Dr. not present during graft insertion?

[JoeW]

Hi,

I have a simple question. I have a procedure booked at a well regarded clinic in California, but was told by the surgeon that he would have to leave at the break due to another obligation that day. He informed me that the procedure would be complete at that point and standard procedure is for the technicians to finish by themselves, doing the actual graft insertions. The only difference would be that he would not physically be in the office as well.

 

I would like to commit because it works with my schedule, but I have reservations paying a lot of money for a procedure where the surgeon is only there for half of the day.

 

Any thoughts would be appreciated,

Joe

[1966kph]

Hello Joe

Is your ht fue or fut?

If it is fue it would not really concern myself and many more but it obviously does others.

If your not happy I would suggest you cancel its your decision.

At least the dr made you aware of the situation unlike some others.

Who is the Dr ?

Have a good day

[JoeW]

Thanks 1966,

It is an FUT procedure. I am hesitant to name the dr.

 

Still mulling it over...But I am leaning toward looking for a different date, regardless of whether the Dr is actually inserting the grafts himself. I think I just feel more comfortable with my surgeon there for the entire process I think. But I will think a bit more on it.

[1966kph]

As for naming the dr that is totally up to you.

I dont know if you saw the thread (when a donor site is left open) if I remember rightly the thread starter was from California but he would not name his dr so he may be from another state.

If you put yourself in the position of that chap then consider if you would be happy for your dr to leave.

To me its a no brainer.

What size of a procedure are you hoping to have? Roughly how many grafts as obviously the greater the number the larger the strip and the possible difficulties this could throw up.

As its fut I would rearrange for a date that the doc would be there till the end.

Theres a clinic here that got a lot of stick because the dr went home when the patient was being bandaged so your probably right not to name him.

At the end of the day its tottaly your choice but the majority of the time ones first thoughts turn out to be correct.

Also if I were you I would find the thread I mentioned and private message the dude and ask if your dr is the one that worked on him just to put your mind at rest as I think he was treated terribly.

Have a good day

[scar5]

I would run.

Doctor knows it is illegal for him to be out, but by telling you, but by telling you like thus he is covering his ass- he is getting you to consent to it, thus letting him off the hook if something goes wrong,.

 

 

You are paying big bucks, putting yourself on the line. It is not a giid way to start your relationship with this doc. You consent- you are weak and he will continue to treat yoi like this in future.. IMO.

 

 

I would run, but I am also a pussy mys.

[Rawkerboi]

Why are you hesitant to name the doctor :mad:?

[Tamagochihandler]

Many top Doctors do not take part of insertion process but they do extractions or the other way around. They delegate extractions but do insertions, depending the method they use to work. The most important thing is as always: that you have a good and clear evidence that his method works with clear and good amount of good results.

After saying this, which is nothing new and it is basically the reason of being of this forum, I must add specifically for your question that I do not consider serious that Doctor is not present during whole process supervising his team work. He is basically a Commander, the one who makes decisions, the one who delegates in others, the one who has the biggest knowledge and is better prepare to get solutions in case something goes abnormal or out of what it is expected...

[LondonHT]

For a FUT i think its quite normal for the Techs to do the implanting as the Dr Takes the strip and stiches you up.

The Dr is usually around though even if his work on you has finished.

[Michael Vories, MD]

Just wanted to add to this discussion that all technicians are working under the supervising physician's license. For this to be valid, the doctor must maintain "direct supervision." This means the doctor must be physically present in the facility. In this case, the doctor is clearly violating his state medical board requirements by being off site while grafts are placed. The patient will still need to have local anesthesia administered, and if there is some type of complication (such as a vasovagal reaction) the doctor would face state medical board disciplinary action. Potentially dangerous situation for the patient and the physician. Hair transplant surgery is an elective procedure, and safety of the patient is paramount.

[1966kph]

Hello Vories.

Are these state laws within the USA or are these the rules that apply nation wide.

Thanks for clarifying for the thread starter were he stands.

Have a nice weekend.

 

Just wanted to add to this discussion that all technicians are working under the supervising physician's license. For this to be valid, the doctor must maintain "direct supervision." This means the doctor must be physically present in the facility. In this case, the doctor is clearly violating his state medical board requirements by being off site while grafts are placed. The patient will still need to have local anesthesia administered, and if there is some type of complication (such as a vasovagal reaction) the doctor would face state medical board disciplinary action. Potentially dangerous situation for the patient and the physician. Hair transplant surgery is an elective procedure, and safety of the patient is paramount.

[KO]

Hey man could you please PM me the name of this doctor?

[1966kph]

Would be very interesting if he turned out to be the same recommended doc from the donor left open thread.

If it is this may well be the end of his recommendation here.

Have a good day

 

Hey man could you please PM me the name of this doctor?

[gillenator]

With FUHT, the donor area where the strip is excised is indeed closed with sutures, staples, etc., immediately after the strip is taken and before the grafts are inserted. Possibly the doctor was telling you that the techs do all of the graft placement and after they are all placed, the procedure is pretty much completed.

