View Full Version : Is There a Downside Going To a Hair Transplant Clinic That Uses Travelling Technician

12-01-2008, 05:40 PM
Posted on Bald Truth Talk Hair Transplant Forums What is the downside of going to a clinic that uses traveling techs? I mean if the techs are REALLY skilled wouldn’t they just be spreading their good tech ways across the various hair transplant clinics they work for? - - - - - - - - - - Traveling [...]

More... (http://hairloss.iahrs.org/hair-transplant/travelling-hair-transplant-techs/)

Steven Gabel, MD
12-04-2008, 06:15 AM
I agree completely with Dr. Feller.

It is so important to have technicians who know the business and know the physician. When I perform a hair transplant, my staff and I meet prior to the patient entering the procedure room and discuss the case and the goals of the specific procedure. I also explain the surgical plan in detail and any specific things I want accomplished. Since I have my own staff that works for me day in and day out, they know exactly what I am looking for and the case runs very smoothly.

If I had to work with a random staff that changes daily, I would not be able to maintain the high quality of work that I perform. The staff would not know what I am looking for, and quite frankly, I would not trust any new person that has not worked for me and seen my work and the extremely high-standards I require for all my staff.

There are several organizations that rotate the hair technicians from office to office quite frequently - the staff one week could be in Seattle, the following week in Orlando, then a month later they could be working in Los Angeles. This means that the rotating staff works with all sorts of physicians and does not develop any continuity. In my opinion, this situation is less then optimal. Therefore, it is important for prospective patients to ask the physician about their staff - do they rotate or do they have a permanent staff that works everyday with that physician? These are very important questions to ask.

Steve Gabel, M.D.
Gabel Hair Restoration Center
Portland, Oregon

12-04-2008, 08:48 AM
I do really appreciate this topic being brought up because it is something I never would have actually thought about myself. The argument to NOT use traveling techs is quite compelling. The best example that hit this point home for me was this comment:

"How good would the NY Giants be if they created a team of traveling players who hardly know each other just before each game and never practiced together? It would be a disaster. And so it goes with traveling HT techs." well said.

Definitely should be on everyone's top ten list of things to ask your potential surgeon. Thanks.

Steven Gabel, MD
12-04-2008, 09:11 AM
In fact, taking your sports example one step further, you hear about players being traded from one team to another; it usually takes months for them to all get into rhythm, if not years of playing together. It is quite evident from watching players who are good and have been playing together for years that they have almost an inate sense of where the other is on the court or field. Again, this is a very important aspect of the procedure and should be asked about.

Dr. Feller
01-19-2009, 11:27 AM
My biggest problem with travelling techs is that the doctor doesn't know what kind of person they are subjecting their unwitting patient to.

When a new tech is brought into an established office as a new and permenent hire, the other techs watch and guide the newbie closely and that person knows it.

However, in the travelling tech scenerio, the techs usually ignore one another so as not to tell each other how to do their business. The relationship is usually adversarial and the doctor has absolutely no clue what's going on.

In the travelling tech scenerio, it is usually the TECH who is in charge, NOT the doctor.

the B spot
01-30-2009, 08:10 PM
Dr. Feller, Dr. Gabel--interesting article.

I think for the most part I agree with both of you. I believe that the technician staff is such an integral part of the hair transplantation process that without dedicated staff, even the most gifted doctors will never fullfill his or her full potential.

When asked the question, "Who is more important, the Doctor or the Technician?" I respond with a football analogy: Put Peyton Manning or Tom Brady behind a poor offensive line, and you have a great QB that is going to have a difficult time getting the job done. You simply must have a great team to produce great results day in day out.

I think asking how long individual members of a particular doctors staff have been working there is a question that should be asked more often by patients doing research on a particular clinic.

Great Article!

Take Care,

Dr. Feller
02-21-2009, 08:39 PM
Thank you Jason.

Dr. F

Steven Gabel, MD
02-28-2009, 11:10 AM

I agree.

08-13-2009, 01:22 AM
I just came across this post... Dr. Feller.. it's an interesting article you wrote, but I see some well known doctors on this forum has multiple offices in across the U.S..

It's a good point to bring up, I wonder if those doctors with more than one office can comment... do the tech staff travels with them office to office or do they have the local permanent staff supporting them?

Jeffrey Epstein, MD
08-15-2009, 10:20 PM
Personally Frekey, I feel that I want my own dedicated team of transplant technicians working on my patients. I have a team of 15 full time assistants- some of whom have been with me for 15 years, most for 6 to 7 years. These techs know so much about what I expect and need from them, and similarly I know each of their strong points i.e. 4 of them are dedicated sliverers, 3 each are purely right or left side planters and 2 are ambidextrous, some are better at assisting with FUE procedures, others with eyebrow transplants, etc.
I do have a second office in NYC- and there, I typically travel with 4 of my Miami techs, and have created as well a team of 3 other techs who work with me as well as my associate in NYC, Dr. Yael Halaas. Dr. Halaas is also a board-certified facial plastic surgeon who particularly specializes in treating women and performing FUE procedures, and she shares my NY team as well.

