Dr. Rahal and deposit question

[Bill - Seemiller]

David,

 

I received your email and also spoke with Dr. Rahal directly regarding your situation. According to Dr. Rahal, you received the postoperative instructions immediately after you provided the deposit. However, you didn't cancel the procedure until 10 days later, which left Dr. Rahal and their staff (which he has to pay for the day) in an awkward position and without a patient for the day. Dr. Rahal claims that he did what he could to accomodate you in order to get you the date you wanted for your procedure. This includes asking another patient who was previously booked on your requested date if he'd be willing to change the date of his procedure. He reluctantly accepted only after accepting a discount at Dr. Rahal's cost.

 

Regarding the discusion of legal action, I spoke with Dr. Rahal and read the email you sent me. Dr. Rahal and his clinic made no threats or claims that they were planning to take legal action against you. However, Dr. Rahal did tell me as was also mentioned in the email that he discussed this discussion topic with their attorney. Their attorney claimed that calling their ethics into question is an actionable offense. The email he sent you was to request that you retract your statement regarding his ethics.

 

I understand you are frustrated by this situation however, it sounds like you simply weren't ready to proceed with another procedure before you went ahead and booked a date with Dr. Rahal. Hopefully you'll take this as a learning experience and consider this before booking another procedure. I truly believe Dr. Rahal can help you and encourage you to reconsider his clinic when you are ready to proceed.

 

Dr. Rahal is certainly willing to speak with you in more detail about this via phone if you are interested in calling his clinic. In my experience, Dr. Rahal is very friendly and laid back and is happy to speak with anyone. In my opinion, he's also very ethical and does amazing work.

 

Best wishes in moving forward with hair restoration surgery in the future,

 

Bill

 

P.S. I am changing the name of this topic to "Dr. Rahal and Deposit Question" as the current topic implies a lack of ethics, which is not the case here.

[Michael5577]

Calling Dr. Rahal unethical was completely out of line but it's very hard for people to admit to themselves that they screwed up and are entirely to blame, so they lash out at others in anger. I've dealt with Dr. Rahal as a patient and he's the most ethical person I've met.

[eddiemunster]

"Dr. Rahal and his clinic made no threats or claims that they were planning to take legal action against you"

 

Really Bill? c'mon. they ask him to remove the post, stating that they discussed the matter with their lawyer and it is an actionable offense. Yes, they didn't explicitly say "we'll sue you if you don't remove your post", but the implication is clear.

 

The responses from doctor reps and moderators to negative posts like this are disappointing. 1000 positive posts fly by each week, but the rare negative post gets beat down. IMO, it hurts the credibility of this site.

Edited February 16, 2011 by eddiemunster

[baldingbro]

I agree with Eddiemunster, It is pretty clear that Dr Rahal's clinic threatened david. This kind of response from Dr's clinics for negative posts like this is unnecessary because nobody really agreed with David's original post. Deposit policy is clearly stated on Dr's website.

[DavidEur]

Thank you for all for your very reasoned responses, much appreciated.

 

If my first post seemed unreasonable, then I am perhaps strongly influenced by my background. I've been the principal investigator on a number of small and larger public sector clinical trials over the last 17 years, and have taken post-doctoral education/exams in medical ethics and good clinical practice.

 

For each trial I've led, I've had to write a patient consent form that basically informs the patient of the risks, their rights and responsibilites of participation in a trial. This is then sent for approval to an ethics committee to evaluate. I can say with 100% certainty that in this situation it would have been deemed unethical to not inform me of the post-op procedure as it would be considered as information that could influence my decision as to whether to go forward or not.

 

You may argue "But this wasn't a clinical trial you were entering!". Very true, but the principle is the same (I could elaborate but choose not to become overly verbose).

 

To argue "but this this the way we've always done things" simply doesn't cut it. It's irrelevant as to whether it's ethically correct or not.

 

Saying "Dr. Rahal acted entirely within his rights" is 100% correct legally, but has nothing to do with ethics.

