Opinions on the following clinics.......

[Ken Anderson, MD, FISHRS, ABHRS]

"And I'd love for someone to explain to me how someone having their name on the front door of the business, so to speak, makes such a difference that they won't run the forums for nine months screaming about how pissed they are because of the work they received."

Thank you Joe for this opportunity to address this issue. I think having your name on the door makes a huge difference for the patient experience, and the end results. As the physician and surgeon, your name and reputation are on the door and on the line. It's not just symbolic. Whereas Dr. XYZ working at some generic place like "Hair Clinic" doesn't really have to think about his name being out there so much, because it's not.

I worked at a place with a generic name for about 4 years from 2005-2008. I thought for sure patients would remember who I was and who did their surgery. I was certain that after a couple of years they would call me up if they needed more hair restoration work done. But they never called. Patients remembered the generic name, and when asked who did their surgery, they simply didn't remember who did it. I saw some of those patients years later after they found me in Atlanta, and they talked about going back to the place with a generic name and being told that the "new guy is even better than the old guy," and then being sold another hair restoration procedure. Many of these patients are unhappy about the results of their second procedure with some other doctor, and are very unhappy with the owner of that generic-named practice who sold them on a second procedure with a new doctor they had no experience with.

I find that the patients that I see enjoy the fact that my name is on the door, and is the name of the practice. They know exactly who is going to be performing their hair restoration; removes some of the ambiguity from the experience.

In terms of ensuring good results, it also helps assure patients that they are getting what they pay for. As we all know, particularly with FUE devices, unfortunately this specialty has a problem with non-doctors performing surgery in this country, to the point where the ISHRS came out with a Consumer Alert for patients about this very subject. Nearly every week another plastic surgeon is jumping into the hair restoration field by merely acquiring a device. There's a brand new practice here in Atlanta, 3 blocks from my office. Doctors who normally perform breast enhancements and Brazilian butt lifts sent out a press release this week, are this very day holding themselves out to the world as hair restoration surgery experts, despite the fact that they have never once performed a hair restoration procedure. Right on their website it states that the board certified plastic surgeon will be "supervising" the hair restoration surgery; guess who's doing the actual surgery over at that office? You guessed it: technicians. What's on their door? Some generic plastic surgery name. What will the patients remember? Some generic plastic surgery name. The physicians who own the clinic are free to switch out staff as often as needed and the public would never know anything changed. But when your name is on the door, and you leave, well, that practice also leaves as it's your name on the door.

As a patient I would be more than a "bit hesitant" with places that have generic names. I would steer clear of such places. There's an exception to this rule, however. Some physicians open up a practice in their name, and open multiple locations on multiple continents with that same name. Will that surgeon with his name on several locations be the one performing the surgery at all of the clinics bearing his name in all the cities and all the continents every day? Of course not. Then WHO is going to be performing the surgery?? It's a very good question that I find this industry has gone out of its way to prevent patients from asking. This local plastic surgery practice near me has a lovely website talking about their new automated hand-held device similar to NeoGraft. They ask (on behalf of the patients) and answer a lot of questions, including "Where will the transplant procedure take place?" and "What sort of sedation is used?" However the one obvious question that they don't answer is "Who will be performing your surgery?" It's assumed from the site that the two plastic surgeons are going to be performing the surgery, but elsewhere it states they are going to "supervise" the surgery. The question of WHO is never answered on their website. That would be extremely concerning to me as a patient.

[JoeTillman]

Valid point. It is still a personal opinion of mine that I would be much more likely to actively seek out surgeons who had their name on the door (unless it came from a referral, which is how I found Dr. Mohebi), which is why I'm glad that Dr. Mohebi changed the name from US Hair Restoration to Parsa Mohebi Hair Restoration. A more generic name to me implies that any number of rotating doctors could be performing your procedure, whether that's true or not. And if it were the case, that's not something that I would feel terribly comfortable with. That's all I meant by that.

Hi Pkipling,

I understand what you mean and thank you for the clarification. It makes sense but I think that your own case, which you just said was because of a referral, supersedes the notion that having the name on the door or not makes a difference. In other words, would your care with Dr. Mohebi have been any different today, because his name is on the door, vs. when you had your surgery and his clinic was known simply as "US Hair Restoration"?

On the other hand, because Dr. L. Lee Bosley had his name on the door, does this mean that you're going to get Dr. Bosley? I think we all know the answer to that one. Same thing with PAI (Pierre Amalotte International); Mr. Amalotte is not even a doctor but his name is on the door of each of the branch clinics throughout North America. Opinions of these clinics aside, you get my point.

