Hmmm...talk about a heated discussion.

Personally, while the members of the Coalition do appear to be a good starting ground for potential doc's and a great way to weed out the endless docs in this field, I would view it as just that: a starting ground for research.

By *no* means are all of these docs performing surgery on the same level of excellency. This is most easily demonstrated by the vast discrepincies in the total # of grafts moved in any given session, among other factors.

I think *every* member of this forum should research all of the docs and their work and decide for themselves who is best. I frankly grow weary of people making blanket statements about all members of the coalition as if they are all producing the same results. It's quite apparent they are NOT! This argument is often given if a prospective patient likes doc 'x's' work but would rather not travel too far, rest assured someone will imediately jump in the discussion reassuring them that there is another member of the coalition or one who is "reccomended" on the site who just happens to be right in their area. Why travel? They say...

Consider the following analogy: All teams on the NFL are professional teams and playing a professional quality game, but they don't all get the same results at the end of the year. Many of them are playing a game which is substandard to their competitors and as a result lose to the better playing teams year after year. In much the same way the "score-board" in the ht field are consistent quality results and the top doc's have endless cases on this forum and on their own web pages. Take a look at H&W's web page, now how many other clinics can compare to that? Or their results on this forum? Some make the argument that not all clinics spend as much time "advertising" or showing their results...that is all fine and dandy, but you can't make a persuasive argument w/out evidence; that argument being 'x' doc produces same quality of work as consistently as 'y' doc, and the evidence being comperable photos or *lack* there of...


View *all* of the docs websites for yourself. To claim they are all on the same level is an insult to many of them. Personally, there are only a couple of docs out of all of the coalition that I would even consider. One can dig up old threads and see that it is very clear that many of them we're far behind the times of other clinics. Case in point: H&W were among the *very* first to require shaving w/in the recipient area to ensure a better read on native hair and thus minimize the risk of transection. *many* other 'members of the coalition' argued against it, only to *later* follow suit. Im not saying that any of the members are producing sub-par results, *BUT* I am saying that they are not all on the same level of excellency by any means...

this *is* cosmetic surgery on the top of your head which will remain their for the rest of your life. choose wisely, and don't let distance even factor into the equation. It's *not* like buying a car or some other tangible object; it *is* a dynamic art form which requires an artist to produce it and the product, unlike a tangible object, can not be discarded but is ultimately augmenting ( ) one's own *BODY* and physical appearance for the rest of their life.

Bill,

I am not sure where your most recent post went to??


I have no hostility towards you. I am not that kind of person. I guess if you would like me to leave this site I can. If you don't feel that I am adding anything to the forum just let me know.

You asked what bothers me most about this forum? Definitely the entry of new docs. It has always bothered me when I see how easily they are "voted" in. When there is such a substantial fee involved it will always bring into question the motive. I personally believe that Pat and yourself have the best of intentions, but are a little too quick to allow more and more docs. So ofcourse we ask why? Well certainly money is one motivator. They are not at all equal and we all know this. Why do we need to water down the field of talent with more entries?

Bill even the best of buds have some disagreements. Don't take it personally. I respect you and know that you are only trying your best.

NN,

I'm really not sure however, how to respond to you at this point since the tone of your last post is a farcry different from your previous one.

I did write you a long reply but decided to remove it as to not further add fuel to the fire. After all, we both already had our say.

Summary of My Last Post

The point however, of the post I removed was to point out a few important facts:

1) Due to the fact that Dr. Mohmand's very website states clearly that he uses microscopes to dissect grafts, Dr. Mohmand's statement that he tried them, B Spot's belief that he uses them, and Pat's response that stated he is disappointed that he "discontinued the use of microscopes", I drew the logical conclusion that Dr. Mohmand did use microscopes at one time.

2) I was not the Associate Publisher at the time of the recommendation so I can't confirm or deny with any degree of certainty what went on behind the scenes however, I know that the high level of membership standards were the same and do not believe Pat would compromise them. You and I both expressed our support of Pat's judgement with some concern on the potential recommendation of Dr. Mohmand thread back in January of 2007.