 

Yes, I waited 10 days before cancelling, but I honestly felt locked in by the deposit (and by a strong instinctive desire to fix what is broken irrespective of consequences. I did, and still do believe, Dr. Rahal would have sorted it 100%). Eventually I decided I'd rather lose the money that come back to work with obvious scabbing. But yes, I waited too long.

 

My point in telling you this is not to play the know-all, I only hope this will assist in an understanding of where my standpoint originates. In public health clinical medicine (where I've worked at least), it's entirely ok to be criticised or advised to perform something in another way for ethical reasons. I've never interpreted this as defamatory or interpreted it as being called an unethical person. That's two very different things.

 

At the same time, I've never lived in a litigious society nor worked as a private physician, so I respect the fact that I don't understand how things work in North America and that I overstepped the line. I apologise for that. It's easy for me, in my work, to say "You have a fair point, this could have been done differently, I should have done that. We can change it so that in the future we do this". I'd lose neither money nor pride.

 

I'd also like you to note that I never even mentioned the name of the surgeon who performed my first disastrous surgery when I posted my 10 month pic, so I'm not vindictive. I'd never go back to him. I would trust Dr. Rahal. But I simply wasn't 100% sure he was negligent and gave him the benefit of the doubt. I had zero fear of legal implications.

 

Until I received the legal threat (sorry but being told my words were defamatory, that it's been discussed with lawyers and was considered actionable, and that I should retract my post immediately, should be considered as a threat), I was even trying to think how I could get 3 weeks off work so I could actually go to Dr. Rahal. So from my side there was nothing vindictive about my mail. It was simply a principle and perhaps a cultural difference.

 

Dr. Rahal, I sincerely apologise for any offence caused, I hope you understand that was not my intention. However, I still believe your (and any other) hair transplant practice could be more ethical if patients were informed of post-op procedures before any financial transaction. I, in absolutely no-way whatsoever, think you are personally unethical.

 

I could improve by ensuring I have all the relevant info. before any financial transaction takes places to avoid wasting the time of the physician, the clinic, and of course, money.

 

Thanks again for everyone's thoughts, much appreciated.

Edited February 16, 2011 by DavidEur

[Bill - Seemiller]

Guys,

 

There is nothing in my reply that "beats down" David or this topic. My post simply provides an explanation based on my conversation with Dr. Rahal and reading a copy of the email Dr. Rahal's clinic sent to David. While I agree that Dr. Rahal and his clinic may have been a bit overly sensitive about this topic, which led them to discuss it with their lawyer, there were no physical threats of lawsuits, period. However, I also feel that Dr. Rahal and his clinic shouldn't have mentioned any discussion of their concerns with their lawyer in the email to David. This did serve to cause some additional and unnecessary controversy. However, I believe they did so to convey the seriousness of their concerns, not to threaten David with a lawsuit.

 

Dr. Rahal admits that he wasn't happy that his ethics were being called into question. However, I reminded him that patients and prospective patients are welcome to share their genuine opinions, experiences and concerns on this forum which may include calling a physician's practice into question. Ultimately, it's up to the adult members of this community to draw their own conclusions once both sides of the story have been presented.

 

It's interesting however, that some would accuse the moderators of "beating down" so called "negative" posts when unlike most other sites, we've always allowed open discussion of them. It's a moderator's job to keep this discussion fair and balanced and provide information they obtain when discussing controversies with both parties. Furthermore, moderators are just as free to share their opinions on any and all topics they wish.

 

I want to say something about personal responsibility and accountability. While a surgeon should provide a patient with all the information he/she needs, simply put, it's up to the patient to obtain all the information he/she needs before deciding to book a procedure. This includes learning all about the procedure, asking any and all questions, and obtaining all of the pre-op and post-op instructions. Most clinics provide the detailed paperwork which includes all the specific instructions after booking the procedure. However, if David asked to see the paperwork upfront or asked Dr. Rahal any and all questions about the procedure and post-op instructions before booking, I'm sure they would have obliged without question. Patients need to be held accountable for their choices. While I feel for David, the reality is, he booked the procedure and paid money without asking all the necessary questions.

