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transplantedphil

FORUM PROPOSAL: Reforming the HT industry

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For those new to researching getting a hair transplant it might come as a surprise, but it is an industry ultimately founded on reputation and not regulation

Any type of universal regulation is impossible to enforce (let alone suggest) because different countries have different laws regarding medical procedures, and clinics themselves even in the same country operate under different conditions … that is even if those clinics even decide to abide by their countries’ laws in the first place. Memberships to certain bodies in the hair transplant community are seemingly more honorific than anything, with no guarantee that even an award winning doctor will behave ethically or in your best interests once you’re under the knife. 

Your choice to get a hair transplant then relies mostly on an understanding of a clinic’s reputation and what is negotiated or agreed upon before surgery, which is problematic in itself because the choices you make with your body and your wallet ultimately come down to how well you decipher an industry built on marketing, patient privacy, and overcoming a general negative stigma attached to male vanity. Any concrete knowledge of the hair transplant industry is seemingly passed along from patient to patient anonymously on forums like these, but as to concrete understanding of their general veracity there are no guarantees of anything.

Consequently, if you’ve suffered the misfortune of enduring a bad result, your only real option is to merely register a negative review online so as to warn others. While conversely theres is no real way for patients to formally honour or praise those doctors who go above and beyond and demonstrate genuine concern and interest in the welfare of their patients, given most patients likely prefer their privacy and simply go on with their lives happy with their good result. 

So my proposal is this - this forum can carve out a niche in the industry by offering prospective patients a “safe space” where basic patient rights are guaranteed and certain doctors who behave ethically and publicly recognised; “A COALITION OF THE ETHICAL” if you will. Doctors would agree to behave (or rather continue behaving) ethically towards their patients and will be recognised and recommended here, while patients who have just started researching the industry would know this is the forum to be on to find quality and ethical doctors. 

While a doctor can never guarantee a good result (nor should they ever), basic things are obvious;

  • refusal to operate on a bad candidate for surgery
  • managing expectations 
  • no bait and switch tactics 
  • no charging for extra grafts taken during surgery
  • protecting a patients privacy and not releasing their image online
  • no false advertising/ fake lighting

This list is by no means exhaustive, merely demonstrative, but if there was a way to make this industry easier to navigate and match patients with the best possible doctors resulting in the best possible outomes, well that means its good news for everyone involved. So I write this in the hopes it will at least prompt a discussion, or cause others to provide similar suggestions of how we can ALL make this industry safer. 

Thoughts?

 

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The general idea is good, but I think most of it is basically what the recommended and coalition Drs on this site are supposed to be following already, at least to some degree. The problem with most of your items is they are either too hard to always follow or they may hurt some patients more than help, and how do you regulate it. I'll go through each of your points so you see what I mean.

- refusal to operate on a bad candidate for surgery - What is a bad candidate for surgery? Some clinics take on tough cases that most others will not. Think of Dr Umar taking on severe repair patients or other Drs who utilize body grafts to get thousands of additional grafts on NW 6 and NW 7 patients that Drs who don't do body grafts would turn down. What about patients who understand that they will only get a small amount of work done, but feel that is OK. This happens a lot with older men who just want a bit of hair to look good for their age and don't need a low hairline with thick hair all over.

 

- Managing expectations - This is just too vague. There are a lot of times when the Dr is the one who convinces a patient to expect more and wants to lower the hairline more than the patient wanted. Expectations go both ways. Also, a high percentage of patients end up going for more work than was orignally quoted by the Dr. Is this because the patient expected more or because the Dr was telling them it will be better than it would be in order to get the patient to go ahead with the surgery or is it just some further hair loss happening, or simply not a great yield.

 

-no bait and switch tactics - So you go in wanting FUT and the Dr suggests you get FUE due to only needing 1000 grafts for a small session. Is he trying to get you to do a more costly procedure or is he trying to help you not have a strip scar? What about the other way around? You go in wanting FUE and the Dr suggests FUT because you have a large area to cover.

 

-no charging for extra grafts taken during surgery - Different places have different pricing policies. What exactly are extra grafts? Where I went they give you a range that they think they they can get and ask you if you want more than that if they can get more. Of course you have to pay for them. They charge you first what they think is the minimum they can get and then after the surgery is done if they got more they charge you for the rest. But that is agreed ahead of time. You can limit the number before the surgery if you have a certain budget.

