If a doctor is recommended but not in the coalition, is he inferior?

[rsn]

This is what I understand, which understanding was hard to reach because they won't give you straight answers here.

 

This site vouches for the good doctors and calls them part of the coalition for ultra refined hair transplants. These doctors, the site is calling the A team.

 

Then the site says there are inferior doctors, who are still better than average but not good enough for the A team. These doctors, this site calls recommended, but not up to the coalition standards.

 

I understand this to be the reality. But if you ask whether the coalition doctors are better than the merely recommended doctors, this site gets all vague, refuses to answer the question, and directs you to the definition for the coalition. It is as if the site is wants to be politically correct at the expense of obfuscation.

 

But there is no way to identify an A team, without labeling the remaining doctors the B team.

 

I guess it is awkward for a site to call the remaining doctors inferior, so this site does that, but is vague about it.

[GreatPelo]

Absolutely not! Not all doctors may elect to be part of the coalition but still deliver great results. Do your own research and make sure your choice is a Dr that is a specialist in hair restoration and has great before and after pictures. Take your time and do you research.

[rsn]

Why would a doctor choose to be on the recommended list, but not on the coalition list? Do the doctors have to pay more to be on the coalition list instead of the recommended list?

[GreatPelo]

If they have been approved by this site they are recommended. But not all good HT doctors may elect to be part of this site.

[TakingThePlunge]

All the doctors recommended by the Hair Transplant Network are among the best in the world. You can view our recommendation standards here.

 

Members of the Coalition of Independent Hair Restoration Physicians are required to meet the following additional criteria:

 

A demonstrated capability to successfully perform large sessions of ultra refined follicular unit grafting via strip excision or FUE hair transplant surgery using tiny incisions and grafts.

The ability to dense pack tiny follicular unit grafts in a given area when appropriate.

 

To learn more about Coalition standards, click here.

[rsn]

As best as I can tell, David is saying that you are better off with a Coalition member, instead of a recommended doctor.

 

Guys who are not experts want a bottom line answer: are the Coalition doctors better than the recommended doctors.

 

It sounds like David is saying that the answer is yes, but he doesn't want to announce the recommended doctors are the B team, so instead of simply saying yes, he refers you to the definition, hoping you will conclude the answer is yes, without him having to outright say it.

 

I think that is what is going on. I cannot be sure, but there definitely appears to be some intentional ambiguity, and declination to answer the question, and I cannot think up any other motivation.

[TakingThePlunge]

As best as I can tell, David is saying that you are better off with a Coalition member, instead of a recommended doctor.

 

Guys who are not experts want a bottom line answer: are the Coalition doctors better than the recommended doctors.

 

It sounds like David is saying that the answer is yes, but he doesn't want to announce the recommended doctors are the B team, so instead of simply saying yes, he refers you to the definition, hoping you will conclude the answer is yes, without him having to outright say it.

 

I think that is what is going on. I cannot be sure, but there definitely appears to be some intentional ambiguity, and declination to answer the question, and I cannot think up any other motivation.

 

Not at all. I believe firmly in this community's recommendation standards and have contacted a number of surgeons (both recommended and Coalition) in planning for my next hair transplant.

 

Not all patients are candidates for mega-sessions or dense packing. Not all patients require these. Ultimately, consistent, natural results, ethics and patient care are some of the qualities that make a top doc. As I've stated many times, the best doc for one patient is not necessarily the best doc for the next patient.

[Sean]

This is what I understand, which understanding was hard to reach because they won't give you straight answers here.

 

This site vouches for the good doctors and calls them part of the coalition for ultra refined hair transplants. These doctors, the site is calling the A team.

 

Then the site says there are inferior doctors, who are still better than average but not good enough for the A team. These doctors, this site calls recommended, but not up to the coalition standards.

 

I understand this to be the reality. But if you ask whether the coalition doctors are better than the merely recommended doctors, this site gets all vague, refuses to answer the question, and directs you to the definition for the coalition. It is as if the site is wants to be politically correct at the expense of obfuscation.

 

But there is no way to identify an A team, without labeling the remaining doctors the B team.

 

I guess it is awkward for a site to call the remaining doctors inferior, so this site does that, but is vague about it.

