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What happens with "extras" at the end of the day?


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  • Senior Member

One of the most recent posts dealt with this issue and I feel it merits discussing for the sake of all patients......

This can be taken a number of ways, so it is up to you to choose the road......

We are dealing with human interaction....and there is no "hairometer."  Yes, there are instruments out there that help, but - as everyone knows - there are no "exacts" in science.  Thus, it is likely, at the end of the day, there will be extra grafts harvested, or the count is short.  If short, no issues, you just pay for what you get.  But, was there a discussion during the consultation if this does happen?  Discussing goals and priorities is important. 

But, what if there are a lot more grafts?  Will they be on the house or do you have to pay for them?  And, where will they be placed? 

There are clinics out there that will just place the grafts and charge nothing.  I applaud them.  Grafts are like gold and should be treated as such.  Where to place them?  If not discussed with the patient during the consultation at the beginning of the day, it is the responsibility of the Doctor, (or at least I feel it is),  to decide where they'll benefit the patient the most.  At the end of the day how exciting and humbling it is for patients to hear....."the doctor gave you $2000 worth of free work."  Just created lots of intrinsic value and good will when phrased this way.....Some will say, you got 300 extra grafts.  Can you equate this to value?  I think people understand money.  What do you think?

Once the procedure starts, and the patient is under local....How can you go to the patient and tell him that he'll be charged for extra grafts?  This may be even against the law.......It would be nice to find out........And yet it happens all the time.  If you are planning on charging for everything that's harvested, discuss it with the patient beforehand.  You could even seem helpful by , perhaps, charging a lesser amount for extra grafts.  

Opinions?

 

 

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  • Regular Member

We need to keep in mind that the patient is a vulnerable state, and should not be asked to make decisions once the procedure has begun. On the morning of the procedure I explain that if we are short grafts, then the patient is refunded the difference, and we have extra grafts, they are placed without charge.

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2 hours ago, Michael Vories, MD said:

We need to keep in mind that the patient is a vulnerable state, and should not be asked to make decisions once the procedure has begun. On the morning of the procedure I explain that if we are short grafts, then the patient is refunded the difference, and we have extra grafts, they are placed without charge.

Awesome! And, thinking out loud, a "positive" remains when you consider - more grafts- more density.  

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25 minutes ago, transplantedphil said:

I somewhat disagree but only on a technicality ... the placement of a graft can be more important than an arbitrary number of grafts. There is an art to this industry after all :) 

With everything being equal.....and we are talking about experienced, talented surgeons....You have 1 graft and you place it "perfectly" in the forelock area.....That's more important than placing 100 grafts in the same area?  Explain.

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3 hours ago, LaserCap said:

With everything being equal.....and we are talking about experienced, talented surgeons....You have 1 graft and you place it "perfectly" in the forelock area.....That's more important than placing 100 grafts in the same area?  Explain.

 

What he is saying is if you end up with a few hundred extra grafts it makes more sense to place them in areas that will create a noticeable cosmetic difference rather than just placing them anywhere simply because we have some extras. I agree with him on that.

 

Al

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I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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I don't think this is decided on the day of the procedure.  An established practice has discussed this ad nauseam.  "Don't have the time?"  They better make time!  If they don't, why schedule so many in one day?  This business is getting very competitive in a number of levels.  

Not being up front....I have a huge issue with that.  Everyone, not only doctors, need to be honest, ethical and up front.  At the end of the day it's the only thing we have.  

Have you ever heard "what a web we weave when we try to deceive?"

You are representing yourself and the company you work for.....

 

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If you're short at the end of the day, the right thing to do is to only pay for what you get.  Most, if not all clinics, will ask for money up front.  This is understandable when you consider the patient is under local once the procedure starts. So the right thing to do, clinic wise, is to give the money back for grafts not transplanted.

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I got a contract from the clinic month before surgery which says

a) If I need more grafts than initially considered, they cost x/€ per graft (approx. 2/3 or 1/2 of the standard price)

b) If I need less my money get refunded

Fun fact:

- I required almost 150 FU more than planned (which for me was almost 40 % more!) and I never had to pay it. 

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23 hours ago, Gasthoerer said:

I got a contract from the clinic month before surgery which says

a) If I need more grafts than initially considered, they cost x/€ per graft (approx. 2/3 or 1/2 of the standard price)

b) If I need less my money get refunded

Fun fact:

- I required almost 150 FU more than planned (which for me was almost 40 % more!) and I never had to pay it. 

Wow....

It's NOT.......that you will need more grafts....If that was the case, why not incorporate it into the plan before the procedure starts? This is, of course, conveniently written that way to camouflage the reality....more grafts were harvested inadvertently.  Moreover, and on the other side of the coin, if less, it's not that you need less. it's the fact that it is all they were able to harvest.

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3 minutes ago, LaserCap said:

If that was the case, why not incorporate it into the plan before the procedure starts?

Cause HT is not an excact science.

Sometimes in real life (if only online consultation before) or after shaving (if F2F consullation before) it looks different than thought. Or your loss was not stabelized (and consultation was several month before). Or  ratio of singles/multies was different than expected. Also, hairline fine tuning before procedures adds a lot of uncertainity in both directions (more/less grafts required).  

Summary: No one can give the exact # of grafts for an optimal result before. Nothing shady in that. Not everyone is  case like Phil.

7 minutes ago, LaserCap said:

 Moreover, and on the other side of the coin, if less, it's not that you need less. it's the fact that it is all they were able to harvest.

Only for a very small # cases this is the reasons. Much more often the prediction just did not match the final outcome. Another example: You started with FIN and reacted better than expected.

 

10 minutes ago, LaserCap said:

 This is, of course, conveniently written that way to camouflage the reality....more grafts were harvested inadvertently. 

Sorry, that is nonsense. See all reasons above.

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