HtQuestions

I have to say this is all very helpful, though I hope it stays friendly even if it gets heated. Two points: 1. @noturavg, I don't mean to suggest the bias problem always reflects mercenary motives--and certainly conferences can be a good thing (assuming there is some substance there, good techniques being discussed or taught etc.) even if not without a few elements of self-promotion (how much of each is going on is one of those judgement calls). But there are other issues, broader self-love and the "mutual admiration society" and the "hopes and future allies society" that can bias judgments a lot even though they are also factors that help people take pride in themselves, work hard and work together. And even mercenary motives can produce great benefits, including good medical work. (But I do think there are some perhaps unsolvable problems particular to this field, because of the lower esteem with which the public holds it relative to other medical specializations and because of the other issues I mentioned in the previous post. One can think of the reverse, what (idealized) factors attract higher (I don't say the highest) caliber people: extreme difficulty of training or rare intelligence demanded, high honor or respect, extreme benefits thought to be conferred, such as saving lives, no menial or demeaning acts or selling required, etc.) 2. Thanks to jacksonbrowne for drawing attention to Pat's post, which makes a number of good points (here): http://www.hairrestorationnetwork.com/eve/146331-what-does-mean-abhrs-board-certified.html#post2111238 About the IAHRS he says: I think it is a good sign if doctors can get removed from a group, since presumably that would be against the (lowest) interest of the group if they were paying dues or for ads etc. Now there could be a very cynical view of this, which I am NOT proposing! and won't even articulate, but some concerns that could arise would be alleviated by: familiarity with the posts of the patients here, which will take some more time for me to do, familiarity with how the acceptance or rejection of physicians into the group actually happens, and confidence that there aren't commissions or side benefits going from a few physicians to the group, or only minimal ones necessary to run the board and pay managers (or is this run by volunteer efforts? seems like an absurd amount of work!). (In an ideal world there would be a mixture of patients and doctors, not beholden to the doctors they are reviewing, reviewing complaints, and doctors setting in common minimum standards of practice (or some commonly accepted protocols).)

noturaverage, You put it very well--there is some (illegitimate) bias among pcps against cosmetic procedures. I would add that the gravitas and responsibility that attracts a lot of people to being doctors in the first place also would lead them to look down on elective cosmetic surgery as frivolous. Of course, most doctors are a little too serious about mere health. I mean, the things that good looks helps along are certainly worth some expense and risks, otherwise why get out of bed, but that's not usually their thinking. (They seem to be a tad overly severe about drinking also!) jacksonbrowne, Thank you for that link. Seems like good advice on that site -- though I'd never be tempted to be influenced by yellow page ads, hair stylists, or tv infomercials. I agree that pcp's are also susceptible to salesmanship and glitz (or for that matter, free notepads and coffemugs). Still, if it were an exceptionally good and trusted pcp (whom you could ask the basis for his recommendations), or if we were taking a survey of many doctors, couldn't it provide some indication at least of what might be a bad practice (they might know more about what bad doctors are like, or at least what doctors violate customary practices, which is generally a bad sign). At any rate, it would help if there some official training standards in ht with some supervision of doctors by doctors (the way there are for other specialties). But since it's purely cosmetic and no life and death is at stake, it's probably not considered to be worth setting up official standards. (As an example, I think it was a great mistake to allow attorneys to advertise -- there is value in the honor and strictness of professional feelings and supervision and restraining crasser sentiments and practices.) Future_HT_Doc, I lean to being cautious on surgery and medicine in general. It's not as though I haven't on occasion made grievous mistakes in purchases, and I'd like not to do that this time. I actually did not notice that any patients were doctors themselves, so I have to pay closer attention--I certainly agree that would help a lot (especially if they were non-ht doctors, as I explain below, and assuming of course they are not also consultants of some sort etc.). This is a good point: That makes a big difference I agree. The only caveat I have is that they still made a decision to get into the hair transplant field--not that that's a bad thing, but it's still a bias (especially considering what I assume are the monetary rewards versus the honor hit in choosing that field). It's not as unbiased as someone who never went into the field in the first place, i.e. you still have an (unwanted kind of) "selection bias" in the sample. For example, if you took only those doctors who practiced in other fields first and then went on to practice homeopathy (sorry for the bizarre example--just using it for dramatic purpose here--I'm NOT comparing ht to it!), that would be heavily skewing the opinions in favor of homeopathy, even though I admit you would be getting some bias improvement over restricting yourself to doctors who had always practiced in homeopathy and nothing else. (of course there's a reverse bias as well (the bias against cosmetic surgery by pcp's), but that's less of worry, since it's the known factor. the scary thing to me are all the unknowns especially in a field that I think had a known bad history.) That's longwinded but the main point is I am trying to sift through and get some trustworthy, intelligent, informed, unbiased judgments, or as close as I can get to that. The marketing and the bad taste of many of the ads and websites are a problem with me, but I try not to overreact. For one thing, its partly a reflection of the customer base--e.g. you get somewhat tasteless viagra ads because a large part of the customer demographics is of a certain kind (aka horny old guys -- but also Bob Dole I guess), and that of course in no way means viagra isn't sound, effective, legitimate, etc. Then you have the past history of ht which probably colors my judgment: the bad hair plugs (associated for some reason in my mind with late night "hair club for men" type ads). But I know these aren't the surgical techniques commonly used now. Nonetheless, it makes it harder for me to sort things through. It would be difficult for me but not as difficult to pick a good cardiac surgeon I think, though some of the same concerns apply (some doubtful marketing and hype by Dr. Jarvik etc.). (Some of the more popular kinds of plastic surgery start to show similar problems, I mean the marketing issues, more problematic motivations of some of the doctors and also the customers, clinics that are "mills," etc.) (The bad taste or vulgarity of the ads or marketing issue is a hard thing to convey but it's really there, and there's not much that can reassure me on that point. But as I said, that's partly a reflection of the customer base, and I certainly don't want to go to a doctor who has only had a few hair transplant sessions, i.e. didn't get a steady stream of patients/customers.) As far as how physicians are recommended here, it's a delicate matter, but as far as trying to get a handle on bias issues, it would help to know how the fees and commissions and ads work--transparency. Some of the same issues would apply to the Mayo Clinic or what have you, but my sense is that there's somewhat more marketing deals, hype, showiness, etc. in this area, more than I am comfortable with. I tried to articulate some of it, but it's still not clear to me. I might have a better perspective after I meet for a couple of consultations (but of course I have to pick the right doctors to have the consultations with!)