 

- protecting a patients privacy and not releasing their image online - OK. I agree on this one unless the patient allows it.

 

-no false advertising/ fake lighting - Lighting is hard to always get the same when you are talking about photos 6 months to a year or more apart. I agree they should always do their best to have the same lighting, but it's not always possible. What if you change light bulbs especially if you go from standard to LED which gives a different color, what if you move to a totally different/new facility. You're going to have different lighting for the next year in those cases. Even a cloudy or rainy day can give a different lighting in the room if it was sunny on the day of the original picture.

 

I'm not trying to put you down or anything. I agree that there needs to be more regulation somehow. I just think it's a lot harder to do that some may think. What I really wish would happen is the better known clinics would start actually pointing out some of the bad ones. For example when they do a repair we should be able to know where the patient originally went to. That would be the best way to find out who dos bad work.

 

Edited by BeHappy
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@transplantedphil Some great points

@BeHappy Some great points

This is exactly why it can prove difficult. 

1 hour ago, BeHappy said:

I'm not trying to put you down or anything. I agree that there needs to be more regulation somehow. I just think it's a lot harder to do that some may think. What I really wish would happen is the better known clinics would start actually pointing out some of the bad ones. For example when they do a repair we should be able to know where the patient originally went to. That would be the best way to find out who dos bad work.

I would imagine that this would provoke some law suits and undermining tactics between clinics which could prove to be harmful/disadvantageous to the reporting (respected)clinic. So therefore would it be in their best interests? 

But despite all of this information being out there, many individuals still choose a clinic such as the majority of Turkish models, with many unknowns purely motivated on price. 


Patient Advisor for BHR Clinic Athens - Greece

ian@drchristianbisanga.com  -  WhatsApp - + 34 642 37 03 83

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

My Hair Loss Website - Hair Transplant with Dr. Rahal

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Not offended at all @BeHappy, and given your experience in the industry as a patient was actually hoping you’d reply. 

I think you hit the nail on the head that it is a lot harder than we can imagine - how do you regulate a worldwide industry where each patient is different and might have fundamentally different goals and expectations regarding surgery? I honestly have no clue but I think it’s worth a discussion. 

Regarding my list it was mostly reactive to things I see on the forums, however if it is at all possible to regulate anything in this industry then i really wish we could formalise things properly; 

Refusal to operate - I based if off this case https://www.hairrestorationnetwork.com/topic/55281-thank-you-kaan-pekiner-doctor/?tab=comments#comment-522260 although the patient never came back to clarify why he wasnt a candidate (it seems his donor wasn't that great). DUPA patients do not seem to be viable candidates either. Difficult cases would seem to be the exception to the rule whereas i wrote this thread with the goal of trying to help those just beginning their HT journey

Managing expectations - this was related to what I see as a common theme when patients dont achieve a perfect result 

Bait and switch - I meant this related to patients knowing in advance who is operating on them

Charging for extra grafts - something that happened to me where the agreed upon graft was exceeded during surgery and I only found out the next day I was expected to pay for everything

Lighting I half agree, but there are seemingly a lot of docs that are constantly moving or “experimenting” with their photography. As there is no real way to regulate this why not just have each clinic simply list the equipment used in how they showcase their results? That seems fair to me.  

I agree with @Raphael84 that the suggestions for good clinics to report bad ones is far too adversial in nature, whereas I was trying to brainstorm ideas where patients are ideally guaranteed certain rights and doctors are equally praised for upholding them. I think the main issue always comes down to one of transparency in that patients never fully know what goes on at a particular clinic so we can never know how to properly judge them (the clinics that make you sign NDA's scare me the most). 

Another suggestion I had is to give out a patient-based award honouring those doctors that behave ethically.

I guess I started this thread in the hopes that people might have ideas of what they would want to change about this industry in order to make things more fair and easier for patients to navigate. So the real question becomes is the current state of affairs the best we can really do?

