Open Letter to the HTN community

[BaldingBogger]

Hi All,

 

I would just like to write an open letter to the HTN network moderators and the community itself for feedback on the below topic.

 

Having been a long term reader i am now amazed at the amount of 'online reps' operating here on this HTN.?

 

It seems even lots of guys who have regularly post in the past have now become these 'online reps'. This concerns me slightly as i am sure most have good intentions but in the interest of transparacy is it possible to know what business arrangements they have with their respective clinics.?

 

Are they on commision etc.? I think these are important facts as people new to the HT scene can be easily directed and often far too trusting of people who may recommend things not in their best interests.

 

The website is an amazing source of information for people in the HT world no question but i think a balance and controls needs to be maintained on the commerical side.

 

I would be very interested to hear from the HTN network management and its members and if anyone else has any other comments on this issue.?

[hairthere]

I understand your concerns, but to put it into perspective, there's maybe 5 clinic reps (Jotronic, Spex, Spanker, Gillenator, Janna) who post in sections other than clinic results on this forum as compared to thousands of members. And I've seen each of them provide valuable feedback that is not self-serving/promoting and even speaks positively of their competition. Many times they don't mention their clinic at all and just share their knowledge. Besides they are all transparent about who they are and rep in their signatures.

 

Plus, the moderators do a very good job of weeding out the shills.

[BaldingBogger]

Thanks for your comments Hair there. I have noticed several others recently in addition to those you mention. (ex posters / patients now reps).

 

As i said im sure most mean well but im rather more concerned as to what could potentially happen in the future. I.e A Feeding frenzy on new posters by people not really qualified to be in the position. 'Just there because they had a procedure or 2 done and read the forum everyday.'

 

PS I'm aware of all these online reps but interestingly the most informative and knowledgeable person i have encountered online is Mickey85 who has no affilation to anyone.

[hairthere]

The only recent patient-turned-rep that I am aware of is Spanker. Are there others that I'm missing? Anyway, I would prefer to have actual HT patients representing clinics than just shill salesmen. At least they have better insight into the struggles of hairloss. I have witnessed another popular HT forum go down in flames thanks to underhanded clinic reps/doctors. But these days you can quickly discern who the shills are.

 

I agree Mickey has been a very nice asset to the forum and there are countless other members who give their time here to help others. Of all the forums I've visited, this one has the finest/most educated/selfless members I've seen and is moderated very fairly. I'm certain Pat, Bill, Dave, and Blake will continue to provide the same balanced forum no matter how many reps join in.

[TommyLucchese]

Agent eye for Rahal too, I believe.

 

I don't think it's an issue as long as it's clearly stated in the signatures and that they give good, honest and impartial advice.

[Mickey85]

Thanks for your comments Hair there. I have noticed several others recently in addition to those you mention. (ex posters / patients now reps).

 

As i said im sure most mean well but im rather more concerned as to what could potentially happen in the future. I.e A Feeding frenzy on new posters by people not really qualified to be in the position. 'Just there because they had a procedure or 2 done and read the forum everyday.'

 

PS I'm aware of all these online reps but interestingly the most informative and knowledgeable person i have encountered online is Mickey85 who has no affilation to anyone.

 

Hey there friend, I appreciate the very kind words. I know I have been rather dormant on this forum as of late, mainly due to being preoccupied with my personal life(all good things though) but I am always here for anyone if they need someone to talk to about anything. Be it a hair transplant, depression stemming from hairloss(or anything else) etc. I have always prided myself of being totally unaffiliated to anyone. I receive no financial incentive at all. But I prefer it that way. Reps cannot say the things that I say, they cannot say "that doesn't look too good" to a clinic-posted result. They cannot say "I don't think Dr X is good at FUE" etc. I really would not have it any other way.

 

For years, many strip clinics were spreading deliberate misinformation campaigns against FUE(low yield being an inherent factor in FUE, FUE only being good for minor recession) while FUE clinics were either silent or making fictitious statements about FUE(Diep labeling FUE as scarless in his Youtube videos, Atlanta Dr claiming Acell regenerates hair in the donor area). No clinic stepped up and brought truthful information about FUE, information that should have been public knowledge from the very start. I had to scour the internet to find documentation and proof that strip distorts the natural geometry of the donor. That strip eradicates the progressive hair caliber gradation in the donor amongst other things. That strip discards the dormant hairs in the strip because they cannot be seen even under magnification. That the hair coming out of the much-appraised trichophytic closure often exits at absurd angles. These are things that both strip and FUE clinics have known about for over a decade and NO ONE put it down in black and white for the patients and potential patients so they could make a totally informed decision. So while I am very proud of the work that I have done, you can see why I am very disappointed and angry at the industry for pulling wool over the eyes of the patient.

