected on colonoscopy but did not have cancer. They developed cancer in the next few years, however, at the same rate as would be expected in the general population without screening.

“They had had a colonoscopy already, some had even had two colonoscopies, and all of a sudden they were coming up with cancer,” Dr. Schoen said. “I said, Whoa. I thought colonoscopy was supposed to prevent all this.”

He concluded that no more than half the cancers arose after the initial colonoscopy. The others, he said, were probably cancers or precancerous polyps missed in the previous colonoscopy or were cancers that grew at the site of a polyp that had been incompletely removed.

The study by the group in Rockford suggests a way to improve colonoscopy: by slowing down. “If you rush things, you miss things,” Dr. Schoen said.

That happens in part because reimbursement rates for colonoscopies have fallen in recent years, and some doctors are doing the exams faster than ever, Dr. Schoen and others say.

“I have heard of people who do it in 30 seconds,” Dr. Schoen said. “Whoosh, and it’s out.”

The Rockford group concluded that doctors should take at least eight minutes to withdraw the endoscope. To remind themselves, they set a timer with a bell that rings once at two minutes, twice at four minutes, three times at six minutes, and four times at eight minutes. Their polyp-detection rate has increased by 50 percent, Dr. Barclay said.

Last spring, a task force for the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy recommended that doctors track their polyp-detection rate. On average, they should find precancerous polyps in at least 25 percent of men and 15 percent of women 50 and older.

But most have not adopted the recommendation.

Still, Dr. Douglas J. Robertson, a gastroenterologist at Dartmouth Medical School and at the White River Junction VA Medical Center in White River Junction, Vt., said it did not hurt to ask for a doctor’s detection rate.

“If you are met with a total blank stare,” Dr. Robertson said, “that tells you the doctor is really not clued in to quality issues and is not listening at national meetings.”

¶ Friday, December 15, 2006 0 comments