Techs perform HTs, not surgeons

[Michael5577]

I want to quote a comment I recently saw:

 

HTs are grotesquely expensive imo, its been my experience that most of work is performed by techs earning probably $20-$30 per hour. In my case not a single graft was transplanted by the surgeon, not one. As far as im concerned since the techs performed the actions of preparing the grafts then transplanting them, technically, they did my HT. The surgeon spent no more then 1hr making incisions, about 15 minutes removing the strip and 1 minute stapling the wound. A further 45 minutes was spent waiting for the anaesthetic to effect.

 

 

I find it interesting that surgeons have no qualms charging outrageous amounts of money (15K + for a megasession) for transplants they don't even really perform. Some would call it preying on the timid and insecure who often have to go in serious debt for a lifetime to get a HT that may or may not look good, but in any case can only give an illusion of a head of hair under good, soft lights.

 

Comments?

Edited July 27, 2010 by Michael5577

[TC17]

Not all doctors have the majority of techs implant grafts. For example, Dr. Konior does the vast majority of graft placement.

 

We're not privy to the financial information of the doctors, so saying that they charge "outrageous" prices isn't necessarily fair. My ex girlfriend has over $225k in medical school debt, and right now as a resident, she's earning a little over $45k per year! I have around $100k in law school debt, and using the standard 10 year student loan repayment calculator, I will be paying around $1,200 per month for ten straight years. Do the math on what many doctors will be paying per month.

 

Doctors should be rewarded monetarily for possessing the intellect to get into, and subsequently graduate from a medical school. They should be rewarded monetarily for the hard work and sacrifice that medical school requires. They should be rewarded monetarily for the economic sacrifice that new doctors have when residents. They should be rewarded monetarily for possessing the skill to be the best of the best at what they do. In short, they deserve to charge prices that afford them something beyond merely a comfortable living.

 

Now I recognize that medicine is not like business, and that doctors shouldn't necessarily charge whatever the market will support because there is a moral component to the practice of medicine that removes it from strict economic analysis. However, hair transplantation is a cosmetic procedure. It's as elective as elective gets. So long as the doctor in question gives back to the community in other ways, I have no real moral issue with what he charges.

 

With all that being said, I find it strange when people on this forum say that hair transplantation is affordable, it's not. It's very expensive and outside the reach of a vast majority of people in the world. Most people do not have the $8,000 - $10,000 or so that 2,000 grafts from strip commonly costs. That's A LOT of money.

 

But, just because doctors charge a lot of money, and just because we all wish that they didn't, it doesn't mean that the doctors are immoral for doing so. At most, with regards to the cost factor, they are amoral. And that, is a very big difference.

[Tao]

I know my surgeon was in the room placing grafts all day until the end. Dr. Konior. And I got great results. Expensive? Yeah, I'd say it was. Basically it came down to a new car or having my hair back. I made the right choice. Hell I bike everywhere anyway.

[Michael5577]

Doctors should be rewarded monetarily for possessing the intellect to get into, and subsequently graduate from a medical school. They should be rewarded monetarily for the hard work and sacrifice that medical school requires. They should be rewarded monetarily for the economic sacrifice that new doctors have when residents. They should be rewarded monetarily for possessing the skill to be the best of the best at what they do. In short, they deserve to charge prices that afford them something beyond merely a comfortable living.

 

 

Nobody said that doctors shouldn't be "monetarily rewarded" for what they do. Obviously, the market decides and if some are willing to pay 15K to be a little less bald, great! My question is really about the fact that they don't really do the HTs themselves. I know an idividiual who had a HT and maybe saw his doctor for about an hour that day, tops. The actual transplant of grafts was accomplished by, in his words, "a fat Mexican woman". As far as he's concerned, she did his HT, and he's not very happy with his results. I did my research and "hair restoration" is a very sleazy business indeed.

