Does Technician Skill Matter?

[CuriousJungleGeorge]

We constantly hear about how important it is to select a good hair-transplant surgeon, because the incisions he makes in the recipient areas determine how good the transplant will be, and his handling of the donor region predicts how undetectable excision scar will turn out.

 

I wonder, though, how important is it which technicians work on a patient? Unlike with surgeons, patients typically know nothing about the team of technicians that will be working on them (other than whether or not it has been assembled by a competent physician) and tend, then, to have no say whatever in whom they get.

 

Can a mediocre technician produce mediocre results from masterly crafted recipient incisions?

 

Thank you.

[Eman]

I definitely believe that mediocre technicians will create mediocre results.

 

Most technician teams are seasoned and have a head technician (no pun intended!) who oversees the whole process along with the doc. If they see something they don't like or that needs fixing/improvement, it will be taken care of.

 

We need to trust the doc has hired the best and has full faith in them and the head technician. Again, the doc typically comes in often overseeing the implanting and the final approval.

 

Great question!

[Dr. Glenn Charles]

I would be the first to admit that Hair Transplantation is one of the most staff dependent procedures in medicine. You have to remember that these are the people that create the grafts and do most od the placing. That means that they are handling the grafts much more than the doctor. It is critical that they are watched very closely by the doctor and that they also take as much pride in the job as the physician. I value my staff and realize that I would not be where I am today without them.

[hairthere]

I knew what a meticulous doc Feller was and had faith he would only chose the best techs. and i was right. he also has a team of up to 7 of them working during the surgery.

[Mr. GQ]

I knew what a meticulous doc Feller was and had faith he would only chose the best techs. and i was right. he also has a team of up to 7 of them working during the surgery.

i also heard all of them were former miss USA and one of them was miss Universe.

[Bill - Seemiller]

The experience and skill of the technicians is absolutely vital to the success and optimal growth of a hair transplant.

 

It not only takes a delicate hand to carefully trim and place grafts, but to do it quickly and efficiently for hours without fatigue setting in out takes a lot of training and dedication.

 

For more on this topic, see The Unsung Heroes - Medical Technicians and Office Staff.

 

Best wishes,

 

Bill

[CuriousJungleGeorge]

Thanks, guys.

 

But I'm asking, a little more specifically, once the grafts have been created and the incisions made, is there any way a technician (reasonably trained) can "screw up" placing them in? I imagine it's simply a matter of inserting grafts into incisions (not to imply it's easy or fun), and that there's not much way to get it "wrong." Is that correct?

 

If the appearance of growth depended on the hands of technicians (placing grafts) rather than the surgeon's creating incisions on the scalp, and patients had different technicians working on different parts of the head simultaneously, a single result might vary widely from one place of the scalp to another.

[biscuit]

Yes, there is definitely a chance to "screw up" the grafts while placing them. The best clinics have techs with a lot of experience and the facilities to ensure that the grafts are split apart correctly, stored in the right environment, then inserted with the right tools at the right pressure and depth.

[hairthere]

more importantly than placing the grafts is the handling and preparation of the grafts after the strip has been removed.

[PLEASE GROW PLEASE]

I believe 99% of the poor results are do to the techs.

The doctor just cuts the strip out makes the incisions then goes and drinks coffee the rest of the day .

A great clinic will always have great techs.

I flooded my clinics techs with a bunch of chocolate and nuts after my surgery because I realize their importance.

Good question Curious as alot of guys think its all the docs work that produces a great result

[wantego]

I think the techs are extremely important. I think they could easily mean the difference between a good HT and a bad HT. The techs do so much of the actual HT.

[Dr. Alan Feller]

The number one reason for graft growth failure is drying-out.

 

The number two reason is mis-handling.

 

Both of these variables are completely technician dependent so you best make sure your doctor has his OWN staff that he works with daily.

 

If your prospective clinic uses "travelling techs" DO NOT BOOK YOUR SURGERY WITH THEM! The best results most regularly come from clinics that have worked as an exculsive team for YEARS.

 

There are plenty of such clinics out there now so pick wisely. Just ask your prospective doctor how many staff they have and HOW LONG THEY HAVE WORKED IN THAT PARTICULAR PRACTICE.

 

You only have one scalp, use it wisely.

-Dr. F

[thanatopsis_awry]

The magnitude of the techs' importance adds an interesting -- if not dangerous/volatile -- dimension to the HT practice. The doctor can't just have consummate surgical skills, but also a keen eye for running a business w/ regard to finding, training, fostering and managing a team of "employees".