Danielkiwi, Thanks for your comments. I too had a doctor who thought even propecia was a bad idea! Weighing risks and benefits vary depending on the person, but I can't say that going bald is a good thing, so some (at least very small) risks seem justified. A good idea based on what you say would be to ask if one's doctor is familar with the new techniques--I assume younger doctors might be better at judging something like this. But the doctor may be reacting to the general character and trustworthiness of hair transplant clinics (not the techniques)--and that's important by itself (regardless of the techniques). I've been looking at some of the doctors who belong to this forum's list and who are frequently mentioned here, Shapiro, Feller, Lindsey, and Hasson. I briefly looked at another "media-comfortable" doctor but there was too much hype and I disliked his California-like (or in this case, Florida) spa emphasis, and his getting testimonials from people who got special benefits from him. Also, I've ruled out doctors that push the laser light (i.e. low level heat) business. I thought one prominent doctor overstated the case for FUE in some videos, or at least didn't present the drawbacks honestly. The big problem is finding doctors who specialize in and do a lot of ht work, but who are also trustworthy and reasonably priced despite the self-promotion and marketing (and of course there's a lot of money involved). Maybe I'm hypercautious, but I was concerned that the doctors listed on any forum or website are paying dues or fees or ads (maybe someone could explain how that all works, here or on other sites--who pays for what), but at this point I think if one gets enough (non-consultant) patient reviews and starts to evaluate that, that's helpful, and it is also helpful to hear what the doctors themselves have to say and how they explain it. I would very much like some sign that a doctor I already trust recommends some of these clinics--or at least see that they receive some recommendations from doctors outside the hair transplant specialty who are known and respected. I wish this subarea were more like other areas of medicine in terms of tone, trustworthiness, analysis, etc., not that some of the same problems aren't everywhere.

Pat, Thank you for your clarification on that. I feel much more comfortable when doctors, all doctors, are absolutely clear about their credentials on their websites, and I hope others can understand why that is an important concern--and why they should not feel embarassed to scrutinize these things and raise questions if something doesn't seem right (BEFORE the surgery!). (I want to point out also that I have no sinister or hidden motive: I am trying to cut through all the marketing hype and untrustworthy information out there, which is extremely hard to do, at least based on what one finds in Internet searches. I am looking to have hair transplant surgery for myself, and haven't yet met or spoken with any doctor or clinic who does hair transplants, but I will soon. Obviously it's a problem getting reliable and unbiased information when so many sites on the internet have a conflict of interest (caused by accepting ads or fees from the doctors they review), or have consultants on commissions posting. I don't see an easy way to separate the good from the bad information, but I'm trying.)