 

New recommended docs appear from time to time. Some docs focus on the patient 1/3 of the time during procedure, while there is another doc that is posting his results towards recommendation that does nearly 100% of the FUE procedure without use of techs. That doc even works on the same patient for three consistent days if needed and does not do more than one patient simultaneously between a dedicated procedure. There are other recommended docs that do 3-4 surgeries at a time and heavily rely on techs, even for extractions. As with any forum, this is also a legal business entity. fees pay salaries/compensation to owners and mods. doctors pay considerable fees to multiple forums to be marketed. Do all recommended docs do equal quality of work? I don't think so. Some are clearly popular versus others. Then there are new docs that are recommended that were barely heard of across forums or really talked about. how can we know if a doctor follows the coalition recommendation standards when a doc's techs are being used for much of the surgery? (extractions, recipient grafting, graft checking, etc). I don't know, but things are not consistent. At the end of the marketing, advertisements, research presented, is a vulnerable consumer & patient, one who entrusts in the advice of the forum and all its parties. Some recommended docs tried Artas on few patients with not so satisfactory results (risking donor through a machine), some use power drills, very very few use manual fue. Some of these things are in conflict with the recommendation standards themselves. So, I just don't know. Recommendation seems like it is just a recommendation. Patients now have to be more than careful when selecting a doctor. Lots of B team docs are starting to join the A team once they join the forums.

[Bill - Seemiller]

Guys,

 

Physicians in each group, whether they're recommended or a member of the Coalition must meet a certain set of standards. Members in each group have proven to meet those standards. To see our standards for recommendation and the Coalition, click here.

 

We typically start out by recommending physicians. It is very rare we consider brand new doctors for the Coalition. Coalition members must meet the additional set of criteria that Dave listed above (also listed in the link I provided). Moreover, in order for a physician we just approved for recommendation to be eligible for Coalition membership, he/she must develop a stellar reputation online for providing excellent, ultra refined results. This comes with time, posting dozens of examples of their results and lots of member/patient feedback.

 

The Coalition represents an elite group of surgeons who have met even more rigorous set of standards. That said, some surgeons who are recommended may be eligible for Coalition membership but have decided not to undergo additional prescreening at this time.

 

At the end of the day, we encourage all prospective patients considering hair transplant surgery to research all physicians they are considering. Patients who choose a Coalition surgeon or a recommended surgeon are choosing a physician who has been prescreened by this community and who have been approved based on a certain set of high standards. Thus, in my opinion, those who select amongst these groups will be in excellent hands.

 

I hope this helps.

 

Bill

[Sean]

So, not all recommended surgeons by the business/forum are not part of the Coalition list?

 

As members of the Coalition go through rigorous screening by the owners, their surgical processes and sets of procedures are obviously thoroughly examined. Do any of these members in the Coalition, employ technicians to do FUE surgical extractions OR have employed any unproven robots for FUE extraction? i am sure as part of screening, such aspects would be noted. As these processes would be in conflict of the standards of Coalition screening.

[Ali Emre Karadeniz]

A question that passes my mind is,

When I look at the criteria for recommendation and coalition membership, I don't see a requirement such as the physician doing graft extractions. Does this mean that technician clinics can be recommended and be coalition members as long as they seem to do ultra-refind surgery with consistent results? If so, I don't see why some clinics are accused for letting their techs do graft extractions. There will also be no point in asking if the clinics do only one patient a day as letting technicians do graft extractions is closely related with the desire to do multiple surgeries a day. If these are not requirements to be recommended then it should be clearly defined and clinics should not be questioned. However if they are seen as a requirement for a certain quality standard, I believe they should be added to the recommendation requirements and both new candidates and previously recommended clinics should be screened for it.

[1966kph]

For once we might actually agree on something Dr karadeniz.

All information of the clinics should be made clear regarding who does what during a patients procedure and I mean all aspects.

Obviously a Dr cannot be recommended if he plays no part in the procedure but if the tech led clinics meet the standard required I think they should be eligible for being recommended.

This forum is all about people wanting to address their hair loss through a transplant and receiving the knowledge to go to a place that has proven results which their patients can back up by sharing their results.

Should the coalition be just for drs that do all of the work or 90% or 80% ? And obviously we are talking fue here as a doc isn't going to be doing the strip division in fut.