3) My thoughts and opinions are my own and I am not and will never be anyone's "puppet" as you called me. I'm not sure how you can say "don't take it personally" when this was a clear attack on my individuality. I'll accept your apology anytime

4) I was all over this post behind the scenes as I am the one who brought this to Pat's attention and stated loud and clear in an email to him my opinion on this matter which was the same as I publicly stated when I said,

"if a physician no longer meets our standards for recommendation, he should no longer be recommended".

Out of respect for our community members, I wanted to give them a chance to share their input before I made my public stand on the issue, which was and is the same privately and publicly.

Your Involvement in our Community

I have always felt that you have had a heart for this community and are genuinely concerned for patients. Your last post however, was a little harsh to say the least. I am not asking you to leave, I just simply don't understand why you stay if you really feel that this patient community is just a money driven scheme. Or were you just lashing out in anger?

Always on the Lookout for New Talented Physicians

It should be no secret to you or this community that Pat and I are always seeking new talented physicians to recommend on this community. Why? We feel that recommending more quality physicians (as long as they meet our high level of standards) will give patients more options as they consider surgery and surgeons. Though it is ideal if a patient member can travel the world, it is not always feasible for the patient. We do not force patients to go to any particular doctor and always encourage patients to research all surgeons they are considering.

Recommendation Standards - Equal in Ability?

We also never made the claim that all physicians are equal in experience and ability. We do however, have standards that all physicians are expected to meet or they are turned down or promptly removed. See our high level of recommendation standards.

Sponsorship Fees, Motivation, and Public Accountability

Yes, our physicians do pay a sponsorship fee for being recommended as it states clearly on our website: "Those surgeons who are carefully reviewed and chosen for recommendation on this site contribute a monthly fee to co-sponsor this online community and display their before and after photos, videos and contact information." This however, is not how physicians are recommended. If Pat and I were really driven by money in our decisions, we would not host an open discussion forum and we would not remove physicians. We could just as easily sit back and collect money for recommending physicians without any public accountability or transparency. After all, discussion forums are often intimidating to physicians because it holds their feet to the fire. It also holds ours to the fire and helps keep us accountable, which is a good thing.

Member Input on Recommendation

Lastly, please read my post to forum member "something" that I've quoted below.

I think you said it best when you said on the potential recommendation of Dr. Mohmand thread, "I guess we have to trust your judgement unless otherwise disputed with evidence from other members." In summary, patient input is considered, but Pat and I make the final decision. But as you know and have seen, physicians have been promptly removed if a patient has had poor results.

We will continue to do our best to run and open and honest discussion forum and recommend only the best physicians who continue to meet our standards.

Best wishes,

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

View our hair loss articles on EZineArticles.com

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To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Bill-I do apologize for the term "puppet" but honestly believe you have changed your stance on many issues. You state that it is because you are now educated more thoroughly. Possibly, but I personally believe that you have had to due to your position and although I understand it, I miss the true open banter.

I believe that the main premise of this website is still a good one, but yes, I believe money has become a big motivator. In knowing or believing this keeps me cautious. Yes it is disclosed that physicians are charged a monthly fee, but if members knew the loftiness of the fee they might also question things. It doesn't mean the forum is a bad thing, but I am certainly going to question the addition of more and more docs that show little evidence of consistency. It starts to dilute things or muddy the water for an individual looking for a HT. The truly elite are sometimes shadowed by those with less talent and I am fearful that people will go to someone and get so so results when they could have easily gone to one of the best. I am certain you can see my logic?

Yes I have stated in the past that we have to trust Pats judgement as I honestly believe members say is very limited. It was more a statement of we have no choice. In this case his judgement was bad, so therefore I stated my frustration with the process. I understand the system is not perfect, but it needs to be. We are dealing with a cosmetic change to humans that they have to live with forever. We can't just trust a doctors website and a few photos. What happened to the concept of needing unsolicited photos from patients?

You use the word accountability to describe the forum. Pat and yourself also need to be accountable. Hell everyone needs to be accountable to someone. There are less and less members that are educated on the process and are willing to challenge things. If I don't who will. I understand it is always nice to have followers that don't question, but in the end what will that do for the forum and hairloss sufferers. We have had some heated debates in the past and they have many times faded without any resolve but atleast they have allowed people to think.