 

Edited by transplantedphil

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Guys, 

This is some great dialogue. It is a very difficult thing to regulate this industry, but as a community if we work together we can definitely improve the industry. I have a vision to make this community the ultimate place for new patients, repair patients and anyone looking to get no non-sense information regarding hair transplant surgery, and hair loss. 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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Guys,

A couple of things...first, the industry is a cosmetic one, meaning, the results of each patient is ambiguous with no real meaningful way of forecasting the end result...it is indeed subjective and IMHO, the industry (doctors, consultants, and staff) need to do a better job of informing patients of the risks or things outside of their control such as the individual's healing, limitations, and overall physiological make-up.  Also, not enough clinics do a good thorough job of getting complete medical history of each and every patient.

Second, results are going to vary between individuals and that's what makes it hard for a dissatisfied patient to bring litigation.  Where is the base point of comparison in order for a fair juris prudence outcome for both parties?  I mean too many times the patient's expectations are unreasonable and too many surgeons are willing to look the other way, knowing the expectation is unrealistic yet they don't want to lose the individual's business so they proceed regardless.

In addition, each medical board is complied of guess what?...other doctors.  So the objectivity is rarely there unless the infraction is so obvious or criminal.

The chances of the industry being regulated is not good.  Again this is a form of medicine that is elective, cosmetic, and very difficult to prove fault unless it is gross negligence or criminal.

It seems that the legal community is of the opinion that if the procedure is "elective" and the outcome was not what the patient wanted, they should have known better,  and the burden falls on the patient, not the clinic.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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18 hours ago, gillenator said:

Guys,

A couple of things...first, the industry is a cosmetic one, meaning, the results of each patient is ambiguous with no real meaningful way of forecasting the end result...it is indeed subjective and IMHO, the industry (doctors, consultants, and staff) need to do a better job of informing patients of the risks or things outside of their control such as the individual's healing, limitations, and overall physiological make-up.  Also, not enough clinics do a good thorough job of getting complete medical history of each and every patient.

Second, results are going to vary between individuals and that's what makes it hard for a dissatisfied patient to bring litigation.  Where is the base point of comparison in order for a fair juris prudence outcome for both parties?  I mean too many times the patient's expectations are unreasonable and too many surgeons are willing to look the other way, knowing the expectation is unrealistic yet they don't want to lose the individual's business so they proceed regardless.

In addition, each medical board is complied of guess what?...other doctors.  So the objectivity is rarely there unless the infraction is so obvious or criminal.

The chances of the industry being regulated is not good.  Again this is a form of medicine that is elective, cosmetic, and very difficult to prove fault unless it is gross negligence or criminal.

It seems that the legal community is of the opinion that if the procedure is "elective" and the outcome was not what the patient wanted, they should have known better,  and the burden falls on the patient, not the clinic.

Now if you could just put this post up as some sort of disclosure clause to any prospective patient we would all be a lot better off. I think a lot of patients (myself included) hear the word "doctor", see the results, go by a clinic's reputation and for better or worse have certain expectations. 

Regulation will always be out of reach so I will always be left wondering wouldn't it be better if there was a way we could formally recognise and distinguish those doctors that behave ethically from the rest. Medical boards are compiled of doctors and doctors give each other the awards, and yet patients are the ones that have to live with the results, so why don't we have a patient led awards system in place? Has anyone ever thought to create one? Or why not use this forum and have a special section of doctors publicly willing to sign a code of ethics statement guaranteeing to uphold the integrity of their patients; such a public statement could then be used as a selling point to patients while doctors get more business in return.

There are some doctors that go so far above and beyond for their patients they are amazing, seems a shame to not honour them. Just an idea ...

 

 

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Regulation is needed.  Many patients are not fully informed By the doctor.  Some are told promises and claims that are not proven.  They are shown results which are not typical.  You can keep going.  


Surgery may be elective surgery but it is surgery and cosmetic which affects a persons face.  If there is a screw up, not only the most visible part of your body your face is affected, but pain from scarring can be an issue and necrosis can be an issue fir some, aside from that the emotional trauma caused can be severe if there is a screwed up situation.  
 

The more you write to the med board for each state you reside in, the more they become aware of the impact this surgery can have.  Along the process, You may learn a lot of people in power and decision makers in your state may be passionate and completely understand your situation.  
 

if they can regulate med spas and massage parlours and tattoo studios, they can sure as hell regulate hair restoration practices.