 

Still, what I don't like is that it is always possible that the patient may need more anesthesia before the procedure is finished and only a licensed physician should be administering anesthesia. That's the law in the land.

 

In addition, what happens if the patient's vitals start failing? Then what? Although it is extremely rare but it can happen.

 

Also, the surgeon should be inspecting what he/she expects. In other words, a responsible and ethical doctor would want to be routinely observing what his techs are doing and making sure each graft is placed properly both in depth and angles. A responsible doctor would look the entire scalp over before releasing the patient and also doing an exit interview which includes advice and addressing any post-op questions involving taking pain meds, etc.

 

Could the doctor have a golf game he is trying to make later in the day? I just don't have a good feeling about this at all...:rolleyes:

[Cryingoutloud]

Hey man could you please PM me the name of this doctor?

 

What is it with you and wanting to know surgeons' names even after patients have clearly indicated they don't want to divulge them? I'm not being hostile but it strikes me as weird how you think divulging info by PM is somehow different to doing so on the main forum. What does the patient have to gain by telling you the identity of his surgeon?

 

Anyway, if I was the patient, I'd run a country mile in the opposite direction to this surgeon and his practice. In an ideal world, the surgeon should not only be present during the procedure but he/she should actually be doing ALL the important aspects; extractions, recipient incisions and administering anaesthesia. Lately, however, clinics and their reps have slowly, quietly moved the goalposts to the point where more and more patients think it's ok to have techs do the everything but strip closures and anaesthesia.

 

The patient should count himself very lucky that he's been told now and not on the day of the procedure. He should take his hard-earned money down the street to a professional

[KO]

I want to know because it is important, especially as a prospective patient, if you have a problem with it then I suggest you shut you mouth and move on because I will not stop.

[Cryingoutloud]

I want to know because it is important, especially as a prospective patient, if you have a problem with it then I suggest you shut you mouth and move on because I will not stop.

 

Take it any way you like - I don't much care - but I'm just letting you know that you just come across as a bit of a creep. If people would rather not divulge info about their surgeon, you should just respect their wishes rather than try to cajole them into doing it by PM as if you can be trusted to keep their confidence or something.

[KO]

Take it any way you like - I don't much care - but I'm just letting you know that you just come across as a bit of a creep. If people would rather not divulge info about their surgeon, you should just respect their wishes rather than try to cajole them into doing it by PM as if you can be trusted to keep their confidence or something.

You come across as a nuisance on many of the clinic threads especially with you comments about "donkey results" so perhaps you should mind your own manners before lecturing others.

[KConK]

Many top Doctors do not take part of insertion process but they do extractions or the other way around. They delegate extractions but do insertions, depending the method they use to work. The most important thing is as always: that you have a good and clear evidence that his method works with clear and good amount of good results.

After saying this, which is nothing new and it is basically the reason of being of this forum, I must add specifically for your question that I do not consider serious that Doctor is not present during whole process supervising his team work. He is basically a Commander, the one who makes decisions, the one who delegates in others, the one who has the biggest knowledge and is better prepare to get solutions in case something goes abnormal or out of what it is expected...

 

I agree with this - from my research it is common for surgeons not to be present the entire time (even Harley Street docs in London), and many that claim to be aren't in reality. At least they are being open with you about that cause a lot of Doctors aren't. I agree that the research of that surgeon's work is a key factor just as much as whether he will be present or not cause as the above says, he is the leader of that surgical team. This was a worry I had myself and is something you can't be definite about until the procedure is finished. I was lucky that my surgeon was present throughout, although he did the majority of the procedure, there were definitely times that he was instructing his team on what to do and was watching them work. I wouldn't run a mile I would just do more research into that clinic and results.

[Cryingoutloud]

You come across as a nuisance on many of the clinic threads especially with you comments about "donkey results" so perhaps you should mind your own manners before lecturing others.

 

I'm not lecturing anyone; you can do what you like. I only asked why you do it. As for my comments about "donkey results", it's just another term for what the surgeons and their reps call a "sub-optimal result". My version just leaves out the sugar-coating and tells it like it is.

 

I asked why you do it I myself have been on the receiving end of not one but TWO of your stalky little PMs asking for my first surgeon's details after I clearly said I didn't want to name him. I ignored the first on 4th December hoping you'd just disappear off somewhere but lo & behold, on the 19th December, you repeated your request. I couldn't understand why you thought I'd tell you by PM as if we were best buddies in class or something and it would be our little secret.

 

Anyway, as I said, do what you like but people don't like being stalked.

[KO]

And I would have kept sending you PMs till you answered. I'm going to do what is best for me, I couldn't care less how you feel about it.

Finally, a number of people have been willing to discuss over PM so it doesn't really matter what you say.

[1966kph]

KO I always thought it a forgone conclusion that in all likelyhood you would be going to Lorenzo Mwamba or bisangi.

But most likely Lorenzo.

 

 

I want to know because it is important, especially as a prospective patient, if you have a problem with it then I suggest you shut you mouth and move on because I will not stop.