I also believe that you and Pat do need to respect the members. We might not always agree, but we are why this site is here. Without us you both have no job. As you wanted an apology I too would like one from yourself and Pat.

NN,

This forum has always been my bread and butter (though not the way you mean it) since I found this place back in 2004. When I was new to hair transplant surgery, the veteran members of the time walked along side of me and gave me the support I needed to go through this journey. I am honored now to be able to give back to so many members of this community by helping direct them to a hair restoration solution that is best for them. I personally feel I treat forum members with a lot of respect and do my best to help them. If you feel I don't, I can't change that, but I'm sorry you feel that way.

The recommendation process if anything, has only become more thorough over the years as we continue to evolve and re-evaluate it. It's not perfect (NN seriously, nothing is), but Pat and I do our best to be thorough in our surgeon evaluations before even presenting them for potential recommendation and then consider member input before making a final decision. This has all been stated above but I can't convince you of this. But if you go back on previous potential recommendation threads and physician removal threads, you'll see that patient member input is considered highly. Patient input has resulted in the removal of several physicians over the years.

Somehow, you seem to think that your opinion should matter more than the others. I watched you complain about Dr. Lindsey's potential recommendation claiming that we don't listen to member input when the majority of the members agreed he should be included.

"Unsolicited patient photos" is a nice concept but is not always possible. If we waited for patients to share their results from any physician we were considering, we would have zero recommended physicians. We do ask for patient pictorial evidence as part of the recommendation process, far beyond the scope of their website. I have had a number of physicians send me photos where I told them frankly, that they were not good enough. Pat and I often work with many physicians behind the scenes for a long time before considering presenting them for potential recommendation.

This is an advanced web community with many people running it, many behind the scenes. Most people involved in this community work hard daily and full time to ensure this community is a free and open place for you to share your input. Physician financial contributions support and maintain this community and its devoted employees. Getting paid for what we do doesn't negate our ethics or our ability to do our job well. In fact, it gives us the ability to work longer and harder to ensure we are providing you (the patient members) with the best education and support possible. In fact, I would find it harder to trust someone who was running a forum community and recommending physicians on their spare time as this could be an indication that the evaluation process has been done haphazardly.

As I stated above, this open forum is about accountability and transparency for all all, yes, including Pat and I. I appreciate that you are working to hold us accountable for our actions. But all I can do is try to assure you that we are doing the best we can to ensure we are only recommending those that meet our criteria. This is why Dr. Mohmand was promptly removed from being recommended on this community.

Regards,

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

View our hair loss articles on EZineArticles.com

Follow us on Facebook | Twitter | YouTube

Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

NN, I believe your prowess in keeping any and all aspects of the forum above board and transparent are helpful to the community at large, therefore your contributions are needed and do more than stimulate discussion, they also help others to be rightly suspicious of any claims made on the forum.

The lesson is to keep questioning each and every result and the physicians involved in a quest to inform the membership in a search for excellent and consistent results.

The question of use, or non use, of microscopic instrumentation is incredibly important. This is the progresson of surgical norms in the West. But not necessarily in the entire world. And results obviously will vary, but certain hair types, like this gentleman Mr. Tarar, can benefit (or at least achieve better looking results) than others with his hair type. And from using less exacting methods in his part of the world, or so it appears to me from a set of pictures not convincing enough to make a truly informed judgement on the results.

More scrutiny and closeup photos may reveal something less complimentary. But what matters most is the patients acceptance of these results, in the end. From the pictures posted he looks really good.