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Something just occurred to me....Do you truly think everyone in the industry wants regulation?  The ISHRS and other organizations tied into the hair restoration industry are  probably making tons of money....Not only from the doctors that know what they're doing - but also from those that don't.  If regulation ever came to be, it would filter a lot of the riff-raff and there go thousands of dollars.

It's always about the money.....

 

 

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25 minutes ago, LaserCap said:

Something just occurred to me....Do you truly think everyone in the industry wants regulation?  The ISHRS and other organizations tied into the hair restoration industry are  probably making tons of money....Not only from the doctors that know what they're doing - but also from those that don't.  If regulation ever came to be, it would filter a lot of the riff-raff and there go thousands of dollars.

It's always about the money.....

Of course they don't ... theres a reason why "competency" is considered high praise in this industry. Any regulation or reform will only come from the patients themselves, but generally speaking once their results come in (besides repair patients who are stuck living in a particular situation) they mostly move on with their lives. So the docs themsleves arent motivated, and the patients (being anonymous and sometimes once off consumers), arent incentivised enough to stick about long term.

@Sean is right about tattoo studios etc in particular countries. I never thought about that. 

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On 11/2/2019 at 6:41 PM, transplantedphil said:

Bait and switch - I meant this related to patients knowing in advance who is operating on them

Oh yes! I totally agree with that. I don't know why I didn't think of it that way when I first read it. That happened to me years ago and it was their standard game plan. One Dr did the consultation and then when you go for the procedure, the Dr who did the consultation is there and tells you this other Dr is going to do the operation because he is actually better at it than I am and you're really lucky because he happens to be free today and we want to give you the best outcome. Who is going to say no to that? If you say no and you want the original Dr to do the work and it doesn't turn out well they blame it on you because you didn't want the Dr who they said would do a better job work on you. If you say OK and let Dr #2 work on you and it doesn't turn out well then Dr #2 tells you that he is not the one who did the consultation, so you need to talk to Dr #1 if you think he promised you something that can't be done. Yep. I went through that run around.

 

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7 hours ago, BeHappy said:

Oh yes! I totally agree with that. I don't know why I didn't think of it that way when I first read it. That happened to me years ago and it was their standard game plan. One Dr did the consultation and then when you go for the procedure, the Dr who did the consultation is there and tells you this other Dr is going to do the operation because he is actually better at it than I am and you're really lucky because he happens to be free today and we want to give you the best outcome. Who is going to say no to that? If you say no and you want the original Dr to do the work and it doesn't turn out well they blame it on you because you didn't want the Dr who they said would do a better job work on you. If you say OK and let Dr #2 work on you and it doesn't turn out well then Dr #2 tells you that he is not the one who did the consultation, so you need to talk to Dr #1 if you think he promised you something that can't be done. Yep. I went through that run around.

 

I found out 45 minutes into my operation that the doc i consulted with was not the one that was actually going to be operating on me. I simply assumed the person with me was a nurse doing the injections and couldnt figure out why it was taking so long. I eventually asked "who are you?" and only then got told that they were another doctor in the clinic. If i had known from the start who would be operating on me i would have simply walked out. 

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On ‎11‎/‎6‎/‎2019 at 10:11 AM, transplantedphil said:

Now if you could just put this post up as some sort of disclosure clause to any prospective patient we would all be a lot better off. I think a lot of patients (myself included) hear the word "doctor", see the results, go by a clinic's reputation and for better or worse have certain expectations. 

Regulation will always be out of reach so I will always be left wondering wouldn't it be better if there was a way we could formally recognise and distinguish those doctors that behave ethically from the rest. Medical boards are compiled of doctors and doctors give each other the awards, and yet patients are the ones that have to live with the results, so why don't we have a patient led awards system in place? Has anyone ever thought to create one? Or why not use this forum and have a special section of doctors publicly willing to sign a code of ethics statement guaranteeing to uphold the integrity of their patients; such a public statement could then be used as a selling point to patients while doctors get more business in return.

There are some doctors that go so far above and beyond for their patients they are amazing, seems a shame to not honour them. Just an idea ...

 

I think that's a great idea!...Have you discussed this with Melvin or Bill?

 

 


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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Believe me guys I take all of these considerations to heart, of course as previously mentioned, our task won't be easy. But we have a responsibility to hold our community to the highest of standards.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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I anxiously await to see what may come of this!

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Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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