 

I honestly don't know how top clinics are able to confidently assemble the initial team AND how they are able to confidently ensure that their consistent quality keeps up.

[Dr. Alan Feller]

Thana,

It takes effort, patience, and money to put together a top notch HT tech team. Travelling techs are the "corner cutting" solution to that problem in the eyes of MOST "HT clinics". Don't forget that.

 

Travelling techs should be outlawed. There is not enough outrage from the public on this very important but throughly overlooked point. I'm convinced this practice is illegal, or at the very least unethical.

 

As for a properly trained and hired staff, I've paid salaries for months before realizing that a particular tech wasn't up to par and let her go.

 

And it may not always be about technical skill.

 

I let a tech go a few years back who was a GREAT tech. A natural. But her attitude was so bad toward her teammates that even after several private discussions I had to let her go.

 

If the team becomes disrupted it's time to cut out the troublemaker, even if it costs some money and an effort to find a new tech. That's why I believe in OVERSTAFFING.

 

The surgery part is about half of what it takes to run a proper HT clinic. It also takes business skills and employee management skills to make it work and come together.

 

Show me a top notch clinic, and I'll show you a doctor who has mastered those non-surgical skills.

[Reverse the Curse]

Originally posted by PLEASE GROW PLEASE:

I believe 99% of the poor results are do to the techs.

The doctor just cuts the strip out makes the incisions then goes and drinks coffee the rest of the day .

A great clinic will always have great techs.

I flooded my clinics techs with a bunch of chocolate and nuts after my surgery because I realize their importance.

Good question Curious as alot of guys think its all the docs work that produces a great result

 

i agree the techs can make or break a ht. i too bought a nice gift basket for the techs. they busted their ass that day. i even let dr hasson have some although he didn't works as hard. somehow dr wang got some too & he didn't even help

rtc

[lost my swagger]

hahahahaha.

[CuriousJungleGeorge]

Originally posted by Dr. Alan Feller:

Thana,

It takes effort, patience, and money to put together a top notch HT tech team. Travelling techs are the "corner cutting" solution to that problem in the eyes of MOST "HT clinics". Don't forget that.

 

Travelling techs should be outlawed. There is not enough outrage from the public on this very important but throughly overlooked point. I'm convinced this practice is illegal, or at the very least unethical.

 

As for a properly trained and hired staff, I've paid salaries for months before realizing that a particular tech wasn't up to par and let her go.

 

And it may not always be about technical skill.

 

I let a tech go a few years back who was a GREAT tech. A natural. But her attitude was so bad toward her teammates that even after several private discussions I had to let her go.

 

If the team becomes disrupted it's time to cut out the troublemaker, even if it costs some money and an effort to find a new tech. That's why I believe in OVERSTAFFING.

 

The surgery part is about half of what it takes to run a proper HT clinic. It also takes business skills and employee management skills to make it work and come together.

 

Show me a top notch clinic, and I'll show you a doctor who has mastered those non-surgical skills.

 

Dr. Feller, but, does "technician style" matter? That is, two very good transplant surgeons might do excellent work but have different styles that lead to good-but-different results in a patient. Is this correct? Likewise, is it likely that two good technicians -- say, one working on the left side of a patient's head, the other, simultaneously, on the right -- produce two different-looking sides of the scalp from the same session?

 

Thank you.

[Dr. Alan Feller]

No, in the end each side should look the same IF the techs were competent to cut the grafts and place the grafts PROPERLY.

 

I don't think you are getting it though. Not all techs are the same with the exception of different "styles". That's the big mistake almost everyone who doesn't read these forums make.

 

Both sides may "look the same" but one side may only have 50% yield due to mishandling or drying out. You do not want to be the person who finds that out AFTER your surgery, which is why you should only stick with clnics with PROVEN CONSISTENT track records.

 

MOST HT TECHS SHOULD NOT BE PERFORMING THIS PROCEDURE. Unbelievably, however, most doctors who hire them are clueless about proper HT surgery and couldn't cut or place a graft to save their lives. This means the TECH is running the surgery, not the doctor, and the poor unsuspecting patient would never know about it. That is unless they read these forums to find out about this dirty little secret that must be exposed and stopped.

[CuriousJungleGeorge]

Thank you.

[Reverse the Curse]

dr feller

do you know of any doctors that use these techs for hire? i'm sure theforum would like to know who's doing this.

rtc

[Dr. Mohammad Humayun Mohma]

Dear Friends

 

If I se a surgery I know all about the clinic.

 

The function of the doctor as oppose to what people believe is most important.