At the moment there are recomended clinics have techs doing a lot of the work in multiple procedures a day but they achieve outstanding results and to me and I would assume 99% of people here it is the result that we are interested in.

Its no concellation that a doc did your ht when its a bad result and to me it is of no importance who does the work as long as I get the result I want.

More up front transparency is required by all clinics and the qualification for recommendation should also be clarified to address the changing landscape that is the modern ht industry.

All have a nice day

Edited December 16, 2014 by 1966kph

[Ali Emre Karadeniz]

The point that I don't agree with anyone who says that it doesn't matter who does the operation as long as the results are good is, there are some hidden patient benefits that may be sacrificed when techs or non-experts do procedures like graft extractions. For example the disadvantage of a 20-30 % transection rate may only be evident years later at the recipient area when density is lost earlier than usual or by less number of grafts available at the donor area 6 years later at a second session. Or another example may be, lets say in a difficult case the tech messes up resulting in a bad result. This may increase the unsuccessful result rate of the surgeon by only 1-2 %, and may be attributed to bad luck at the time, but it will not only be a tragedy for that patient, but it will be a bad result that could have been avoided had expert hands been on the case.

[Lateatnight]

"For example the disadvantage of a 20-30 % transection rate may only be evident years later at the recipient area when density is lost earlier than usual or by less number of grafts available at the donor area 6 years later at a second session."

 

Thank you Doctor,

for all the sleepless night i'm going to face from now on

[mikeey]

Hi Dr. Karadeniz , can you pls educate us on this ?

 

I need help to understand , can u please lemme know that after the HT , when the hair starts to sprout at 3 Months , will the hair come out of the skin all at once ? Like all the grafts that were planted ? OR they come out little by little ..... and Not at once

 

I had read somewhere that ALL the FU's that are Viable and can grow Hair , Sprout at once Between 3 and 4 Months post HT , and after That its Basically Thickening and Maturing ... Nothing Else !

 

As you are very well experienced in this , please take some effort and help educated us .

 

Regards

[1966kph]

All that you said above regarding transection and it only becoming apparent later would be the same if a Dr had done the extractions.

Your basically saying that all the clinics that utilise technicians to do the extractions shouldn't be doing as a few years down the line the transection rate will be evident?

All doctors including yourself at some point have poor results and I believe that every single part of the procedure is crucial to a successful ht.

To say that a successful ht is only achievable if a Dr does one part or another is to my mind inaccurate or how would you explain away the failed procedures were it was just a doc doing the work?

I have seen the results of a tech clinic on a norwood 7 that stands up very well against the best surgeons results for the amount of grafts so the graft survival rate must of been very high and I have seen far worse from recommended docs utilising fut rather than fue.

Of course we are never going to agree on this as if you were to change your opinion you would be talking yourself out of a job.

This is were we differ.

You are protecting your lively hood were as I am just interested in the result from a patients prospective.

What does concern me is that on the tech led clinics or any clinics website they should clearly state the amount of experience a tech has performing the job.What role they play in the procedure and how many years they've been at the clinic

Its no big deal to allocate a page or two of a website for this purpose.

If as you say a result is only a final result years from the ht the results that clinics and patients post up are not a true reflection of the end result.

I have never read or heard of this scenario before and maybe you could tell us on what evidence you are stating this?

Could you please post a link up to the said information?

So how many years would you say before a result is a result?

Have a good day

Edited December 16, 2014 by 1966kph

[1978matt]

All that you said above regarding transection and it only becoming apparent later would be the same if a Dr had done the extractions.

Your basically saying that all the clinics that utilise technicians to do the extractions shouldn't be doing as a few years down the line the transection rate will be evident?

All doctors including yourself at some point have poor results and I believe that every single part of the procedure is crucial to a successful ht.

To say that a successful ht is only achievable if a Dr does one part or another is to my mind inaccurate or how would you explain away the failed procedures were it was just a doc doing the work?

I have seen the results of a tech clinic on a norwood 7 that stands up very well against the best surgeons results for the amount of grafts so the graft survival rate must of been very high and I have seen far worse from recommended docs utilising fut rather than fue.

Of course we are never going to agree on this as if you were to change your opinion you would be talking yourself out of a job.