Edited September 5, 2010 by Michael5577

[TC17]

You're generalizing when you say that it's a "sleazy business." You're also attempting to justify your disdain for the high prices charged by hair transplant doctors by attacking the doctors personally by minimizing what it is that they do in the surgery. Removal of the strip, creation of the incisions, and suturing of the donor are the most important aspects of the surgery. Techs implanting grafts that are checked by the doctor really isn't an issue. Do you complain that the dentist doesn't do everything in your dental appointment? Do you complain that your family physician doesn't check your BP at your yearly physical? Would you complain if your attorney delegated research tasks to an associate of his? Of course not, unless the end result was less than satisfactory.

 

For many doctors, they aren't as good at implanting as their techs. I want whomever is best at that particular task doing it.

 

It's also ridiculous that from your one friend, and your (apparent) lack of research, that you've managed to conclude that the doctors involvement in hair transplantation is so minimal. I'm not an apologist for any doctor or clinic, but your views are misguided and your statements are unnecessarily antagonistic and inaccurate.

 

I highly recommend that you continue researching and maybe your views will change.

[Michael5577]

TC17, you sound like a shill and not like an objective analyst. I didn't get personal with you at any point. I don't appreciate the patronizing tone either.

 

Thanks.

[TC17]

Again, I urge you to do further research and to read some of my previous posts on this forum. I am as far from being a shill as anyone here. I will say no more on this topic.

[mahhong]

Michael5577,

 

I appreciate what you're saying but that's business and it happens everywhere. I mean, literally, everywhere. Those who open businesses, head businesses, are the commanding executives of businesses, earn more. It's not really outrageous, it's capitalism and it's fair.

 

Look at it this way. You have a HT done and it's not acceptably performed. Chances are you'll be taking it up with the doctor, not the techs. If a surgery falls into disrepute it's the doctor that will be demonised, and very unlikely to be the techs.

 

In other words, doctors have to be accountable for everything that happens in their business. They also have to plan your procedure, they have to ultimately be responsible for you. As the originator of the business and the most accountable person, as well as the person ultimately response for patient plans, the doctors are the professionals and probably do earn the most money.

 

You also haven't taken into account overheads. Rent, bills, R+D, advertising and other running costs. It's not just a doctor and a few techs - it's a whole business that needs to be paid for.

 

I don't know what the techs are being paid or what the ratio between their fee and the doctor's is (nor is it our business, really) but businesses work that way. Everything from call centres to banks to football teams to schools are run in such fashion, where the head of the team gets paid the most. Perhaps they don't work as obviously hard as the techs on the day, but these doctors are running a surgery and the time and responsibility it takes to do that warrants the costs.

 

Finally, even if the distribution of fees was unfair, what does that have to do with HTs in general? I don't see how HTs prey on the timid or insecure. I think everybody on here understands pretty well the sorts of results you can expect, the sort of costs you can expect and the sacrifices you may or may not need to make. HT costs are roughly in line with any other cosmetic procedure and many would consider regaining their hair much more important than a flashy car or extravagant vacation (both of which can in theory cost more).

 

Generally speaking my experience of the hair restoration industry has been a positive one. Most reputable surgeons are very honest about what you can expect results wise, and more often than not it's a big improvement cosmetically. I haven't seen a single top surgeon boasting about restoring every hair on your head and trying to part you with $15k before you've had a chance to think. I'm sure it happens, but it does in every industry.

 

Overall my comments on your quote would be that if you see it that way you shouldn't get an HT. If you feel there are better things to spend your money on, then there are. If you feel the results are not what you would be pleased with, then they're not. However, as a blanket statement about the industry, I think it's ultimately an unfair assessment.

[EpilepticSceptic]

Michael5577,

 

Have you yet had a state-of-the-art megasession HT performed by one of the coalition docs recommended on this site ?

 

If not, then you are very green and have little knowledge of the process.

 

I learned more in 1 day of getting my HT than I did in 5 years of research on various forums.

 

A megasession URFUT HT is so complicated and labor intensive that it requires a large team of highly skilled people to pull it off. The HT surgeon is sort of like an engineer/architect, and the techs & staff are the laborers. Do you think the engineers who design F-15 fighter jets should also be the ones in the factory doing the work ?

 

The HT doc excises the strip, staples it closed, and then makes all of the incisions where the grafts are placed. This is ALOT of work, and if he/she also had to place all of the grafts then the chance of fatigue causing mistakes will increase exponentially.

