Hasson and Wong really say this?

[Anouar]

Docs don't want to fault procedures on themselves and want to blame it solely on physiology yet they are willing to stand behind their work. Well is it physiology or not? You got so much going on during this operating procedure. The doc is only a small part of the procedure. The majority of the work is done by the techs and you’re telling me this aspect of the procedure is flawless? You have a number of techs who are handling the grafts from cutters to the ones who implant these fragile babies. This idea of this doc is good and this doc is bad blah blah blah. These guys are as good as their techs. Most docs cut the donor, suture and make the incisions. The hard work comes from the techs. These are the guys who are nameless. They can make or break an ht. You better hope you have some good techs. Techs that are paid well and not overworked but most of all take pride in doing their job.

Edited April 20, 2011 by Anouar

[HARIRI]

You are right Anouar, I totally agree with you. Techs work more than Doc during the surgery, maybe in that procedure, The techs of Dr. Hasson weren't good enough. Cause no one can question Dr.Hasson skills. So I guess there were some new techs involved maybe.

 

Its very sad, to see techs names aren't introduced and given their weight. What I like about SMG is that they have a head tech called Janna who contributed a lot or Dr. Rahal techs who spent years with him as stated in his website. Good point Anouar.

[hairthere]

Anouar makes a good point. However, I think it is the techs who are as good as the doctor. The doctor hires them and trains them, and is ultimately responsible for the way they perform. The surgeon sets the standard for every aspect of his practice. Therefore a meticulous doctor should have a meticulous staff and vice versus. I think it's also important that the clinic has a large staff of techs working to avoid fatigue.

 

"The techs of Dr. Hasson weren't good enough. Cause no one can question Dr.Hasson skills. So I guess there were some new techs involved maybe."

 

Hariri, This is a rather inflammatory and irresponsible statement to make. How can you say this so definitively? Many top HT clinics hold onto their techs for a long time. I cannot say this is for certain as I have no personal experience with H&W, but I'm willing to bet most of their techs have long tenures. I cannot imagine they would suddenly have a staff of newbie techs performing surgery. Perhaps someone from the clinic can verify this before we start making assumptions.

Edited April 20, 2011 by hairthere

[Dr. Alan Feller]

An,

 

You bring up a good point. The cutting and placing of the grafts certainly is not flawless. Which is why a smart potential patient picks a clinic that has a solid track record and uses a large number of techs for each case to get as close to perfect as possible.

 

Since techs and doctors are just human no one can realistically expect a "flawless" procedure. Those that do should not seek cosmetic surgery of any kind. Thankfully, no clinic claims to offer "flawless" surgery so the scenerio you are presenting never existed.

 

Instead, educated patients look for a clinic that produce the finest results on the most consistent basis within the boundries possible by the human beings who work there. That is the best realistic situation anyone could hope for. After that, it's just up to patient physiology.

 

It's possible that a technician had a bad day, or perhaps even couldn't show up for work. This might lead to a lower result. However, the best clinics are overstaffed and can easily pick up such slack so that it never showes in the final result. That's just one aspect of what makes a great and reliable clinic.

 

So patients have to understand and accept before hand that while the clinic cannot perform a "perfect" surgery it will perform the highest quality surgery possible within their ability. And isn't that all anybody could ever ask of another human being?

 

Now, if a patient can demonstrate that a doctor did not perform a procedure to the level generally accepted by the industry as it exits at the time of surgery, then the doctor should explain himself. And don't think this hasn't happened. In fact, forums like this made their "bones" on patients taking pictures and calling out their doctors online. Those clinics that did not respond and did not mend their ways, perished. It's no coincidnence that the boom in hair transplant quality coinsided with the rise of the internet.

 

Patients must understand doctors and their staff are not perfect and when they choose a clinic they do so based on the best ODDS of getting the best results possible. After that it's what they themselves bring to the table which is, of course, their own physiology.

 

Take the current thread. No question in my mind this surgery was performed to the level accepted by the industry. Above, in fact. Yet the results are not what one would expect. Could it have been the non-perfect techs that caused the poor growth? Possibly, but look at the surgical photos. The procedure looks as flawless as it gets. Nice clean work with an excellent distribution. No evidence of slacking or malpractice. I'm sure the staff was by and large the same staff they've used for hundreds or thousands of other surgeries. So what are the odds that it was the "fault" of the staff? Very low in my opinion and impossible to quantify anyway.

 

Now also consider the patient had prior surgery that also did not grow very well. Don't the odds of physiology playing the major role significantly increase in your mind? It really should.