This is were we differ.

You are protecting your lively hood were as I am just interested in the result from a patients prospective.

What does concern me is that on the tech led clinics or any clinics website they should clearly state the amount of experience a tech has performing the job.What role they play in the procedure and how many years they've been at the clinic

Its no big deal to allocate a page or two of a website for this purpose.

If as you say a result is only a final result years from the ht the results that clinics and patients post up are not a true reflection of the end result.

I have never read or heard of this scenario before and maybe you could tell us on what evidence you are stating this?

Could you please post a link up to the said information?

So how many years would you say before a result is a result?

Have a good day

 

I see you're still banging on about Dr M's technicians. Is he your uncle or something?

 

No one would go to a technician led clinic out of choice except for financial reasons. Who would do a better job: 1)Dr L, bringing his 20 years experience giving full time and attention over 2 days, and paid $20,000 dollars to extract 3000 grafts meticulously minimising transection, or... 2)Dr M's technicians, 1 year experience and paid $2,000 to extract 3000 grafts in 3 hours?

 

Let us know when you figure it out as 99% of the forum already have:).

 

The technicians are just interested in getting 4000 viable grafts that aren't damaged. They have no incentive to work carefully and preserve as much donor as possible for later use. It is not their name on the clinic's door and if it goes bust they can go off and get another job elsewhere.

 

They will always have some 'hits' where it all comes together and results in a decent outcome, but even then it is hard to know what damage they did to the donor.

 

If you don't care about the above issues then best of luck with your $2,000 HT.

 

Personally I wouldn't have a HT there if it was free and they paid me $20,000!!

[Lateatnight]

I see you're still banging on about Dr M's technicians. Is he your uncle or something?

 

No one would go to a technician led clinic out of choice except for financial reasons. Who would do a better job: 1)Dr L, bringing his 20 years experience giving full time and attention over 2 days, and paid $20,000 dollars to extract 3000 grafts meticulously minimising transection, or... 2)Dr M's technicians, 1 year experience and paid $2,000 to extract 3000 grafts in 3 hours?

 

Let us know when you figure it out as 99% of the forum already have:).

 

The technicians are just interested in getting 4000 viable grafts that aren't damaged. They have no incentive to work carefully and preserve as much donor as possible for later use. It is not their name on the clinic's door and if it goes bust they can go off and get another job elsewhere.

 

They will always have some 'hits' where it all comes together and results in a decent outcome, but even then it is hard to know what damage they did to the donor.

 

If you don't care about the above issues then best of luck with your $2,000 HT.

 

Personally I wouldn't have a HT there if it was free and they paid me $20,000!!

 

I agree with you.

But reality is that you pay 20000 bucks and get extraction by two techs with one or two year experience the most skilled and the other one, three days or so.

[Ali Emre Karadeniz]

 

The technicians are just interested in getting 4000 viable grafts that aren't damaged. They have no incentive to work carefully and preserve as much donor as possible for later use. It is not their name on the clinic's door and if it goes bust they can go off and get another job elsewhere.

 

They will always have some 'hits' where it all comes together and results in a decent outcome, but even then it is hard to know what damage they did to the donor.

 

If you don't care about the above issues then best of luck with your $2,000 HT.

 

Personally I wouldn't have a HT there if it was free and they paid me $20,000!!

 

Dear Matt, no! Turkish techs are not even interested in getting 4000 viable grafts. They are programmed to do the maximum punctures, that is about 6000-7000 punctures at the donor area and get out whatever is viable in a period of 2-3 hours. I have witnessed with my own eyes that a tech told me he was going to do 7000 grafts over two days. They don't even use surgical loupes. He did indeed do about 6000 punctures with the bare eye at the speed of a sawing machine but what he got was 2700 half damaged grafts. They also transplanted the totally transected grafts which do give some yield. The techs who are programmed to get 4000 viable grafts are very rare and are probably the only ones work for the recommended doctors here and maybe a few more.

 

Let me tell you a funny story:

I had a patient recently who had considered one of these technician clinics before deciding on me. He asked what I thought about the other clinic he considered while we were operating on him. I didn't want to speak against the other one as I didn't think it would make much sense. So I decided to ask my techs who were preparing to place the grafts. I asked them if they would have a HT there if it were for free. They quickly answered no, with disgust. I then asked each of them how much money they would ask to be paid to have it done. The youngest and least experienced one wanted to be paid 200.000 USD to have a HT done by the technicians! The others asked for even more. So as an answer to my patients question, I gave him the numbers that my techs told me!