__________________
My hair is a man made disaster.

Dear Friends

I am surprised on the comments of all the members in this forum.
If I Shoe you my grafts that we make with our loop magnification, I am sure you would be able to compare them with any other world class centers.
YES minimum standard should be maintained but it should be of the results. Buying a 3000 US $ microscope does not make much of the difference in the cost. I am on my way back from Orlando Live Surgery Workshop and giving a lecture on cosmetic donor closure, tricophytic scar closure technique, for the simple reason, we all see the hair grow how many of us have bothered to see the donor area scar of the patients. so the standard of work should be based on the outcome not what you use.
I would put an analagy here
suppose if the minimum standard of formula one is to do one lap in lets 1 min, is it really necessary to have a ferrari to do well the answer is NO, if you can reach the basic standard with or without an equipment, i am sure it should be of not much importance.
there are certain job related problems with use of microscope and then atleast have a look at my grafts that are dissected under loop magnification.
What about a person who can buy microscope but his results are less than minimum natural standard. Is that what you call fair?
well I am not only surprised with the comments but also hurt, you want to know if I use microscope or not , you do not want to see the standard of the results. Having said all this, you must understand the racial limitation. the hair we have to deal with are much more thicker and the density is also different, the skin reaction is different. may be its the ethnic difference in our part of the world which might have over the time showed me that I need not to use microscope.
Well as far as the price is concern, I am the most expensive in Pakistan, still charging 1.5US$ per graft, there are people who are doing less than half, they did posted their results as well.
I am sorry to hear the discussion, I felt it was not fair based on my clinical judgement. When ever we decide we have to take in consideration of the ethnic back ground, the type of hair shaft, the skin type, laxity, etc
anyway, if microscope is the only creterion to be in a forum that represented the high clinical standard then I dont know whether to buy a microscope or magnifying camera with a screen.
Well Pat, I am pleased that you did give me a chance, sorry that I do not own a microscope.
I hope to see you in Montreal this Sept on ISHRS meeting where i might be conducting a workshop.
Its irony that some one did not considered the clinical variations and other aspects before giving a verdict.

regards
Humayun Mohmand

__________________
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I am a medical advisor to Lexington International and Hairmax. What ever I say is my personal opinion.

Dr. Mohmand is recommended on the Hair Transplant Network

The price is because the income in this part of world is on an average less than 500 to 700 US$ for most of the people who are garduates and masters, so its the local economy the dictates the price.

There are two school of thoughts with microscope or magnify projection as in wall mounted camera and screens.

The idea is to reduce the garft damage.

With respect to the comment on DR Sheparo's result. I am not saying that microscope results are not better. What I was referring was that his results when he was not using microscopes were equally good.

anyway, I hope that you will all consider the ethnic difference between caucacian hair and South east asian hair.

Humayun

__________________
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I am a medical advisor to Lexington International and Hairmax. What ever I say is my personal opinion.

Dr. Mohmand is recommended on the Hair Transplant Network

Dr. Mohmand,

I respect the work that you do. I have no issues with you at all, but I still believe that standards are there for a reason. It is believed that microscopes are necessary for optimal results and I feel for you that they are expensive and you are not paid what physicians here are, but that does not make it right to make exceptions. I can't in good faith tell a person to see you. Possibly you will be able to purchase the technology in the future because it does look like your work is good.

Dr. Mohmand,

I personally feel that the results you are producing and have been demonstrating look good. But I believe a more superior result can be achieved by using superior tools. Research has proven that the use of microscopes to dissect grafts minimizes follicle transection thus preserving the finite donor hair supply maximizing hair growth yield. Regardless of the hair density, color, texture, and skin type, I have seen no evidence to negate that microscopes as a tool are superior to 2.5 loop magnification. I am open however, to evidence that suggests otherwise.

Remember that nobody is saying that you are producing poor results. But evidence suggests that using microscopes will produce even better results. And at the Hair Transplant Network, we want our patients to visit physicians who are using the most up-to-date tools and technology that will give them the best result possible.

Results are looked at first and foremost however, we have to consider the tools used that accomplish the end result. There are clear indications that some tools are simply better than others.

It is quite impressive that you've been able to achieve such quality results without using microscopes, but imagine how much more using state of the art tools can help your practice?

I hope that you will view this thread as a chance to excel rather than an attempt to knock you down. I have great respect for you and hope that you will adopt the regular use of microscopes into your practice.

Like Pat, I will be attending the ISHRS conference in September and look forward to meeting you there.

Best wishes,

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

View our hair loss articles on EZineArticles.com

Follow us on Facebook | Twitter | YouTube

Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.