 

Is Dr. Hasson morally or ethically responsible to assume any of the financial risk? No. Not if the patient can't demonstrate a failure to perform to the level generally accepted in the field, and as an expert I can attest based on the data that this surgery was performed as well as could be expected.

[Anouar]

Good clean work doesn't mean some grafts were weren't damaged in the process. Can you tell this upon examination post op and is a doc willing to say to the patient "by the way looks like some of the grafts have been damaged". I very much doubt the latter. The techs may get a scolding but rarely do docs take any blame. Top docs always have clean post op appearance. They don't always result in a successful hts

[Dr. Alan Feller]

Good clean work doesn't mean some grafts were weren't damaged in the process. Can you tell this upon examination post op and is a doc willing to say to the patient "by the way looks like some of the grafts have been damaged". I very much doubt the latter. The techs may get a scolding but rarely do docs take any blame. Top docs always have clean post op appearance. They don't always result in a successful hts

 

Again, this is a good point. Not all great looking work grows well. This is true as this thread demonstrates. But turn it around. If a patient has poor growth does that necessarily mean the grafts were damaged during implantation? Perhaps, but the chances are extremely low if those grafts were placed by techs who've literally done it a million times before. Once that reality is accounted for, there can only be one conclusion: physiology.

 

Each of your examples demands absolute perfection, a non-realistic standard. You also mentioned in your scenerio that "some" of the grafts may have been damaged. No doctor would deny some grafts are damaged during implantation. Again, we are not perfect, but the number of damaged grafts must be cosmetically insignificant in general for that clinic or that doctor would hardley ever have any good results. Such is not the case for "top docs" which is why they are catagorized "top docs" in the first place.

 

By the way, there are definitely ways to tell postoperatively if grafts have been damaged or mishandled, but if you don't work in the field you wouldn't know what to look for. I do, and I can assure you, this case was done as properly as can be done. I would have performed it no differently from what I can see in the pictures.

 

So lets set the standard right here online from now going forward:

 

If a patient has a transplant and it doesn't grow well, the reason is physiological UNLESS a patient can substantly demonstrate that the surgery did not rise to the level generally accepted throughout the industry. If a perspective patient can't accept this standard, then he is not a qualified patient and should not request nor be acceppted for a surgical procedure.

 

Remember, no patient is forced to undergo a hair transplant procedure. If you are losing hair and going bald you can just allow it to happen and accept it as millions do. However, if you want the best chance of recovering a cosmetically significant portion of that hair then your best CHANCE of getting it back is through hair transplantation. And if you want to increase your odds of getting the best result possible, then go to a so-called "top clinic". That's the most any human being can do to reclaim his lost hair through surgery, and thankfully millions have succeeded in doing so-present company included.

Edited April 20, 2011 by Dr. Alan Feller

[corvettester]

 

So lets set the standard right here online from now going forward:

 

If a patient has a transplant and it doesn't grow well, the reason is physiological UNLESS a patient can substantly demonstrate that the surgery did not rise to the level generally accepted throughout the industry. If a perspective patient can't accept this standard, then he is not a qualified patient and should not request nor be acceppted for a surgical procedure.

 

 

Dr. Feller,

 

I categorically do not accept your standard. No offense, but I find your position self-serving.

 

Your position effectively waves the physician of all liability and responsibility. Essentially, you're using the same argument the tobacco industry has used for years by claiming that a direct causal link cannot be made between cigarette smoking and lung cancer.

 

I hate to imagine the burden of proof a butchered HT patient would have to provide in a court of law to remedy his case and receive just compensation for damages from his doctor. The burden of proof, should lie equally on the doctor and patient.

 

As I’ve said before, a quality physician stands behind his work, not his lawyers.

 

Aside from your last statement, with which I emphatically disagree, thank you for your contributions regarding this topic. You've made many valid points and shed a lot of light on the topic of realistic expectations. However, I will never accept, what amounts to, a standard of physician infallibility.

 

 

Corvettester

Edited April 21, 2011 by corvettester
Clarity. Grammar.

[Anouar]

I'm not suggesting perfection but you are led to believe by this thread that top docs execute ht procedures according to the highest standard thus the perception is one of perfection with little error. The docs or techs can't be liable in this situation thus the burden is on the patient who has poor physiology.

[hairthere]

From what I have seen, most top clinics do stand behind their work and their patients. I have seen countless cases of perceivably failed procedures where the clinic offers further surgery, or touch-ups, either free or, more commonly, greatly discounted. Now, it is rare that a clinic will offer a full refund (I do recall reading of that happening once). My first HT doc offered me further surgery, free--the problem there was I knew without a doubt that his skills and techniques were outdated resulting in the failed outcome. Another procedure with him would have been pointless. I did ask for my money back, which he refused, and had to take a legal route, albeit unsuccessfully.