 

Most(not all) reps are sanctimonious in that they do not see that they are consciously or subconsciously promoting an agenda sometimes at the expense of the patient. They believe that their clinic never has bad cases and that their surgeons/employers are some kind of Christ-child or savant, free of flaws. They never admit the fault of the clinic for a bad result, instead they target "patient physiology". Then why do they offer a repair session on the same patient if the patient's physiology is a fixed factor?? I could tell you stories about some well-regarded reps that would make your local second hand car-dealer look ethical.

 

These statements of mine make me a popular person for patients and potential patients looking for honesty, but they also make me very unpopular to clinics and surgeons. I would not have it any other way

Edited February 8, 2014 by Mickey85

[hsrp10]

There is one rep here who doesn't use a real name and its never certain if he/she is making the actual comments/replies or if its the doctor himself.

Spanker and I have mentioned about this before.

 

All the other ones here though are pretty impartial and quite helpful to even those who seek another clinic.

[home1212]

I think all the reps from the reputable doctors and clinics provide excellent feedback on this forum - they are the very reason forums like this exist - they've shared their experience, knowledge and expertise so that we can navigate through the minefield. I am very appreciative of what this community has grown and developed into, support for all hair loss sufferers looking for viable options and answers. This would not be possible without the client reps. Thank you.

[Mickey85]

There is one rep here who doesn't use a real name and its never certain if he/she is making the actual comments/replies or if its the doctor himself.

Spanker and I have mentioned about this before.

 

 

 

Curious as to whom this rep may be...

[TakingThePlunge]

BaldingBogger

 

While I can understand someone questioning the motives of a clinic rep, I also have to point out that, first and foremost, there are no reps in this community that attempt to sell, manipulate or otherwise coerce members into procedures with their respective doctors. That type of behavior would not be tolerated by members or moderators and would ultimately be very counterproductive in my opinion. Our savvy forum members can smell b.s. a mile away.

 

Anyone representing a clinic must state as much in their signature. We work hard to identify and weed out shills and have a zero tolerance policy for such behavior. Members who have been around for a long time (and certain physicians) know this to be true.

 

As I'm sure you are aware, the Internet is a minefield that must be carefully navigated. We can do everything in our power to maintain an open and transparent environment but, ultimately, it's each individual's responsibility to perform their due diligence.

 

Would you propose banning clinic representatives altogether? Why shouldn't happy patients like Spanker and agenteye, who are active online, become reps for their doctors? Who better to share credible experiences than someone who was here contributing and benefiting from the combined knowledge of our forum before they even chose their physician and then had an excellent result and continued unselfishly giving their time to help others suffering the pain of hair loss? These are the guys that doctors like to have represent them because of the sincerity they bring to the table.

 

As long as the representative's affiliation is stated in their signature, I don't believe we need to know each individual's compensation. I can tell you that most clinic reps are not getting rich off their gigs. For most, it's part-time work and they see it as getting a little compensation for something they'd be doing anyway.

[Bill - Seemiller]

BaldingBlogger,

 

Thanks for expressing your genuine opinion and concerns on our forum. As David already pointed out, clinic representatives are required to disclose their affiliation with their clinic in their forum signature. Furthermore, we ask clinic reps to share their knowledge and help to educate forum members rather than to blatantly promote their clinic. Most representatives are quite good at providing useful and educational content and they are all identifiable through their forum signature. This kind of transparency allows the adult members of our community to draw their own conclusions and decide to take advice from who they wish.

 

That said, I do have some concerns about forum members being hired by clinics to represent them. While these members can still provide objective advice, their primary purpose on the forum has changed making them geared more towards answering questions regarding clinics they represent rather than general hair loss questions and objectively recommending other surgeons they believe in. That's not to say this doesn't and can't happen, but the balance is somewhat shifted.

 

This community is highly popular with dozens of new members joining every day and tens of thousands of visitors daily. Thus, your involvement as forum members provides great influence and information to the masses of hair loss sufferers seeking real information. A special thanks to all regular contributors who do so much to help countless balding men and women all over the world with their forum posts.

 

Best wishes,

 

Bill

[Jotronic]

I think that as long as the representative is open and forthcoming about their identity then there shouldn't be too much fuss but this also depends on how they behave. I've been giving advise based on my experience and observations for twelve years now (as of next month) and I've been working in an official capacity for the clinic that did my work for the past ten years.