Jeffrey Epstein, MD, FACS
Miami and NYC

08-18-2009, 02:04 AM
I left you a follow up question on your website blog, but never got responded... Do you (Dr. Epstein) perform surgeries in your Scottsdale, AZ office (or only consultations) or only Florida and New York? Do your techs join you in the AZ office?

A little off topic, but you recommended to transplant hair into a scar area. I imagine you would use FUE techiques for small scar 1/4 in wide 6 inches long. But I see you mention your HITs technique of closing scars from strip method that are hard to see. Would these techniques allow for hair to be cut as short as a size 1 clipper setting or smaller?

Last question... since this is a scar repair...is there any preparation waiting period to be had before surgery can start? I don't have any MPB, only scars.

My goal is nearly invisible scar with the ability to cut short hair when ever I want...I haven't been able to ever before.

Sorry for going off topic, but they are sorta related.

Jeffrey Epstein, MD
08-18-2009, 03:27 AM
Happy to answer your questions Frekey on this forum.

With reparative procedures of donor site scars, there are several steps I typically take, in an series of carefully planned steps. Typically, as a first step I will try to perform an actual scar repair - excising the scar then closing it in a plastic surgery fashion that often will include my HITS (a version of the trichophytic) technique. Oftentimes that will result in a partial improvement in the scar, but if it is not sufficient and/or I feel that this type of scar repair is not indicated (i.e. tight scalp), I will go right to FUE grafting into the scar.
Being realistic- you may never be able to cut your hair with a #2 or #1 razor, even with the very best techniques, depending upon what your scar looks like currently, the density and calibre of your hairs, and the color of your scalp. These are all things which can be discussed prior to any surgery after review of photos and/or in-person consultations.
Finally, no special pre-op preparation is necessary to have this procedure.

Jeffrey Epstein, MD, FACS
Miami and NYC

08-18-2009, 10:43 PM
Do you perform surgeries in the Scottsdale AZ office Dr. Epstein? If only consultations...I would still consider going to AZ first instead of Florida or NY.

Jeffrey Epstein, MD
08-19-2009, 04:05 AM
Frekey- Sorry- I only see in-person consults in Miami, Boca Raton, NYC, and Tampa. What many of my out of town patients do is have a live webcam consultation with me- we've been doing these for the past 2 years, and they are quite worthwhile, giving both patient and doctor the opportunity to "meet" in person.

Jeffrey Epstein, MD, FACS

John P. Cole, MD
09-16-2009, 05:13 PM
I think it really depends so much on the physician as to whether traveling techs are a good idea. Some physicians are far more detailed in their approach to a hair transplant or any cosmetic surgery procedure for that matter. Other physicians are less detail oriented.

If the traveling tech is less detail oriented, that tech makes a good fit for the less detailed physician. In this case I think the situation answers the question for you.

In other instances, the tech is very good and through. They want to perform up to the standard of the physician. If the physician is sloppy, the good tech can make that physician better, but they cannot make up for the physicianís lack of attention to detail.

Iíve known some very good traveling techs over the years, who met my standards, which are quite high. For the most part, however, I think they are a bad formula. The traveling tech tends to work with so many different physicians that they can get lazy. They also do not anticipate what the physician needs and intends to perform. Therefore, I think it is always better to have a physician whose staff is local.

At the end of the day, I really boils down to a physician who is dedicated to their work and a staff that is just as dedicated. A permanent staff is always the best situation, but a high quality permanent staff is really what you are after if you are a patient.

Traveling physicians and techs also lead to problems. A traveling tech will eventually burn out especially if the physician demands a high quality of service at all times. Iíve found over the years that the usual burn out time is about 3 years for a traveling tech with a traveling physician. For this reason, I quit traveling between clinics to provide hair restoration surgery some time ago. I prefer to keep my techs fresh and avoid burning them out. It is one thing for me to travel to perform consults, but it is another thing to ask my surgery team to pack up my equipment and travel out of town to provide hair restoration surgery. Of course Iím sure there are exceptions all over the world, but that is my experience.

Jeffrey Epstein, MD
09-17-2009, 05:51 AM
I'm largely of the same thought as John re:techs. Personally I prefer to use the same people who are 100% committed to me and my patients- therefore I have 14 full time technicians who have worked for me exclusively for years. Just this morning, I walked in on my FUE surgery patient asking Karen my assistant how long she has been with me- and it was such a confidence-booster when she replied to the patient "7 years with Dr. E".
I do travel to NYC on a monthly basis- find it to be invigorating and exciting, and the 4 to 5 techs with whom I travel find it that way as well- plus they get paid extra to do so, and love the extra money. Now that I have a full-time NY associate- Dr. Yael Halaas- we have two full-time assistants in her office, so I have been able to assemble a nice team of assistants for both offices.
John put it perfectly- detailed physicians (a gentle way to say compulsive perfectionists) are the most important element in achieving excellent results, and set the stage for top work by the techs that complement the surgeon's work.

Jeffrey Epstein, MD, FACS
Miami and NYC