 

The conundrum is that one man's successful HT could be another man's disaster, as Lorenzo pointed out earlier. So if HT clinics do offer full refunds, (which I am guessing the critics in this thread are suggesting) where is the line drawn as to what is an acceptable result? In my opinion, the best any consumer can do is understand fully what a HT involves, manages expectations, and finds a great HT clinic. I do understand though, it is a bitter pill to swallow when you spend such a large sum of money and you're unhappy with the outcome. Plus,a strip scar is not a nice reminder of what happened. Thankfully there are an increasing number of quality surgeons available now lessening the odds of failed HTs.

Edited April 21, 2011 by hairthere

[lorenzo]

This thread has taken an interesting turn. I think we all fail to understand that when we are taking about a person poor physiology or bad results we are taking about a small percentage. In my opinion and I have seen and help 100's maybe less than 1%. Although you probaly get around 5% that are not happy I can only speak from my experiences. So its probaly easier for the doctors to give the less than 1% back their money and tell the other that arent happy (that have good results) to take a hike.

Instead the doctor dont act like that. They are concerned and want a patient to be happy. So in most cases the doctor will find out what it will take to make the client happy. This sounds easy but its not. Most patients that arent happy will never be happy. Forums like this are good to show both good and bad results and allow the doctors to defend themselves or to justify the transplant. Unfortuanately it can also be used to threaten, and damage a doctors reputation even if the results is exactly what was expected or promised.

Dr. Feller is an honest doctor passionate and always to the point. There really is no real way of knowing exactly why a transplant doesnt always turn out. If you do 1000,s of procedures and 1 dont turn out. Does this make the doctor a bad doctor? Absolutely not. Doctor refuse patients all the time if there is any signs that the transplant MAY not turn out. I have witnessed patient begging for surgery and Dr. Hasson telling him he cant do it. That day he cancelled the surgery, gave the patient back his money and paid his staff. If he didnt care it would be easier to perform the surgery and if it didnt turn out tell the patient I told you it may not. I am sure all top doctors have the same stories.

Many posters dont have the experience to see what happens behind closed door only about there own surgery. So I understand why many have a one dimension way of thinking.

 

This is my opinion

[Dr. Alan Feller]

Corvettester,

By having surgery in North America you yourself have already acknowledged and accepted the standard I posted. That “standard” you say you reject is not a mere perspective invented by me, but an objective reality all doctors and patients already agree to every day-you included. It formed the basis for nearly every word in the informed consent document you had to read and sign prior to your own surgical procedure. It wasn’t given to you by your doctor to trick you or take advantage of you, but rather because the law dictates a doctor must provide informed consent prior to commencement of surgery.

It doesn’t wave the physician of all liability and responsibility as you wrote. Not even close. If the procedure is not performed to industry standards you can bet the farm that doctor can be held liable. Not just in a court of law, but in the court of public opinion online as well.

And you need not worry about the burden of proof a butchered patient would need to rise to in a court of law because such butchery would be readily obvious to any judge and jury.

But why bring up the extreme of butchered HT patients? They are almost a thing of the past and cannot be reasonably compared to patients who only experienced poor growth yields. This thread is not about a butchered patient, but rather one who experienced a poor growth yield. You obviously agree with this since you have rightfully been supporting Dr. Hasson and not his patient on this thread.

Your phrase “a quality physician stands behind his work, not his lawyers” is catchy but misleading. The only time a doctor will stand behind a lawyer is AFTER a patient has already hired one of his own. And what exactly does “stand behind his work” mean to you? Please check your informed consent document from the doctor you chose to do your surgery and see if your particular definition is in there. It isn’t.

Corvettester, do you think Dr. Hasson has “stood behind his work” with respect to how he has dealt with his patient Nothappy? If your own HT results are not satisfactory to you in the next 6 months and your doctor or his rep tells you the same exact things Dr. Hasson and his rep told his patient, will you make a thread and take on the roll Nothappy did here by taking your doctor to task on a public forum?

Specifically, if by six months from now any portion of your hairline doesn’t grow in to your satisfaction will you demand a free procedure from your doctor and/or your money back? And if he doesn’t want to give it to you will you come online and do as Nothappy did to Dr. Hasson? Will you perhaps hire a lawyer and bring a lawsuit? And in both cases on what grounds would you hold him accountable if he already made it clear to you before- hand in writing that the results of your procedure may vary?

Corvettester, I can guarantee you that EVERY doctor who learns of this post will want to read your answers every bit as much as I do. And I thank you for your participation in this very important thread.

