FUT/ Strip advantages, apart from cost

[olmert]

Jotronic does not understand the nature of industry, which has nothing in particular to do with hair transplants.

 

When an industry is young, there is more opportunity for a provider to stand out. In the beginning, plumbing was a real skill. The best plumber gave you substantially more value than the average plumber and could charge a premium. As an industry matures, there were fewer opportunities for the best plumber to stand out. The best practices permeate and become known to the worst provider. The best become less and less distinguishable from the average. So today, the best plumber and even the best diamond cutter can't give you a much better product than an average one and cannot charge much of a premium.

 

Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices.

 

FUE is also more mature, and just starting to become mainstream option and take over market share from FUT.

 

So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor.

 

To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss.

 

But Dr. Hasson and all FUT experts are in a tougher situation than they were a few years ago. This even Jotronic will concede. And the FUE experts like Umar are in a better situation than they used to be in. As time goes by, things will get tougher for Hasson and easier for Umar. The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's.

 

Ultimately, the same process will happen to Umar once cloning starts.

 

You might ask why Hasson does not simply go FUE. It is because his expertise is all in FUT, and he can make more by sticking with it than by learning FUE from scratch.

[Since21]

Comparing hair restoration to plumbing, which requires no aesthetic or artistic skill, is way off base. Hair transplantation requires as much artistic skill as it does technical skill. And artistry is not something automatically acquired with time. Jotronic is right. There will always be a few standouts in any field that are separated by results, and in a field that requires artistic skill, that's what separates the good from the truly great.

[Mickey85]

Mickey85, so you think you will get an inferior result with Bhatti? He is really the only cheap FUE guy.

 

I foresee a day when no one does FUT anymore. If the best FUE docs get FUT level yield, then eventually all FUE docs will get FUT level yield. And they will charge Bhatti level FUE prices, which isn't much more than FUT. With price and yield barely favoring FUT, there will be almost no reason to do it anymore.

 

For me, bhatti does show potential to be a great fue suegeon, i just havent seen enough results grown out from him to list him in my top tier catagory. Time may change that though. That said, i do believe he is better at FUE than most north american suegeons.

[Jotronic]

Olmert,

 

Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices.

 

Five years ago, in 2009, FUT was already nearly 20 years old so while it was less mature than it is today it was still twice as mature as FUE is today. If you think that there is less difference between the best FUT docs and the rest of the field you are sadly, sadly mistaken. 30% of our business, and I'm certain that of Shapiro(s), Rahal, Feller, Konior, etc, is repair from the same class of surgeons that have always cared more about your dollar than doing the best job they can. That is a fact and I see it all the time.

 

FUE is also more mature, and just starting to become mainstream option and take over market share from FUT.

 

No question it is growing but it is has a way to go before it overtakes FUT as the dominant form of hair restoration.

 

So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor.

 

To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss.

 

Two reasons why this entire argument is moot.

1. Dr. Hasson started developing his skills almost 20 years ago, not five or ten.

 

2. You fail to understand that with FUE the profits are far higher especially when you are talking about an FUE doctor that routinely pushes several to tens of thousands of grafts (scalp and BHT) for roughly double the price of FUT. With our clinic each doctor has about 12 technicians most with close to ten years experience, some far more, and they all get paid very well to so they don't leave. With an average FUE clinic you need maybe two technicians and a receptionist. Double the cost per graft and 1/5 of the staff. Do the math.

 

The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's.

 

What premium do you refer to? If a patient gets 4000 grafts the fee is 4.00 per graft. It used to be a bit lower but about 7 years ago the price went up and it's still a bargain.

[olmert]

You fail to understand that with FUE the profits are far higher especially when you are talking about an FUE doctor that routinely pushes several to tens of thousands of grafts (scalp and BHT) for roughly double the price of FUT. With our clinic each doctor has about 12 technicians most with close to ten years experience, some far more, and they all get paid very well to so they don't leave. With an average FUE clinic you need maybe two technicians and a receptionist. Double the cost per graft and 1/5 of the staff. Do the math.

 

 

 

What premium do you refer to? If a patient gets 4000 grafts the fee is 4.00 per graft. It used to be a bit lower but about 7 years ago the price went up and it's still a bargain.

 

1. How do you know FUE doctors make more?. Even if FUE doctors need less technician time, they also must give more doctor time per graft. I've read people claiming on this forum (without citation) that some doctors who do both FUE/FUT push FUT because it is more profitable for them, owing to less doctor time per graft.

 

2.By "premium" I am not referring to what the consumer profits or loses. I refer to what economists call "economic profit" of the doctor: this is to say the particular doctor's hourly wage minus the average doctor's hourly wage. The better doctors often have economic profit. And of course everyone has some natural inclination toward equality and bristles a bit at someone charging, such that he makes more than the average doctor, even if the doctor still provides a better value to the patient. Unlike the doctor, the patient usually isn't in the 1%, and it reminds the patient that the doctor is not entirely motivated by the patient's interest.

 

 

BTW, I predict that FUT prices for H & W, and others is going to go down, or at least not keep up with inflation. This is because more patients are choosing FUE over FUT, and the total number of transplants is staying constant. So the FUT doctors are going to have empty slots and will have to compete with each other to fill the slots. Also more FUT doctors will offer FUE, which will be a little awkward, after pointing out the disadvantages of FUE for years. They will say point to the change in technology.