 

I had techs with 10/15 years experience at implanting grafts working on me, so IMO they were highly skilled professionals. And that is ALL they do! Would you really want the same person trying to do everything in your procedure ?

 

You really need to do some more research my friend. It seems your friend probably went to a shady clinic. There was a clinic (somehwere in NY I believe) that was closed down years ago because they had a garbage man dissecting & placing the grafts -- the HT clinic was his night job !!!

[Davis]

First off not all HT's are created equal.

 

There is a reason why only a few specific docs consistently give good-great looking results while others give butcher-mehh results..

 

Even at $25/hr x 6 hours. You are looking at $150, x 4 techs = $600.

That is only the transplant itself, not including prep and post time.

 

 

That does not include potential medical coverage they are given as well as other perks...

 

Let us also consider rent, equipment ( keeping up with potential new technology) constant research...

 

Oh and a little thing like spending a ton of money on a medical degree and taking the risk of starting your own practice...

This all add's up very quickly.

And let's not forget not all sessions have a $15k price tag on them...

based on what I have seen the avg is in the $7-$10k range

 

Without getting into specifics I know certain docs will perform the strip and fue specifically themselves, while most of the implantation is done by the techs

 

Even though it is very emotional to us all, let us not lose sight of the fact that this is still only a cosmetic procedure

[wb280]

Michael,

 

I think the seniors have spoken nothing but the truth. Its not like a life-or-death situation and u get to decide if its worthwhile to pay that money to be less bald. Its just a demand supply equation. Put yourself in their shoes and hell ya, i will be surprised if u, as a practitioner will charge less!

 

Also, i did a 3150 grafts with a reputable doctor and yes, while i agree a HT is not exactly cheap, the work involved is no doubt intensifying. From cutting the strip and excision to implantation and sewing up the donor ( fyi my dr is part of the 3 teams X 2 personnel who got involved with the actual implant ), i cannot disagree that it takes a lot of knowledge and skill in which only docs who have gone a long way from graduating in med sch to being a qualified practitioner can qualify.

 

I have no qualms abt your post complaining its too expensive. Hell, everyone has their opinions but to state that hair restoration biz is sleazy, i think u might have crossed the line a little bit

 

The seniors have suggested that u do more research and spend more time looking at photos and results and u probably will have a less biased opinion soon! though that does not mean the docs will charge u less by any means

[NotUrAvg]

I think this is an interesting and important discussion. Michael has a right as a consumer to question how much of the surgery is performed by the surgeon, and whether the compensation is appropriate, especially when the surgery is this expensive.. There is no question that the surgeons are involved in the most important parts of the procedure, however, I think you cannot minimize the importance of graft preparation and placement which is often entrusted to technicians. TC had made the comparison to checking BP, but I think it's a bit more important than that. I've read a few posts here about people who had grafts that did not grow because they were improperly placed. I'm not an expert, and I'm sure the senior members could comment better as to the potential complications of inappropriate preparation or placement. Now, you probably don't need an MD and $200K of med school debt to place a graft, but i think the surgeon has an obligation to oversee this process closely and ensure that he has employed only competent and experienced staff. Hell, you probably don't even need med school to be a good HT surgeon. It's all about good training and experience. Very little of what you learn in med school is directly relevant and applicable to the surgery. So do I have a problem with techs placing the grafts.... nope, as long as they know what they're doing.

 