[EpilepticSceptic]

You are right Anouar, I totally agree with you. Techs work more than Doc during the surgery, maybe in that procedure, The techs of Dr. Hasson weren't good enough. Cause no one can question Dr.Hasson skills. So I guess there were some new techs involved maybe.

 

Its very sad, to see techs names aren't introduced and given their weight. What I like about SMG is that they have a head tech called Janna who contributed a lot or Dr. Rahal techs who spent years with him as stated in his website. Good point Anouar.

 

This is a ridiculous post. It's amazing the broad sweeping statements people can make sometimes on this forum without having any legitimate knowledge concerning what they are talking about!

 

When I had my surgery with Dr. H there was a MASTER tech (her name is Jodi) who has been working with him for 15 YEARS !!! To me she was Jedi Jodi ! She was indeed a take charge kind of gal, and she obviously knew what she was doing to such a degree that she seemed more like a doctor than a tech to me. The other tech had over 7 years at the clinic, and these were the two techs that worked tirelessly on me for 8 hours implanting my grafts.

 

To highlight just how important a MASTER tech is in a complex procedure like this, I remember very early on when they first started planting she told Dr. H that some of the holes were too small and he needed to slightly increase the blade size because her "feel" was being thrown off a bit. And it wasn't that Dr. H made a mistake either; he sized up (by eye) my grafts and made custom blades to fit, just like he had done thousands of X before. But something about my skin/physiology was throwing off her very delicate feel, and she KNEW this instinctively because she's been doing it for 15 years !! So right away he made the adjustment; this was also in the very beginning when only a small set of holes had been made.

 

This helped me realize the importance of a master tech, because you CANNOT expect any human being or doctor to be completely perfect or psychic. It has to be a TEAM effort. It was really great watching her and the doctor interact because she spoke to him like a peer instead of a mere employee, and you could see that he has tremendous respect and appreciation for her valuable skills. It was my impression that the master tech is like another doctor in the room who has a specific expertise based on many years of experience, and she/he will double check everything and make sure all is done to the highest standard.

 

I think you also have to look at the numbers when it comes to a clinic like H & W. There are 2 great docs at that clinic, and they are booked solid for months in advance (and it's been that way for many years). If the techs were really hit and miss then IMO there would be a disgruntled patient popping up every other week. But this is simply not the case.

Edited April 21, 2011 by EpilepticSceptic

[lorenzo]

Hariri you are a huge Rahal supporter and I agree he is a great great doctor. So you have made a great decision if indeed you are getting surgery from him. I dont pretend I know much about his operation I can only talk about the results and the write up on him from other posters. Have you ever seen a live result from him or H&W?

Please dont pretend you know everything about H&W or made this type of comments about their tech or how they run their business. You question that they are going to use new techs that bad? Or that the doctors who run a successful clinic dont have the knowledge or experience after all these years to use good techs? Many clinics good or bad will mention names of the tech this mean very LITTLE in the final results.

Hasson & Wong Surgical Staff

 

Its unfortuante in my opinon that you go from a poster that was enquiring about surgery to one that thinks he knows everything. Call me defensive or whatever you wish but your comments are rubbish. 100% rubbish. I agree the EP 100%.

[HARIRI]

Sorry but I 100% agree with corvettester. "position self-serving and waves the physician of all liability and responsibility". We never want the HT industry become a tobacco one for sure. Patients should really be considered, cause with a poor surgery, the person wont look normal anymore even he is balding. I don't know why some docs have lack of emotions and psychological care to the patients and blame it all on them. Just put yourself in that patient shoes.

 

Lorenzo dont think being a sicilian italian could give you the guts to talk me this way, but I guess you need to get some lessons about good manner, you are just lucky that you are partially representing H&W, but in my eyes you are just a bambino.. Did you hear that Bill? Is it an offense to make a direct insult to another forum member, if you banned Tsakalos for offending Lorenzo. Then what about Lorenzo offending me? Or is he special. I never attacked anyone in the forum. Just spreading my opinion with respect. Rubbish he said, everyone heard how low person you are.

 

All what I said is MAYBE the problem of the poor growth of NOTHAPPY was because of some of the techs were new and not because of Dr. Hasson. I said MAYBE. Just a thought? Is it not allowed also? All is human nobody is a Godess. I hope you understand the meaning of MAYBE. You could have replied like ELEPTICSCEPTIC in an educational way, no problem with that. But with this low style its not good.

 

But I wont offend you back cause you wont manage to ban me too from the network. I know you are just trying to flame me up. But you wont success in that, you were big in my eyes Lorenzo but now you show me the real you.

