Physician On-boarding/Removal Criteria

[Melvin- Admin]

Dear Community,

Our process of adding a surgeon has always been a collective effort. We have asked for input from our Community before deciding to add a physician. However, this process hasn't been perfect. One of the criticisms we have received is that any anonymous user can vote, and they may or may not be qualified to decipher whether a surgeon is worthy of our recommendation. 

This is a valid criticism we have received. I have thought about this and agree the process could be better. As a result, we have come up with what we feel is a good solution. Rather than rely on the entire Community, which can consist of new or inexperienced users. We have carefully selected our most senior members with the most knowledge and are already trusted by our Community to collectively judge a physician's work. In addition, we will continue to seek counsel from our physicians who are already recommended. These members will be unpaid, so there is no conflict of interest or biases. But they are people we can point to and show the amount of experience and knowledge they have acquired through their years of being members. 

We have also received criticisms that removing a surgeon is a lengthy process that isn't done proactively. This board of members will help decide whether a surgeon warrants removal from our Community. I want to stress that both of these criticisms are valid. It is our job to make this process better for the good of our Community. 

Furthermore, we have put all the emphasis on accepting physicians who already have a reputation on the forum. However, if we want to be the best scouts of surgeons, we cannot rely on already famous physicians. There are a lot of top-notch physicians who are doing quality work that are unknown to our forum. A talent scout that only scouts known talent can hardly call themselves a talent scout. As such, we need to include criteria for reviewing unknown surgeons, with the caveat that their recommendation will be tentative and conditional. 

I have spoken to some of our members of the consul @A_4_Archan and @Gatsby, who are both very well-versed in hair restoration surgery. Here's what we have come up with as criteria:

Experience: The surgeon must have performed at least 1,000 surgeries with a consistently high patient satisfaction/track record and portfolio. Physicians may not always be known on this forum, but we will respect and accept other forum reviews or review a surgeon's portfolio independently.

Surgical involvement: The surgeon must be involved in every procedure, from the consultation and design to the procedure itself. We understand some surgeons delegate certain aspects of the procedure. For example, technicians may extract the grafts or implant the grafts. The surgeon must be involved in one of the three-part aspects of surgery (extraction, sites, implantation). The surgeon must create the recipient sites. The surgeon must only perform 1-2 surgeries per day. We will not count surgeries performed in the same clinic by other doctors as part of those surgeries.

Ethics and Integrity: One of the most critical aspects and one which we should hold surgeons accountable for is their ethics and integrity. Surgeons can be talented and skilled, but if they don't have ethics or integrity, they do not belong on our list. Surgeons must be willing to accept criticism publicly. They must also be willing to work with the patient if unsatisfied. No money-back guarantees exist, so we cannot expect a surgeon to offer refunds. However, we expect surgeons to fix any issues that may have occurred free of charge. For example, if there is a lack of density. We expect surgeons to fix this issue free of charge. If patients receive a strip and their scar has stretched. We expect surgeons to do a free scar revision. The most important question for a surgeon is, "What will you do if I'm not satisfied?" This solution should be in writing. We cannot expect a surgeon to pay for a patient's procedure if the patient decides to go elsewhere.

There are a handful of surgeons I know are top-notch, but they're unknown on our forum. Part of learning more about these physicians is doing an interactive podcast with them so that we can ask them these complex questions. In addition, I think asking them to perform surgery live and broadcast it on the forum is critical. They can go live on Instagram and show us their process and involvement. It's easy to spot talent and skill by seeing a surgeon perform surgery and seeing their graft placement, extraction pattern, etc. This will be reviewed independently by our board. 

In addition, all of our board members will be clearly shown on our site with a brief description of their experience and knowledge. We want the process to be transparent. It should be stressed that none of our board members will receive any compensation.  

Ideally, I would like to go back to visiting clinics in person and filming surgeries in person. However, this can be done virtually through these live sessions instead of me going in person. The benefit is that our unbiased board members can review it and form their own judgment separate from me.

Removal Criteria

Any physician who stops meeting our criteria will be reviewed independently by our consul. In the past, we have relied on the reviews posted on this forum to make this decision. This has been viewed as reactive and not proactive, which is fair. But a similar process can be done for the removal. The board can examine a doctor's work independently instead of a patient review and collectively determine whether a physician should no longer be recommended. I firmly believe we need to be tactful. If a physician is ethical and has been doing their best but no longer meets our criteria despite their best efforts. I do not believe we should remove them publicly or try to harm their reputation publicly. If a surgeon is unethical or behaves unethically, we can inform the Community that they have been removed due to questionable results/ethics. 

Thank you all who have given us your constructive criticisms and held us to the fire for the betterment of our Community. 

Onwards and Upwards,

[Hairwolf]

Surgical  involvement: The surgeon must be involved in every procedure, from the consultation and design to the procedure itself. We understand some surgeons delegate certain aspects of the procedure. For example, technicians may extract the grafts or implant the grafts. The surgeon must be involved in one of those aspects of surgery

@Melvin- Admin so that means that certain Drs on the recommended list will be automatically removed as they do not fit the above criteria? 

[Chrisno]

"For example, technicians may extract the grafts or implant the grafts. The surgeon must be involved in one of those aspects of surgery."

This criteria doesn't make sense to me.

Does it mean that a recommended surgeon must either extract or implement grafts to be on the recommended list? So surgeons who use highly experienced technicians for graft extraction and implantation, but "only" do the most crucial part of the procedure, i.e., the recipient sites / slits, need to be removed from the list?

[Melvin- Admin]

Allow me to clarify, they must be involved in at least one aspect of three-part process. Extracting, Creating sites, Implanting. 

[Chrisno]

1 hour ago, Melvin- Admin said:

Allow me to clarify, they must be involved in at least one aspect of three-part process. Extracting, Creating sites, Implanting. 

Would it be possible to tighten the definition further, saying that surgeons must do the recipient site creation? I think we would have a hard time recommending a surgeon who does extractions and/or implanting but not recipient sites.

[Melvin- Admin]

4 hours ago, Chrisno said:

Would it be possible to tighten the definition further, saying that surgeons must do the recipient site creation? I think we would have a hard time recommending a surgeon who does extractions and/or implanting but not recipient sites.

Good suggestion, absolutely.

[laverita]

Yes, I would say doctors should punch every graft and cut every recipient site..so they are piercing the skin. The techs remove the already scored grafts, clean as needed, and place into the sites the doctor makes.