Edited April 25, 2014 by olmert

[Spanker]

1. How do you know FUE doctors make more?. Even if FUE doctors need less technician time, they also must give more doctor time per graft. I've read people claiming on this forum (without citation) that some doctors who do both FUE/FUT push FUT because it is more profitable for them, owing to less doctor time per graft.

 

2.By "premium" I am not referring to what the consumer profits or loses. I refer to what economists call "economic profit" of the doctor: this is to say the particular doctor's hourly wage minus the average doctor's hourly wage. The better doctors often have economic profit. And of course everyone has some natural inclination toward equality and bristles a bit at someone charging, such that he makes more than the average doctor, even if the doctor still provides a better value to the patient. Unlike the doctor, the patient usually isn't in the 1%, and it reminds the patient that the doctor is not entirely motivated by the patient's interest.

 

 

BTW, I predict that FUT prices for H & W, and others is going to go down, or at least not keep up with inflation. This is because more patients are choosing FUE over FUT, and the total number of transplants is staying constant. So the FUT doctors are going to have empty slots and will have to compete with each other to fill the slots. Also more FUT doctors will offer FUE, which will be a little awkward, after pointing out the disadvantages of FUE for years. They will say point to the change in technology.

 

 

I really don't see the point in this part of the debate because every doctor is different and every clinic is different. The cost of a facility and staff in Chicago is not going to be the same in other countries, states, and cities. Some strip and FUE docs do more than one case a day which will really increase their profitability. The teamed up doctors will have less overhead (likely) with the exception of staff, and even that may be a little reduced. Then small clinics like Dr. Konior's who only does one patient a day, because he is involved in 100 percent of the implantation. So what's that time worth? I would guessed that if you averaged out doctor's pay vs minutes spent with the patient, he is in the lower paid range of physicians, but I do not imagine that he is the cheapest my any means. My point is, what a doctor makes and what a doctor charges, regardless of the type of procedure, do not necessarily directly reflect a doctor's actual pay, because there are so many variables with time, staff, location, number of patient's, etc.

 

As far as economic profit, (as the economists call it as you say), I do not think you are using the term correctly. I recently took graduate level economics. Economic profit basically refers to the difference in the accounting profit and opportunity costs. If a doctor's office had $1,000,000 accounting profit, but the doctor owned the facility and could have rented it out for $200,000 that year and stayed at home or went fishing everyday, his economic profit was only $800,000 that year and not $1,000,000, because of the opportunity cost of $200,000 (these are simple numbers that don't deal with taxes of course).

[olmert]

1. If Spanker is right that doctor charges do not vary much with what the doctor is making (and presumably on the doctor’s skill), but rather vary with factors unlikely to affect the result (for example, location, performing two procedures at once), then a patient would be throwing out money to go to the expensive doctors instead of say the cheap doctors in India with satisfied patients. And we are talking big money by not picking doctors like Bhatti and Madhu (like $20K versus $4K).

 

2. I use the term “economic profit” because for purposes of this analysis, the doctor’s opportunity cost for his current practice is to have a practice similar to the typical doctor, with the typical doctor’s accounting profit. Graduate economic classes are generally more about math than economics.

[1978matt]

BTW, I predict that FUT prices for H & W, and others is going to go down, or at least not keep up with inflation. This is because more patients are choosing FUE over FUT, and the total number of transplants is staying constant. So the FUT doctors are going to have empty slots and will have to compete with each other to fill the slots. Also more FUT doctors will offer FUE, which will be a little awkward, after pointing out the disadvantages of FUE for years. They will say point to the change in technology.

 

No idea where you're getting your information but that isn't the case:

 

Article from 25th March 2014-

Statistics released from a recent member survey conducted by the International Society of Hair Restoration Surgery (ISHRS) – the world’s leading medical authority on hair loss and hair restoration – have shown a marked rise in the number of surgical hair restoration procedures being performed around the world over the past decade.

Since the ISHRS began tracking trends in hair restoration, with its first Practice Census member survey in 2005, the extrapolated worldwide volume of surgical hair restoration procedures performed from 2004 to 2012 has jumped 85 percent, with a total of 310,624 procedures being performed worldwide in 2012.

“Until recently, people undergoing hair transplants preferred to keep their surgery a secret, especially celebrities and other prominent public figures,” said Dr Parsa Mohebi. “But now the tide has shifted, and people from all walks of life are no longer shying away from publicly talking about their hair transplant procedure – similar to how they would discuss any other popular cosmetic surgical procedure that can shave years off a person’s appearance.”

While traditionally men have dominated the hair restoration patient base, the survey showed that women increasingly are turning to hair restoration surgery to address hair loss as well– with the number of women undergoing hair restoration surgery worldwide increasing 20 percent from 2004 to 2012. Dr. Mohebi noted that men and women face many of the same concerns regarding hair loss and often express how it makes them more self-conscious and negatively impacts their work and personal lives.

[GoForIt]

Hopefully in our lifetime we will just have a few grafts punched out and all the follicular units we need - resistant to DHT cloned .

 

Until that time it is a personal choice with a right answer for each person based on the advantages and disadvantages of each procedure.

 

Speak with a few ethical physicians who do each procedure and make the right decision for you.

[Paulygon]

I chose strip because I don't ever really plan on shaving my head, and I wanted to be able to use the vast majority of my best grafts, at which point, I will have the option to tap out my FUE reserves.

 

 

same here.. that, in combination with yield vs. cost was a big selling point for me. I am very happy with my decision. since I already have the scar, I plan on going for another strip procedure (or two, who knows) before I start doing FUE.