Edited April 21, 2011 by HARIRI

[TC17]

Dr. Feller is right in articulating the legal standard for negligence, but it misses the all important point of defining what the standard is.

 

I'm not sure that the standards employed by, and the quality of work done by the physicians of this community is the benchmark. In fact, unfortunately, I believe it is far lower. For example, if a physician doesn't use microscopic dissection, only has one tech instead of a team, puts too much donor in the front or in the crown, transplants an unnatural looking hairline, or, doesn't use follicular units at all, is that doctor guilty of breaching the standard of care? Maybe, maybe not, but my gut tells me NO, that doctor has not breached the standard of care for a hair transplant doctor because the standard of care is simply to do what is reasonable, and what is reasonable for a hair transplant doctor will not be defined by the cream of the crop, i.e. the doctors of this site. I think the standard is that of the thousands of physicians NOT recommended on this site who do work that we would consider subpar.

 

However, just because the floor is negligence, doesn't mean that patients have to, or even should accept that. Patients are free to bargain for whatever terms they want! If you're not happy with the doctors proposal, tell him to take a hike and make him a counter offer. If he is unwilling to abide by those terms, then take your business elsewhere! There is nothing wrong in contracting for a percentage of graft growth, and a refund for those that do not grow, or any other creative (legal) terms that you can work out with your physician.

[Anouar]

Lorenzo, you’re a joke. You come on here patronizing everybody who says something contrary to your thinking. You call Hariri’s comments rubbish while yours exceeds rubbish in every manner. You want to discredit members of the community by calling them one dimensional thinkers because you have the inside scoop on what goes on in the ht process. So, “all you one or two time ht patients your experience and knowledge doesn't mean anything stacked up against Lorenzo” and of course those that never had an ht "don't bother to speak". I guess instead of us commenting on this thread, why don't we leave it up to you. Maybe you can even take Joe's job. On second thought I hear the Dallas Cowboy cheerleaders have and opening. I used to have huge respect for H&W but the more vile you spew out the more I become disenchanted. Like i said you do more harm to them then help them.

Edited April 21, 2011 by Anouar

[bonkerstonker]

Dr feller in relation to the post you just made to corvettester, dr hasson guarantees that all his transplanted hairs will grow and it's written by hasson and Wong in the prepaperwork so I would imagine corvettester would go back as that guarantee is not something patients ask for it's their standard policy. That tells me hasson and Wong must have a huge success rate to do that.

 

Obviously if all the hair grows but you don't get yield that's a different story but that's why most take finasteride as well I suppose.

[Dr. Alan Feller]

Epileptic,

Great post. Really, very well said. You just spoke pure reality and the dynamic you witnessed between tech and doctor during your own surgery is the mark of a great clinic.

 

TC17,

Thank you for your participation. I've forgotten how much work and time goes into posting on these topics as I haven't really posted much in the past few years and credit anyone who takes the energy to engage in these conversations.

 

Perhaps I'm not making myself clear in my posts. So I'll try to boil it down as best I can.

 

The "standard" that I'm referring to is not one that can be selectively applied or even debated. It is just a reality of any and every type of surgery and it must be understood and accepted by the patient before agreeing to surgery. With respect to growth yields, this agreement is very often forgotten when posting online.

 

It still holds that if a doctor's procedure does not rise to the standard of the industry he can be held accountable in a court of law. It also still holds that if a doctor's procedure does not rise to the standard expected by readers of forums like this one that he will be held accountable in the court of public opinion. This includes the choice and density of the placement of grafts. I agree that while front loading a low hairline is not negligence it IS bad surgery in most circumstances and is frowned upon online.

 

But if a procedure was performed correctly and the growth yield is low, and the patient was properly informed of this possibility then the responsiblilty cannot fall on the doctor because he has no control over what the body will do after the grafts have been implanted. Sure, one may speculate that the surgery was performed improperly by the doctor and/or staff, but what are the chances of that if the clinic is very experienced and has many techs? It has to be low to nil.

 

I'm not posing a hypothetical, I'm stating how it simply is. Unfortunately, unhappy patients want to forget the realities of surgery and place the blame for the growth yields on their doctor. MOST patients do not do this. Most people intuiatively understand the limitations of surgery, but a very vocal few choose to cast the realities aside and create posts that attempt to hang low yeild results on their doctor. That's what this thread is about to my mind, and several others I can think of in past years.

Edited April 21, 2011 by Dr. Alan Feller

[Dr. Alan Feller]

Bonker,

 

Thank you for jumping in.

 

I think you are missing the point.