 

1) The quality of the scar depends on the doctor so a poor scar means not necessary a poor doctor but he is responsible for that scar, atleast he did not had a good evalution of the donor area.

2) The selection of donor area depends on the experience of the doctor.

3) The natural looks and the design of the receipient area or hair line is dependent on the Doctor.

 

The Tech are responsible only for hair growth, so in my openion there are so many occasion when you would see un-natural results but wonderful growth, this means a good tech but a non trained or less experienced surgeon. bad growth of hair means bad handling and hence poor techs quality.

Having said all this as Doctor is the team leader he is directly responsible for every thing. The bug should stop with him.

[CuriousJungleGeorge]

I should hope, at least, no coalition physician works with "traveling techs.," then.

[Dr. Mohammad Humayun Mohma]

The phenomenon of travelling tech is mainly in USA.

I have not heard of this in Pakistan.

It is cheaer for Doctors to hire such Tech as they dont do enough cases per month to make it viable to hire tech for full time. so they pay these techs on as and when required basis.

 

Its all about economics

[Janna]

I don't believe hiring of traveling techs are prevalent mainly in the USA. I know few doctors in Europe who use them for "economic" purposes. And since many countries are close in proximity, it's easier and cheaper for some European countries to share techs. However, we do get resumes from time to time from techs who will work per diem. Having worked at ONE clinic my entire HT career, I have never been a traveling technician but they are, imo, getting a bad rap here. You either have the skills or you don't. The important aspect is that the doctors doing the employing of permanent staff or traveling staff recognize the skills and utilizes them appropriately. If you are a skilled technician whose dependable, trustworthy with a good attitude, I personally dont see why being a traveling tech is thought of as a bad word. I can't speak for all traveling techs but from my experience of talking to some of them, they perfer the per diem so they can work when they want and they simply like traveling. Some of them have worked for a long time between two or three different doctors so they have become accustomed to each clinic's protocols. I've worked with four other doctors at our clinic (without traveling) so I don't see much of a difference for another tech who travels and works for 2,3, or even 4 other doctors. A clinic who performs 2 or 3 ht surgeries a week can't employ full time techs or a doctor who's starting out has to employ 2 or 3 experienced techs to cut and plant while their permanent staff are being trained. We've always strived to be overly staffed so we don't have to incur the expense of covering travel expenses AND paying their daily wage.

 

Of course employing 12 technicians with 10 FT is a big expense but there are few reasons to be on the cautious side rather than be caught off guard by being short handed. We have 10 FT techs and 2 PT techs, 1/2 dozen of us have been employed at SMG for 7-13 years. Dr. Shapiro has felt more technicians to share the meticulous work the better for patients. We are all trained on the microscopes to sliver and create the trimmed grafts. Loopes are also required for planting. Our protocol is such that a senior technician and doctor carefully scrutinize the recipient sites to make sure the incisions are filled properly for each and every case. We have a long and thorough training protocol.

[Cam Simmons MD ABHRS]

Originally posted by Dr. Glenn M. Charles:

I would be the first to admit that Hair Transplantation is one of the most staff dependent procedures in medicine. You have to remember that these are the people that create the grafts and do most od the placing. That means that they are handling the grafts much more than the doctor. It is critical that they are watched very closely by the doctor and that they also take as much pride in the job as the physician. I value my staff and realize that I would not be where I am today without them.

 

I would like to echo Dr. Charles' opinion.

 

Hair transplantation is a team sport. The doctor is the quarterback, coach, and general manager but you can't win championships without great players.

 

When hiring and training a technician, you need someone who has manual dexterity, people skills to make patients and staff comfortable, but mostly you need someone who is dedicated to being the best at what they do.

 

There are many steps in every hair transplant and the results are only as good as the results of the poorest step. High quality work from Doctors, Sliverers, Graft-cutters, and Planters is essential for consistent high quality results.

 

Ultimately the doctor is responsible for everything. It is up to him or her to make sure that he has got the right people on the bus, the right people in the right seats, and the wrong people off the bus (as per Jim Collins in "Good to Great".)It is also up to the doctor to supervise every step of the procedure. I have staff that are self-motivated and reliable so I can trust them to do what they do best. Supervising them involves spot-checking each step throughout the day and fine-tuning the plan as we go. If I had to look over every staff member's shoulder every minute of every day that would mean I put the wrong people on the bus in the first place.

 

Great doctors only keep great technicians on their team and great technicians only want to work for great doctors. I am blessed with a fantastic staff, who are highly skilled and always do their best work ... and I should tell them this more often!