As far as whether they are getting compensated too much, it's difficult to compare HT surgeons to non-cosmetic physicians. Its nice that people think doctors should get reimbursed well for the commitment, debt, and sacrifice it takes to acquire their expertise, but HT surgery is a little different, and more like a business. Compensation for HT surgeons is based on the market, where as non-cosmetic surgical reimbursement is usually determined by insurance companies. If you were to compare the two, it would probably appear that HT surgeons are getting way overpaid for the time/energy/liability, but I don't think you can make a direct comparison. Take neurosurgeons or heart surgeons who perform equally long surgeries. Their presence is integral to every step of the procedure, they are dealing with much more complicated surgeries which a much higher and more serious complication rate, and their overhead is much higher with OR fees, real anesthesia monitored by anesthesiologists, higher malpractice, and more preoperative/postoperative time commitment. These patients require extensive work ups beforehand and you can't really do preoperative consultations over email, and postoperatively patients are sick and usually admitted for a few days. Most of these surgeons get paid a fraction of what some of the high billing HT surgeons are getting (a strong argument could be made that these doctors are probably getting underpaid). But the truth is HT surgery is a cosmetic procedure, and the doctors would not be charging those prices, if we as patients weren't willing to pay those prices. I'm sure there is some sleaze out there, as it is the world of cosmetic surgery. But I agree with WB that its probably a little over the line to generalize it about the whole industry. With adequate research, a vetted surgeon, and willingness of the patient to part with that amount of money for a cosmetic procedure, I don't see anything wrong with the status quo.

[wb280]

I cannot help but nod my head all the way while reading your post NUA

 

Your point on neurosurgeons or heart surgeons... i just want to share some experience. At least in my country, such heart ops are way more expensive than HT. I had a customer who had liver transplant. The whole op, inclusive of hospital stay etc etc, came up to more than USD200,000!

I reckon the only way u can pay an amount as extravagant as this is to undergo FUE with N**Graft ( JUST KIDDING ! I AM NOT STARTING A DEBATE ON THAT!!!)

 

In my opinion, its always back to demand and supply. If the surgeon wants to charge that amount and customers are willing to pay, there is nothing morally wrong about that.

 

By the way guys, NUA and I share the same surgeon

[Bill - Seemiller]

Michael,

 

I appreciate you starting this discussion and while I don't think you're seeing the entire picture, I can understand some of your concerns.

 

For starters, it takes an entire surgical team including the physician and his/her technicians to successfully perform and complete a hair transplant procedure. Each technician is also paid handsomely (and rightfully so in my opinion) to carefully sliver, dissect and implant fragile hair follicles into tiny recipient incisions made by the surgeon. While you may only see your surgeon harvest the donor strip and punch tiny holes into the balding areas, what you're not seeing is the quality control physicians put into properly training, supervising, and managing their staff to ensure top notch work and ultimately, results. Some surgeons also are more "hands-on" and involve themselves in other aspects of the procedure including placing some of the grafts themselves.

 

Some patients may consider the price of a hair transplant relatively high. However, surgeons aren't pocketing the entire $12,000 (give or take depending on the size of the procedure) for each surgery. Physicians have to pay all of their staff from the technicians to the secretaries to the consultants that all work harmoniously in running their practice. This includes medical benefits and other costs associated with operating a business. Each procedure also takes all day and involves a number of experienced, professional hands working with each patient to ensure they get only the best results. Sure prices could be reduced, but at what cost? Should physicians hire inexperienced technicians and pay them minimum wage to reduce the price of your procedure? Or would you rather obtain the best result possible for a lifetime and pay a little more?

 

Additionally, hair transplant surgery is an optional, cosmetic procedure and nobody "needs" this procedure, even if the desire for it is strong.

 

Vehicles are also very expensive, but some people don't mind spending $40,000 plus on a vehicle they really like and will enjoy for 10 plus years. The good news is, investing in a quality hair transplant with a top notch physician can allow patients to enjoy their new head of hair for a lifetime. Honestly, this is how I justified the cost of the procedure(s) to myself.

 

I've shared this before, but I'll say it again. Since the average American spends approximately $30,000 on a new car every 5 years, I figured I'd keep my car for 10 years and spend the extra $30,000 on a new head of hair which will give me back my lost confidence for a lifetime. That way, I still haven't spent anymore than the average American and I still enjoyed my car and a brand new head of hair to boot :-).

 

I do encourage anyone considering a hair transplant to do their due diligence in researching the procedure including the advantages, limitations and possible risks that come along with it and the best physicians who regularly perform successful procedures with excellent results on a daily basis.

 

Best wishes,

 

Bill

[haircut]

Bill,

 

Excellently said!