 

If h@w give a written guarantee it's not to make grafts grow and promise a particular yield, because that's a guarantee no human being can make. For example, I can guarantee in writing that you won't get hit by a bus today, but that won't prevent you from being struck. Furthermore, should you survive, if after coming out of ICU you took that written guarantee to court it would be thrown out as unenforcable. Of course I'm trying to inject some humor here, but I think this makes the point.

 

A doctor CAN guarantee that he will do "something" if grafts don't grow, like put more grafts in for free or discount, and perhaps even offer money back, but that may not be enough for the patient who is primaily concerned with their transplant growing perfectly. Take this thread for example. If NotHappy has a written guarantee that Dr. Hasson will do "something" if his growth isn't satisfactory to him, then why did he create this topic and engage in public online warfare with Dr. Hasson and his reps? Doesn't look line any guarantee made to him was satisfactory. Do you see my point?

 

If Nothappy understood and agreed before hand that he may NOT have satisfcatory results, would he be as upset and aggressive as he's been on this thread and his blog by casting about in an effort to lay blame on his doctor? Not likely. But if he did so despite this understanding it could not be morally justified.

 

That's why I want the standard of reality, as I've posted it, publicized so that patient expectations and understanding can be better assured.

 

Thanks for joining in, I think this is sorely needed conversation that all potential HT patients should read and learn from.

[corvettester]

Dr. Feller,

 

Thanks for your response. I hope I can give the community a satisfactory answer to your queries. I’ll try to be concise; however, for the sake of brevity and clarity, I’ll answer your questions in three separate posts.

 

This post will deal with our conflicting definitions of informed consent and standards of care. The second post will respond to your questions regarding my thoughts on Carefree and NotHappy.

 

A third post will address your questions regarding my personal experience and expectations… as I’m especially glad (and flattered) to learn that not only you, but “EVERY” doctor, as you claim, is interested in hearing. I really don’t see why this is necessary though. I mean, I’m just one person. I’m sure my opinion and expectations are different from everyone else.

 

 

Starting from the beginning…

 

I read my informed consent contract carefully before signing it. It read nothing like your statement. Whether or not it forms the legal basis in a court of law is irrelevant and can only be determined by the courts. The fact that it would have to go that far for any patient is a red flag in itself. I couldn’t care less what the courts think.

 

Simply put, I don’t understand it, nor do I accept it, the way you do.

 

Your standard is predicated upon the assumption is that physiology is the primary, if not exclusive, reason for poor results. To start from the premise that failure can only be attributed to physiology, unless proven otherwise, is disingenuous and self-serving. What if the standard read “Physician Error” unless proven otherwise? I’m sure you wouldn’t accept that.

 

Thus, I disagree with the fundamental premises (assumption) of which your standard is predicated.

 

As I mentioned in my post, the burden of proof must lie equally on the patient and doctor. Essentially, by your standard, all a doctor has to do is say “Prove it!” and he’s off free. I mean, let’s be realistic: proving it can be more expensive and burdensome than the HT itself! Essentially, your standard slams the proverbial door in the face of the patient. I don’t want that kind of doctor.

 

Let’s not go into trying to define the nebulous concept of “standard of care.” I’m sure any competent lawyer could weasel his way out of that one.

 

Therefore, I refuse to accept your standard. Not only that, but I find the principle behind it utterly distasteful. I’ll have nothing to do with any doctor who hides behind such legalese. The patient and doctor should be working together from the beginning.

 

I already knew the risks before I got my HT. However, physiology is not the only risk—physician and technician error is one too. To disregard such possibilities would be just as reckless as to disregard the risk of physiology.

 

Therefore, to disregard such possibilities from the outset in the contract, within an agreed upon standard of quality and accountability, would be equally reckless, disingenuous and self-serving.

 

 

I am sure that your definition will hold up stronger in a court of law, as you no doubt have experience in litigation. However, I doubt it will stand in the court of public opinion… in the minds of men considering FUT/FUE.

 

In any event, I almost feel like all the legal speculation is moot. I mean, the root of a lot of these patient complaints stems from a patient feeling let down by the process, the system, the doctor… that the doctor doesn’t support him or isn’t standing behind his work.

 

I’m sure you remember the cases of BadLuck and John Mallory. Your supporters kept trying to paint the situation as a patient having unrealistic expectations or acting in bad faith. The reality was that, although both BadLuck and JM were unsatisfied with their results, the real problem was that they felt let down by their doctor in regard to post-op care and a sense of support… not to mention, let down by the community.

 

As per your remarks in regard to why I brought up “butchered” patients, it’s for the same reason I used the tobacco industry analogy: to emphasize my point. Certainly, no HT patient has to worry about a slow death like a cigarette smoker would. I just resorted to hyperbole to make a point.