 

On the flip side, I believe that clinics could do a better job in providing prospective patients with a much more thorough overview of the procedure and what to expect before and after before patients book their procedure. I think too many patients end up in awkard positions because they simply didn't know something.

 

The question here is whether or not the responsibility falls on the physician or the patient when expectations aren't clear or reasonable? Personally, I think it's a combination of both. Physicians simply need to do a better job in communicating how the procedure works and what to expect at their clinic while patients need to do a much better job in researching and asking as many questions as possible prior to booking surgery. Assumptions are very dangerous and need to be avoided by both parties.

 

Honestly, this is a case of less than optimal communication and a few false assumptions. Hopefully both David and Dr. Rahal will learn from this situation and be better prepared for future situations.

 

Best Regards,

 

Bill

[DavidEur]

For the record I think Bill has handled this situation very well. He doesn't agree with everything I say and he doesn't have any financial interest in letting me have my say.

 

He could have easily pulled the thread, removed me as a member, or both. Especially as he has years of dealings with Dr. Rahal, likes him, and I'm a relative 'nobody'.

 

But he kept a calm head and chose not to. I never felt unfairly treated, on the contrary, he provided an excellent perspective on this situation, irrespective of whether we're in 100% agreement.

[Michael5577]

David, let me ask you a question, do you think it's fair to ask Dr. Rahal for your deposit back because of your cancellation? I'm just amazed that you think you were wronged in this instance and can express doubt about Dr. Rahal's ethics. This entire thread is a waste of time on your part. You screwed up.

[gattaca]

David

 

My dconcern comes from the fact that you arent having surgery with Dr. Rahal. Egos aside and i think a few were hurt in this whole manner. THE MOST important thing to me is you get great results after what you been thru with your last surgeon.

 

You need to make sure that you go to a great. I ask you this. Remember everything you went thru with your last surgery? the pain, medicaation, waiting.. only not to get good results?

 

wouldnt going to a great surgeon who can give you great results worth it if it means having scabs for a a week or 10 days longer? what i mean is the short term sacrafice i believe is worth the long term investment! and you couldnt choose a better doctor then Rahal.

 

I wish you the best!

[DavidEur]

Michael, it's great you had a very positive experience with Dr. Rahal and I understand your frustration with my post. Let's leave it at that please.

 

Gattaca, thanks a lot for your angle on things, I agree with you the most important thing is getting a good result and as I've stated I'm sure Dr. Rahal would have delivered.

 

It's not the scabs per se that bother me, the major factor is being able to return to work in 2 weeks post-procedure without scabs.

 

I'm actually very positive that I'll get this sorted and grateful that I live in a day and age where I even have the luxury and opportunity of getting a natural looking hair transplant (if you choose the right doc).

 

Best wishes to you

Edited February 16, 2011 by DavidEur

[gmonasco]

It's not the scabs per se that bother me, the major factor is being able to return to work in 2 weeks post-procedure without scabs.

 

I don't want to beat a dead horse here, but I'm kind of puzzled. You initially wrote "I said I hoped to be back at work in 14 days" but then you were "sent all the pre and post-op instructions stating I couldn't even touch the recipient area for 14 days, at which time scabs could begin to be gently removed." Does that not fit your timeline? -- at the end of the 14th day, you remove the scabs and go back to work. Or is the issue that you can't remove all the scabs at once, so you'd still have some scabbing after the 14th day?

[Sparky]

You wouldn't be able to be 100% sure that you could get all the scabs off in one day.

[DavidEur]

After my first transplant I had what appeared to be one large solid scab, so my fear would be that (as Sparky mentioned) only parts would come off at day 14. Non-shaved but with scabs would be less noticeable, or shaved but no scabs. But shaved and scabs would be.

 

There's of course a large variation associated with individual healing factors and post-op routine. To be honest I've no idea how I'd have looked at 14 days but do know that scabs seem to sit relatively long on my skin. As I mentioned in an earlier post, I should have taken it up directly with Dr. Rahal and asked if there were alternatives.