[RCWest]

Grotesquely expensive? You should have had a procedure done 15 or 20 years ago when grafts were $20 a piece! The $4-$5 a graft they charge now is a breath of fresh air to me. Hair transplantation is probably the most labor intensive job in the medical field, and I give thumbs up to anyone who can dissect and implant thousands of grafts for 8 or more hours a day, day in and day out!

[haircut]

I have actually been thinking the same thing. I had transplants in the mid 90's when they WERE $20 a graft.

[waveskier]

My surgery was done by 2 female technicians. They were both highly skilled at what they do. In fact it is ALL they do, and they do it often enough to be very proficient.

 

Yes my doctor did the surgical cutting and removal of the donor strip, but the ladies did the rest. I was amazed at how they could stand for hours doing such tedious work. They were always pleasant and answered all my questions without hesitation. All in all I have no complaints. I should also mention that my fees were considerably higher than most. My doctor brings in his technicians from Chicago and they stay for one week out of the month the do the graft work.

 

It was either this or me flying off to somewhere which was not an option at this time. So I am assuming that part of my cost covered the expenses of the techs. I paid for the convenience of staying in my own home.

[the B spot]

Dealing with the costs associated with hair transplantation is difficult. However, we should understand that the inclusion of more qualified technicians is a result of consumer demand, not from doctors.

 

Most clinics employ a sliding scale that reduces a cost per graft for larger sessions. A few short years ago doctors were charging 10-15K for 1000 to 1500 grafts. That same amount of money now gets you a top physician and 2500-3500 grafts in many instances.

 

Gone to are the days of 2-3 assistants, whereas many clinics employ 8-12 technicians, who take time to train and time to bring along slowly until they are proficient.

 

For most of us, getting a HT is a choice between a new car, vacations, electronics, etc... so I understand how difficult it is to plunk down 10-30K on new hair. But the decision is YOURS and yours alone.

 

I wish you well in your pursuit of hair restoration and please feel free to ask as many questions as you like.

 

Take Care,

Jason

[Sparky]

If there was 12 people working on you for a day thats an average of $2500 before overheads, I cant think of any way to justify that.

[Dr. William Lindsey]

With some reservations, I jump into the fray.

 

There are alot of good points, all said 2 or 3 times. I won't add to that.

 

Suffice it to say that this kind of procedure is a luxury purchase. The market does a pretty good job in setting prices, and if a doctor is not busy enough, lowering prices definitely adds to the case book. There are lots of expenses associated with running any business, and at least in hair, the doc gets paid last. That hurts in slow months like August, when everyone is at the beach and not doing hair....but is made up for other times of the year.

 

I complain all the time about high prices too. For example, I love to go to Utah to ski. At Christmas week, the cheapest fare I could get is 780.00. You know why? Its because the airline knows that anyone who is coming that week has enough money to pay for premium lodging prices, premium prices for a rental car, and is going to be dragging an entire family out while schools out. They "got cha". They know it and so do I. But, I want to go that week and take the kids. If I could just wait a week, the prices for everything drop 60% or more. But, school is back in session.

 

So its a luxury to go that week. As a family we make the decision to spend money then, RATHER than get new cars, fancy watches etc. My 97 4runner has 185k miles on it, but still runs fine. I'd rather have 3 ski trips every year than a new truck.

 

Same with other luxury items. I have had countless patients in hair, face work, and even back when I did Ear Nose and Throat, who would think my prices or even insurance co-pays were outrageous, yet they have a Coach bag, a luxury watch, or drive a new car every other year. That is the beauty of capitalism. You can save, spend, or waste as you want.

 

Lastly, while I am sure there will be those who agree and disagree with my comments, I respectfully say that this thread has been beaten like a bad dog. I tend to check the network on Tues and Weds. and this boy has always been near the top. I plead for this thread to drift on down and lets have another topic....maybe laser hair stimulation???

 

That always brings out a crowd.

 

Dr. Lindsey McLean VA

[wb280]

I agree with Dr Lindsey. The market is, like any other luxury items, all abt demand and supply. If it bothers u enough to spend that dough, u cannot blame drs for charging that amount.