 

I certainly agree with you that these days a butchered HT job is not likely. I don’t think anyone read my words to imply that that what I was saying about NotHappy.

 

And, yes, I do worry about the burden of proof with such butchered patients. Lawyers are a very clever breed. They can twist the obvious and find unlikely, yet legally permissible, mitigating circumstances. That is why I think the legal option is almost never really an option for most people.

 

As for my phrase being “catchy but misleading,” I disagree. I would like to think that in most cases you are right in saying that “The only time a doctor will stand behind a lawyer is AFTER a patient has already hired one of his own.”

 

However, you’ve proven to be the exception to this rule. I remember a case involving you and two separate dissatisfied patients. In that case, it was you who threatened to start legal action against JM and Badluck. So I don’t understand how you can make such a claim…

 

My definition of a doctor who stands behind his work can be seen on virtually every thread involving a dissatisfied patient of Hasson & Wong… I even referred to H&W as the “gold standard of patient care” in one of my previous posts where I compared the difference between how you and H&W in treating dissatisfied patients (JustAGuy / HairMeOut).

 

Again, thank you for turning this thread into something educational and truly informative. If you refer to my post (#84) you’ll see that I was expressing frustration with the direction it was going.

 

Also, for future reference, I respectfully request that you try to be a little more concise when enquiring my opinions. You must have asked me twenty questions! And now I have to answer them! No worries though, I understand. Hopefully you have a better idea of where I’m coming from now.

 

I’ll briefly address my thoughts on Carefree and NotHappy in another post coming shortly and my personal experience in a third post.

 

 

Corvettester

[corvettester]

Dr. Feller,

 

The current situation with NotHappy is unique in that there are several questions arising as to the veracity of the OP’s identity (Carefree, Vince Hair, Widow’s Peak) as well as the true nature of the final result. As far as anyone knows, NotHappy did not start this thread.

 

It is true that I do support Dr. Hasson on this topic, but not at the expense of NotHappy. If you go back and read NotHappy’s first post (#32), you’ll see that although he is clearly disappointed and upset, he is civil and remains open to discussion.

 

He is dissatisfied with his result, but his real pain stems from his feelings, founded or not, that he is not supported by H&W. If he feels he is unsupported, he has the right to say it. If he feels his results are bad, he has the right to say it… and he doesn’t have to sugarcoat it either.

 

This doesn’t mean he is “engaging in public online warfare” as you claim. By the same token, he doesn’t have the right to lie, attack Dr. Hasson’s character or mudsling. I haven’t seen him do any of that.

 

This is my point. The HTN was a created by and for patients. It’s supposed to be a safe space for us. That is why its so upsetting to see posters treated this way… we’re all in the same boat here. I will always give a member the benefit of the doubt, as I will the doctor. I just don’t feel like everyone else is doing that. For this reason, I truly sympathize with NotHappy as I’m sure a lot of us do—doctors included.

 

I am unabashedly pro-patient. I would not have undergone an HT had it not been for the HTN. I don’t care how many results I saw posted on various clinic websites. It was meeting real people that persuaded me... the good and the bad.

 

 

Yes, I do believe Dr. Hasson is standing behind his work… now if only we could convince NotHappy! He’s a tuff-cookie, no doubt. But instead of denouncing him as a disingenuous liar, let’s just work it out.

 

Throughout this unfolding drama, Dr. Hasson has remained professional, civil and cool-headed… as well as primarily concerned for the patient welfare! I think most would agree on that.

 

There seems to be a lot of unknowns regarding his case. That is why Joetronic asked us to reserve judgment until the can get him in the office for a follow up. That sounds very reasonable to me… in fact it sounds down right amazing that H&W would be so committed to their patients as to fly them to Canada to make this right.

 

Again, I have to say “Wow!” to the dedication of H&W and their respective staff! As I’ve said before, in my opinion, they truly do embody the gold standard of patient care. Their reputation is in my opinion the most well deserved because they work the hardest for it.

 

But it’s not only H&W’s post-op patient care that sets them apart. H&W’s consistent and comprehensive dedication to showing their results on the HTN, with frequent updates, high definition photos and videos, that shows their commitment to the community.

 

I take issue with the few posters who have suggested that H&W is somehow disingenuous for posting so many results! Are they crazy? I wish all clinics were as prolific as H&W in posting. Not to mention, Joetronic is truly a pioneer in setting the standard for what is reliable and accurate. Did you see the 18 video series he recently published? Again, simply amazing!

 

 

Corvettester

[lorenzo]

Hariri you have made some strong strong accusations.