[1966kph]

Hello mat i hope you are well.

Please research before giving examples because for a while now Dr Lorenzo has not been doing all the extractions and his clinic treat several people a day.

Both of these go against what Dr karadeniz deems to be good practice.

This thread has strayed a little off topic.

Quote by1978Matt, Let us know when you figure it out as 99% of the forum already have.

I as well as everyone else knows the answer but the fact of the matter and you stated it is that not everyone has got 20k or 30k.to spend on a ht,s..

You also missed the points that dr karadeniz made about the time frame for results to come to a conclusive outcome,

I am not banging the drum saying roll up get the best ht on the planet for ?2000 what i am saying is that those who have limited funds can get a result that probably 95% of their patients are happy with but the only reason that one tech clinic gets mentioned here is because its the only one.

Why not go to all the patients threads of said clinic and tell them they are all fools?

That they dont know their arse from their elbow or a good ht from a bad one?

We all have our preferences where we would go its up to the individual.

Every failed ht result is damage to the donor and as i have said according to dr karadeniz the damage to the donor and even the recipient areas is only evident in years to come.

I've seen and read enough about the said clinic to know that they are giving their patients what they want were is the problem with that?

You dont need to go there others do and if the patients post up shit results it will warn off people from going there what is the problem with that?

If the patients get what they want who are you or i to say they should of gone elsewhere?

And please do a bit of research if your going to be stating figures,as far as i am aware the least experienced tech at said clinic has is 6 years and the lead tech i think has 11 years.

Many recommended clinics using motorized fue do 3000 or 4000 grafts in a day or manuel punches doing 5000 in 2 days how meticulous are they being?

And the clinic i would imagine would want to get a good result as bad results are bad advertising and several procedures are several lots of profit so i would imagine they would try to preserve the donor supply somewhat.

And when you say some hits to my knowledge i have only come across 2 patients who were not happy of probably 30 or more now that's not bad for a bunch of muppets is it ?

I sincerely hope your ht does not as dr karadeniz says thin over time due to a problem that occurred at the time of your ht and why are you more interested in trying to straighten me out rather than ask the doc to elaborate on his statement.

Well that's enough of me banging on

And how on earth did you figure it out that he is my uncle ?

You have a nice evening

Edited December 17, 2014 by 1966kph

[1966kph]

Dr karadeniz could you please answer the questions i asked earlier

Quote by dr karadeniz [ For example the disadvantage of a 20-30 % transection rate may only be evident years later at the recipient area when density is lost earlier than usual or by less number of grafts available at the donor area 6 years later at a second session.]

 

Quote by1966kph

[i have never read or heard of this scenario before and maybe you could tell us on what evidence you are stating this?

Could you please post a link up to the said information?

So how many years would you say before a result is a result? ]

 

And please get over yourself going on about how you dont want to be calling certain methods of the ht industry but then proceed to.

Please elaborate on the points you made

[KO]

Please learn how to use the quotes.

[PupDaddy]

Of course, an ill-advised extraction pattern, graft damage and transection, and surrounding damage is just the extraction side of the equation. The $2,000 technician-performed transplants at the clinic in question also involve technicians mapping out and making all the recipient sites, using a motorized drill no less, to make the execution of this cosmetically critical task "easier." I'm with Matt1978. You couldn't pay me to submit to a bargain-basement FUE hair transplant performed by low paid technicians, set up as a sideline to a doctor's plastic surgery practice, in violation of that country's medical laws. The idiom, penny-wise and pound-foolish comes to mind -- the "pound" being one's precious, finite donor and the long term devastating consequences (financially and emotionally) of a botched transplant.

[rsn]

PupDaddy, can you tell me more about what mistakes can be made with implanting of the grafts by bad tech's?

[fisher4man]

Considering the title of the topic;

 

If a doctor is recommended but not in the coalition, is he inferior?

 

We all know Dr. Lorenzo has recently abandoned his HTN membership, but, was he a recommended or coalition member when he was here?