 

Since the beginning I showed my full face in my photos, showed complete progress of each of my procedures in almost real time, shared my full name and the city in which I live. I am about as much of an open book as one can ask for and far more so than, well, anyone. I obviously make my living doing this and from the beginning, at my insistence, I have been a salaried employee and not on commission.

 

As far as my biases go, I think it is obvious due to my history and of course due to my signature stating that I work for Hasson & Wong. One question I often get when I'm on the phone is "What's the difference between H&W and Dr. (insert name here)". I give my opinion but then I tell them that they should not believe what I am saying BECAUSE I work for H&W and then I direct them to this and other forums and our Youtube channel and I tell them to judge for themselves and that anything I say is verifiable and documented online. I don't BS because I don't need to.

 

My experience also includes actually working in a clinic. I'm "in the trenches" so to speak and I get to see surgeries every day. Sometimes I sit in and ask questions and the great thing about this is that I have an understanding of surgery that few lay persons do, in both FUE and FUT. I've extracted grafts via FUE, I've cut grafts under a microscope and of course I've been through several surgeries myself so I certainly have that expertise going for me:)

 

Regarding other clinics, I am happy to recommend others when I see a need. I don't comment much on the results of other clinics however because I'd rather let other members be heard in this regard. If anyone wants to know my opinion, I'll give it, but many times it won't be pretty. I see things that most people don't until I point it out to them.

 

Of the clinic reps that post here I find that most of them are honest and forthcoming. I've butted heads with a few over the years but ultimately I think most are honest and knowledgeable. There are the occasional reps that come and go and some may or may not be of the strongest character but the membership tends to figure these posters out and send them packing.

 

So while your question and concern makes sense I think it general it is unwarranted.

[Spanker]

While I obviously don't have the experience that Jo does, I'm proud of the contributions I make and I feel like have helped a lot of people in the last 3.5 years, at least I hope I have. I became a rep this past August. I have set in on procedures with Dr. Konior and consults as well and plan on continuing at least a few days on site annually for continuing education on his clinical protocol as well as regular contact and discussions on hair restoration with the doctor himself.

 

Dr. Konior's work speaks for itself and I don't have to sell his services. I feel like I'm the same poster that I was before I began representing Dr. Konior and that was understood and encouraged as part of our agreement. I regularly recommend other clinics based on the needs of the patient like location, budget, type of procedure, size, etc. For instance if I get a email from a guy needing 7k grafts in one shot that lives in Canada and wants strip I may recommend H and W. Or a guy from Europe on a budget looking for really good FUE, I may tell him check out Dr. Koray. I always try to be a patient advocate above a clinic rep. Dr. Konior knows this about me and I feel like he respects it.

 

The main difference for me as a rep is that I get a lot more pm's asking about my experience with the clinic/travel/hotel/post op, etc., however Dr. Konior is always personally available thru email to answer questions. A lot of my role is also post-op emotional support as a prior patient of the clinic and I feel like there is an added value to the clinic to have a former knowledgeable patient that makes himself available pretty much 24x7 for anyone that needs to email me or speak to me, although again, Dr. Konior is very available as well and I encourage all patients with medical questions, no matter what clinic they go to go straight to their doctor with any concerns.

 

I will say that I'm not commission based either and I don't know any reps on htn that are (there may be some, but I don't know of any).

 

I am surprised that there is any concern about this as some of the greatest contributors over the years have in fact been reps like Jotronic and Spex. I feel like there is room for more reps if their hearts and minds are in the right place. There are plenty of non-rep veteran members here (like greatjob, cantdecide, newhairplease, and many many others) in addition to the moderators to keep the board on the up and up. They won't put up with pushy salesmen and they shouldn't. This type of activity gets called out very fast and the board does a great job at moderating itself. To suggest that htn should try to limit a doctor's option to choose to employ reps to represent them on htn would, in my opinion, be a mistake.

 

As for any other points to be made regarding this open letter to the forum, David's points were spot on and I think he made great points. If I could have said it better myself I would have but he covered anything else that I could have to added to conversation at this point.

 

I will say that I appreciate all of the regular veteran posters on the forum, reps or not. They add to the community a vast amount of knowledge and a continuity that makes this the best hair restoration forum on the internet and I consider many of them friends and a great emotional support system for battling hair loss.

 

In short, I feel like this issue is really a non-issue.