First you said

Seems that H&W has diplomatic immunity in this forum ;-)

 

 

So I guess there were some new techs involved maybe.

 

Its very sad, to see techs names aren't introduced and given their weight. What I like about SMG is that they have a head tech called Janna who contributed a lot or Dr. Rahal techs who spent years with him as stated in his website. Good point Anouar.

 

But I wont offend you back cause you wont manage to ban me too from the network. I know you are just trying to flame me up. But you wont success in that, you were big in my eyes Lorenzo but now you show me the real you.

 

I wont manage to ban you? What are you talking about? This comments states that I have the POWER to have somebody banned which in other words puts this the WHOLE forum in question. In my opinion you need to watch your word because you make it sound like I can have people banned. This 100% is not the case and once again you are questioning the website by making these type of accusation. If I offended you I apologize but its hard when somebody talks rubbish about a clinic that knows nothing about. There nothing wrong with stating your opinion if you have facts or believes but comments like yours are either bad humour or a wrong way of thinking.

 

 

 

 

 

Anour is unfortunate that you find it neccesary to start name calling. When somebody makes comments that they know nothing about that can damage any clinic is that ok? I am sorry that are are either over sensitive or beleive you are hair transplant guru. I find it quite disturbing that picture me in a cheerleader outfit.. If you read any of my posts in the past you will notice the I never insults any recommended doctor nor do I ever tell anyone to go to H&W. I get alot of emails and messages from people and I give them my knowledge and what I believe.

Anyways you are entitled to your opinion I am entitled to mind although if you look at any of my post you will notice I dont lower myself to name calling. I repectfully disagree with what you say about me because number 1 its incorrect and quite damaging to my character.

In the future if I comment to somebody else you dont have jump in an insult me by calling me a joke. Hariri can make his comments against me if he wishes to disagree I am sure he doesnt need anyone helping him or lowering himself in order to prove a point.

I will no longer post on this topic I think the reasoning behind it is losing focus. If you want to discuss this further you are welcome to send me a private message.

Edited April 21, 2011 by lorenzo

[Bill - Seemiller]

Guys,

 

As a patient, I certainly want the best results for myself and anyone battling with hair loss. But let's remember that hair transplantation is an elective surgery. Thus, when we agree to undergo hair transplantation, we are accepting all the realities that come along with it - which includes the possibility of less than optimal growth, scarring, and other complications, even in the best hands.

 

We recommend physicians on this site based on their high standard of care, ethics and a proven consistency of excellent results. But hair transplant surgery even with the best surgeons using the most advanced techniques comes with no guarantees. This may be due to various complications (physiological, surgical or otherwise) or because a patient's expectations are unrealistic.

 

I agree with patients that physicians ought to be accountable for their work, good and bad. However, a physician using state of art techniques who typically produce excellent results with only the occasional complication (poor growth, etc.) can't be put in the same category as physicians/clinics using outdated techniques and regularly producing subpar results.

 

What separates the elite physicians from the pack are not only those who produce excellent results consistently, but those who stand behind their patients when complications arise.

 

However, instead of a collaboration between educated patients and expert physicians, I typically see a lot of blame, resentment and hostility. This anger slowly brews in some patients over the long year as he/she waits for results that never come (or doesn't meet his/her expectation) and is exacerbated if/when a physician doesn't respond to the patient's concerns in a timely and reasonable manner. It's also exacerbated when some members of this community jump in with finger pointing and accusation, especially before the physician/clinic has a chance to respond. Then it's exacerbated even further when angry and bitter patients of the past who feel they were treated unfairly begin maligning physicians, this community, and/or the hair restoration industry as a whole.

 

Nobody likes poor results, not the patient, not the doctor and not the members/publishers of this community. But if a patient has selected a physician with a world renowned reputation like the ones recommended by this community, I see no reason why instead of blame and hostility that both parties can't work together to help the patient get the kind of results he/she ultimately deserves.

 

In this case, Hasson and Wong have offered to fly NoHappy to Vancouver for an in-person evaluation and NotHappy has accepted. I certainly hope that all parties work together to come to a fair and reasonable solution that satisfies the patient's concerns.

 

In the meantime, I encourage this community to try to keep the big picture in mind and continue to offer support to NotHappy without unnecessary blame.

 

Best Wishes,

 

Bill

[Tao]

Amen.

[TC17]

H&W is a first rate organization and I think they handled this situation beautifully.

 

The things I hope people take from this topic (1) no doctor can reasonably guarantee a result, and (2) just because the default standard of care for a hair transplant doctor is negligence does not mean that the patient need to accept that - the patient is free to bargain for whatever terms he wishes, and the doctor is free to accept or reject those terms.