Yes, I am aware that they are not experimental like BHT (sorry if I used that word by mistake), so perhaps comparing the two isn't completely fair, however, since the success rate is still much lower than strip, those patients that undergo FUE should be aware of this (which seemingly, you present to them in some way, hopefully in writing), so there is no problem there.
I think this is good...I am aware that not everyone is a candidate for FUE, and it takes an ethical doctor to refuse surgery on someone who is not an FUE candidate...so this is good. I've read about too many doctors doing surgeries on patients that are not candidates and it turns out to be a nightmare. Regarding ethics, I do not question you.
This is more of a personal problem with me rather than an ethical one. I simply suspect that patients (even though they know the facts) can be exploited, even if unintentionally (which I truly believe Dr. Feller, that you would not do it intentionally). There are certain states that people can be in which "clouds" their ability to make an informed decision, typically those states are normally those in desperation. There were big controversies way back when whether it was ethical to perform medical experiments on prisonors even though they agreed, because their "state of mind" was said to be clouded. Inevitably, medical experiments were mandated to be stopped on prisoners. Though it's not a perfect comparison by any means, someone going into get an HT by a well known doctor who constantly yields excellent results could be "clouded" with excitement with hopes and dreams of a new head of hair and agree to anything just so you'll perform the surgery on him. So in the event of a failure of the FUE surgery, this patient COULD argue that he let his excitement cloud his judgement and get the best of him. Now I'm not stating that this is your problem Dr. Feller, at least, not entirely...a patient MUST own up to their own decision making...however, I just see this as a potential issue, that could arise and come back to bite you.
And as one who is not a strong advocate for unabashed capitalism (simply because it's easy for the little guy to get stepped on), I'd like to see the PATIENT win out rather than the DOCTOR in the event of a failure. This is a personal opinion. I agree that you are doing everything to inform the patient of the situation, and if he agrees, it's on his head...however, it's the philosophy I have a problem with. The bigger guy can afford the loss...the little guy can't. So I think the bigger guy should let the little guy win in the event of the failure.
In most cases yes...but think about those people who want FUE:
1. They are trying to avoid a strip scar
2. They might be like me and wanting to tap into reserves when they are stripped out
3. Want faster healing time
Since you've only ran into this situation one or two times (which is good), we don't really know if it happens again which patient might be the bombshell who will set off based on my above points. Again...I rather see the little guy win over the bigger guy, if things don't work in the little guys favor.
I know you care about your patients and want the best possible result for them...but:
1. "unabashed and unapologetic capitalist"
2. "can't afford to lose valuable days of surgery on a HIT OR MISS procedure like megasession FUE, particularly when I know I could have scheduled sure-fire strip surgeries on those days"
3. "Yes it IS about the money as such days like those can add up".
I'll add a few more opinions here.
1. If the surgery is HIT or MISS...why do you offer it when you know very well the patient MIGHT come out disappointed and lose $4000? He might not opt for strip or even have the option for it.
2. When you say you "can't afford it", I'm assuming this is the capitalist side of you that wants to make the most money possible talking. Surely you CAN afford it since the percentages of this happening are obviously extremely small, as you said one or two. But I think most likely who CAN'T afford it is the patient who might be stuck shelling out $4000 and get nothing in return IF they can't opt for strip or choose not to.
3. I know you love your work...and you do it well. I also know that as a business, it's important to make money, and I don't question your desire to make money...after all...that's the main reason why we work isn't it? If I could...I'd retire and I'm only 29
My entire post can be summed up in this statement: It's good to make money, it's great that you love your work, but I think sometimes it's better to give the little guy the victory when in doubt. In business, sometimes it's better to cut your losses in order to keep the customer (or patient in this case) happy. Heck, after all, the patient is already going to be disappointed enough that FUE won't work for him...let him have his money back and take it as a loss. Surely...any doctor in your fiend CAN afford it with a heavy clientele like yourself. In the longrun, I think you'd be even MORE respected if a failure like this does come up, and you give the patient his money back IF he strongly objects to strip.
Anyway...on a brighter note...I think you do great work and I still believe that you have taken FUE a long way. I'll be interested to see when and if this will evolve even further in the coming years.
Bill