[wylie]

Hey there friend, I appreciate the very kind words. I know I have been rather dormant on this forum as of late, mainly due to being preoccupied with my personal life(all good things though) but I am always here for anyone if they need someone to talk to about anything. Be it a hair transplant, depression stemming from hairloss(or anything else) etc. I have always prided myself of being totally unaffiliated to anyone. I receive no financial incentive at all. But I prefer it that way. Reps cannot say the things that I say, they cannot say "that doesn't look too good" to a clinic-posted result. They cannot say "I don't think Dr X is good at FUE" etc. I really would not have it any other way.

 

For years, many strip clinics were spreading deliberate misinformation campaigns against FUE(low yield being an inherent factor in FUE, FUE only being good for minor recession) while FUE clinics were either silent or making fictitious statements about FUE(Diep labeling FUE as scarless in his Youtube videos, Atlanta Dr claiming Acell regenerates hair in the donor area). No clinic stepped up and brought truthful information about FUE, information that should have been public knowledge from the very start. I had to scour the internet to find documentation and proof that strip distorts the natural geometry of the donor. That strip eradicates the progressive hair caliber gradation in the donor amongst other things. That strip discards the dormant hairs in the strip because they cannot be seen even under magnification. That the hair coming out of the much-appraised trichophytic closure often exits at absurd angles. These are things that both strip and FUE clinics have known about for over a decade and NO ONE put it down in black and white for the patients and potential patients so they could make a totally informed decision. So while I am very proud of the work that I have done, you can see why I am very disappointed and angry at the industry for pulling wool over the eyes of the patient.

 

Most(not all) reps are sanctimonious in that they do not see that they are consciously or subconsciously promoting an agenda sometimes at the expense of the patient. They believe that their clinic never has bad cases and that their surgeons/employers are some kind of Christ-child or savant, free of flaws. They never admit the fault of the clinic for a bad result, instead they target "patient physiology". Then why do they offer a repair session on the same patient if the patient's physiology is a fixed factor?? I could tell you stories about some well-regarded reps that would make your local second hand car-dealer look ethical.

 

These statements of mine make me a popular person for patients and potential patients looking for honesty, but they also make me very unpopular to clinics and surgeons. I would not have it any other way

 

This is a great post Mickey, and absolutely spot on.

 

To the OP: Those who attempt to minimize your questions will usually be either the reps themselves or the owners of this board. There is nothing whatsoever unique about any of this, as large amounts of money are made in the HT industry, and the potential for abuse is systemic in any industry with profit margins like this one. As hard as some people try and distance themselves from the past, it was only a few decades prior that this entire industry was anchored to a foundation of deliberate misconception, giving the "industry standard" mini and micro grafts, which succeeded the hideous plug graft. Has this industry progressed since the dark days when disfigurement was the "industry standard"? Of course it has,thanks to technological advances. Have forums like this one (and the spokespersons for vetted physicians) helped the prospective patient? You bet they have. Does the potential for abuse remain? Absolutely.

 

Your questions are entirely valid and far too rarely brought up for discussion. The patient (and to a lesser extent, discussion forums and the industry itself) benefit when questions like yours are brought up for discussion and topics like these are exposed to sunlight. When reps get defensive and try to minimize your concerns, that is when you have every right to become skeptical, and believe me, you have every right to be skeptical.

 

Radix Omnium Malorum Avaritia

[abcd0000]

I agree with everything said. Users who represent doctors and duly state it in their signatures are completely OK and I am grateful for the info they provide to the community. The forum is pretty transparent in the way it functions and I don't see any problem with recommendation system. Other users like myself share their experiences out of solidarity to other users and gratitude to their doctors, because I also leaned on other people's experiences when booking my HT.

 

My only objection is that HTN recommendations may create an illusion of standard where in reality there is a scale. Not everyone recommended is Dr. Lorenzo, Dr. Bisanga or Dr. Hasson & Wong. Specifically (incited by the llvlludassar's case) I looked at Dr. Mohmand Humayun's work, and I can't see why on earth is he recommended here. But it has nothing to do with representatives.

 

Either way, like in real life--you need to open your eyes and look around you....

Edited February 10, 2014 by abcd0000

[scar5]

.....there are no reps in this community that attempt to sell...... That type of behavior would not be tolerated......

 

Well, why are they here? They are employed to sell, period. God bless them.

 

I think the key is to pick your way through the good stuff they say, the bad stuff they reveal and infer from the bits they leave out altogether.

 

I used to wonder if there should be a part of the board where reps would not be allowed to post, but then I figured it would be hypocritical. We are all bargaining with the devil to an extent.

 

Without the commercial incentive, there wouldn't be a single light bulb burning at HTN.

[BaldingBogger]

Originally Posted by David - TakingThePlunge View Post

.....there are no reps in this community that attempt to sell...... That type of behavior would not be tolerated......