As I'm sorting through all of this, has anyone asked their regular personal doctors for advice or referrals on hair transplants? I assume some doctors would probably disapprove of cosmetic surgery in general, but I wonder if their advice has been of use to anyone, or whether anyone has asked. They would probably know less than someone who specializes in it, but otoh their judgment would (probably) not be as subject to bias and self-interest. (One little thing I've noticed is that the clinics that don't specialize in "FUE" or do little of it tend to be more explicit about the downsides of FUE, but that gets challenged by the clinics that do; so it seems like it's going to take some time to come to an informed judgement about all of this!)

NotUrAvg said: I'm inclined to agree with you. I would have advised him to be upfront about his medical school as the much better policy. On the other hand, even though hair transplants can be a good thing (in those cases where they work well -- I don't know what percent do), it is not a very respectable specialty for a doctor, even compared to cosmetic plastic surgery (perhaps because it is not only cosmetics but cosmetics for men). That's probably going to affect the motivations and judgments of many if not most of the doctors in this area, so one has to have a wider tolerance. You make an excellent point that ability and honesty are not the same thing. One would like to have a great deal of both though, especially when a knife is involved.

While I don't mean to curtail the discussion of do vs md, the question I mean to focus on is this: whether it is or should be a concern that a given doctor does not reveal where he received his medical degree, but says he "received his medical credentials from the University of the State of New York," without saying that is only an administrative agency, and not a medical school. Or is that generally acceptable in this kind of outside clinical procedure? perhaps it's specific to new york? I just saw that Future_HT_Doc offers a possible explanation (below). (thanks). Does anyone know if the New York Institute of Technology's College of Osteopathic Medicine was ever called the "University of the State of New York." It seems unlikely since that is what the administrative agency in New York is called (as I understand it). I wouldn't say "trying to hide," but it could be that he was picking something that sounds better and is technically correct (as the accrediting agency), but may turn out to be slightly misleading. But again, I may be overlooking something simple here.

Thank you @NotUrAvg, That is the issue, or specifically a doctor's decision not to state his medical school, but instead refer to the "University of the State of New York." First, confusion is likely to result: most readers would (wrongly) assume that means SUNY (or think a couple of words got transposed in typing). Second, it's not a medical school at all, and most people would (wrongly) assume USNY [sic], whatever it is, is at least a real university. I didn't find elsewhere in his website any mention of his true medical school. To clarify and extend a bit my question: 1. Should I be worried that a doctor does not reveal his medical school, but refers to something that is not a medical school as if it were. 2. Or am I completely mistaken and is the University of the State of New York entirely appropriate, at least for a hair transplant doctor? @jacksonbrowne, spex: DO's and MD's seem to have almost identical education and training, though it seems peculiar to decide to become a DO, given it's less known by the public (and the only difference I've read, I have some minor skepticism about--the emphasis in DO training on osteopathic manipulative treatment.) But that's not my question--for hair transplant surgery (assuming no general anesthesia is used), I suspect a more limited set of factors count, such as technical experience and choice of method (jacksonbrowne put it well, "skill, practice, and volume"). My original question has mainly to do with credibility (what could be taken as an evasion about one's medical school), given that the industry is obviously dominated by marketers and hype for a number of reasons (for one thing, better doctors would probably prefer something with more respectability). Let me emphasize I have absolutely no grounds for doubting the many great reviews of the doctor in question here--it's only a question about how he presents his medical training in the bio, and I'm not sure that's incorrect--I think it depends mainly on what USNY is, what the accepted practice with other doctors concerning that, etc.

I'm thinking about having a hair transplant. I have a question about a doctor who receives great reviews here--and I have no reason to doubt that. I'm a little uneasy though that his website says he "received his medical credentials from the University of the State of New York." Does anyone know anything about that? As far as I was able to find out, it doesn't seem like that's a medical school at all but some sort of state accrediting or administrative agency. Also, any opinions on what weight if any to place on where a doctor received his degree? (I mean given the kind of procedure, minor surface surgery.) Thanks.