 

 

Thanks all for input on this one. Its good to hear from the HTN community on this. And its good to hear HTN are 'on this' topic somewhat.

 

However I do think comments like the the above are slightly naive. Selling wont take place via posts on a public thread. People are smarter than that. It can take place in a one on one situation offline after contact is made on the forum. I know this from personal past experience which i suppose is one of the driving factors behing this thread.

 

I also agree whole heartedly that the website is a great tool for the HT community and that each individual must do their own due dilligence and do their own extensive research before committing to anything. It is up to each invidual to decide for himelf and make the best informed decision.

 

Ultimately I also don't agree that this topic overall is a non issue. I think its a very real potential issue that prospective patients and those new to the HT world need to be aware of. And hopefully this thread has gone a small way to aid that.

Edited February 10, 2014 by BaldingBogger

[TakingThePlunge]

Well, why are they here? They are employed to sell, period. God bless them.

 

Scar, many times I agree with your insights and opinions. However, in this case I do not. I understand and encourage caution as it's clearly an asset when it comes to making purchases of services and products that have a such a great potential to affect our lives for better or worse. People need to be informed about hair transplants before choosing a physician and I think this community does a stellar job at that. When I say "community" I'm talking about members like you, reps, moderators and physicians combined.

 

I stand behind my statement. You will not see reps making hard sales on this forum. And, if you did, they would immediately be called out by members and lose their credibility. That's the system taking care of itself. There is a huge difference between someone sharing their own experience and satisfaction with a physician that changed their life for the better and trying to manipulate or coerce someone else to follow in their footsteps. In fact you will very often see clinic reps congratulating and supporting members who have decided on physicians other than the one they represent because they know that they're still in good hands and can expect a great result.

 

While I understand skepticism and conspiracy theories are par for the course when there is profit to be made, it's more than frustrating when you know what goes on behind the scenes is more about patient advocacy and quality service than maximizing profits. I can't speak for all hair loss communities or all clinics in that regard but I can speak from my experience with this community and the clinics and reps that I've had the pleasure of personally interacting with.

 

In the end, the success of this community is proof enough of its ethics. If this was a place where any doctor could buy a recommendation and then sic an aggressive sales staff on unsuspecting and naive consumers, it wouldn't be long until every single light bulb burning at HTN was extinguished.

Edited February 12, 2014 by David - TakingThePlunge
typo

[TommyLucchese]

I think reps are great for the doctors and even better for the patients. I'd never have had my surgery without the help I got from Spex (and continued to get post op) and while of course it benefited Dr. Feller, it benefited me more as I've got a great result that I wouldn't have had otherwise.

 

[edit] Plus look at all the posts they make in threads that don't concern the doctor they represent. They provide a wealth of knowledge which is beneficial to everyone.

[scar5]

I agree with the sentiments posted by David and Tommy, in as far as the motivation to initially participate and continue to participate with honesty and genuine humility must be manifested by something much wider and more than raw profit.

 

I have learnt loads from these guys, Jotronic and Spanker types, and I think they a help a great deal of people. A lot of it was factual and a lot was the kind of prudently measured subjective stuff you only get from years of wisdom and a willingness to offer that wisdom free of charge to others.

 

I have also seen how myths have been peddled and propagated along the journey when it suits the business end of things and I have no problem with that. (Lol, until I do) but anyway, I think objectors don't live long anyway. Let the show roll on.

[hairthere]

Let's face it, the doctors/clinics that are at the top of their game don't need to hard sell, or be subversive. They have waiting lists months out. The don't advertise at all from what I can tell other than to simply post results on this forum. There's an abundance of baldies, and a growing number of HT surgeons doing great work.

 

That wasn't the case 10 years ago when I went for a consult with MHR and an independent surgeon named Joseph Karamikian. I chose the latter because he didn't hard sell me and he seemed to get what I wanted. Turns out he was just the lesser of two evils. Lucky for me I then did a google search and somehow found a pro-patient hairloss forum that I didn't discover during my brief pre-surgery research.

 

Since that time the list of top HT surgeons has grown exponentially. But there are clearly still many clinics out there doing subpar HTs. We see their foul work pop up here from time to time, and their shills crawl out now and again, but they are quickly squashed.

 

Like I said, I have witnessed another popular forum go down in flames at the hands of a clinic’s “sales” force. These guys were extremely pernicious and operated very slickly. I used to get into some heated debates with them, as did other community members, and they were relentless. I know we see bickering from time to time on this forum, but believe me, nothing like this.