I do respect your opinion and I do understand your point so thank you for engaging me on this. I look at this from the perspective of what a lay person would expect to learn if someone says "never go to a clinic that doesn't have the name of the doctor on the door" and they walk in to a clinic that DOES in fact has the doctor's name on the door, as a baseline requirement, and not realize that the doctor behind the name no longer does surgery or may still perform surgery but to a lesser standard than we think is required.

[JoeTillman]

Thank you Joe for this opportunity to address this issue. I think having your name on the door makes a huge difference for the patient experience, and the end results. As the physician and surgeon, your name and reputation are on the door and on the line. It's not just symbolic. Whereas Dr. XYZ working at some generic place like "Hair Clinic" doesn't really have to think about his name being out there so much, because it's not.

I worked at a place with a generic name for about 4 years from 2005-2008. I thought for sure patients would remember who I was and who did their surgery. I was certain that after a couple of years they would call me up if they needed more hair restoration work done. But they never called. Patients remembered the generic name, and when asked who did their surgery, they simply didn't remember who did it. I saw some of those patients years later after they found me in Atlanta, and they talked about going back to the place with a generic name and being told that the "new guy is even better than the old guy," and then being sold another hair restoration procedure. Many of these patients are unhappy about the results of their second procedure with some other doctor, and are very unhappy with the owner of that generic-named practice who sold them on a second procedure with a new doctor they had no experience with.

I find that the patients that I see enjoy the fact that my name is on the door, and is the name of the practice. They know exactly who is going to be performing their hair restoration; removes some of the ambiguity from the experience.

In terms of ensuring good results, it also helps assure patients that they are getting what they pay for. As we all know, particularly with FUE devices, unfortunately this specialty has a problem with non-doctors performing surgery in this country, to the point where the ISHRS came out with a Consumer Alert for patients about this very subject. Nearly every week another plastic surgeon is jumping into the hair restoration field by merely acquiring a device. There's a brand new practice here in Atlanta, 3 blocks from my office. Doctors who normally perform breast enhancements and Brazilian butt lifts sent out a press release this week, are this very day holding themselves out to the world as hair restoration surgery experts, despite the fact that they have never once performed a hair restoration procedure. Right on their website it states that the board certified plastic surgeon will be "supervising" the hair restoration surgery; guess who's doing the actual surgery over at that office? You guessed it: technicians. What's on their door? Some generic plastic surgery name. What will the patients remember? Some generic plastic surgery name. The physicians who own the clinic are free to switch out staff as often as needed and the public would never know anything changed. But when your name is on the door, and you leave, well, that practice also leaves as it's your name on the door.

As a patient I would be more than a "bit hesitant" with places that have generic names. I would steer clear of such places. There's an exception to this rule, however. Some physicians open up a practice in their name, and open multiple locations on multiple continents with that same name. Will that surgeon with his name on several locations be the one performing the surgery at all of the clinics bearing his name in all the cities and all the continents every day? Of course not. Then WHO is going to be performing the surgery?? It's a very good question that I find this industry has gone out of its way to prevent patients from asking. This local plastic surgery practice near me has a lovely website talking about their new automated hand-held device similar to NeoGraft. They ask (on behalf of the patients) and answer a lot of questions, including "Where will the transplant procedure take place?" and "What sort of sedation is used?" However the one obvious question that they don't answer is "Who will be performing your surgery?" It's assumed from the site that the two plastic surgeons are going to be performing the surgery, but elsewhere it states they are going to "supervise" the surgery. The question of WHO is never answered on their website. That would be extremely concerning to me as a patient.

Hi Dr. Anderson,

It's good to see you engage on BTT. Thank you for your points, which I do understand. Your experience working for such a clinic (that doesn't have a doctor's name on the door) makes sense and I absolutely know what you're talking about. The revolving door that some clinics have is a problem as it does take the focus away from the doctor and puts it on the company and the doctor is just a hired hand. Of course, your neighbors down the road are the biggest problem in the industry today, as I see it, because it's turning surgical hair restoration into 1-800-Dentist.

I think that if we were to remove the vacuum FUE clinics out of the equation (that's my new reference to such clinics), the ones that do these butt lifts and tummy tucks as well, and simply assume that anyone seeking out surgical hair restoration should use the IAHRS as a baseline of reference then the "hesitation" would be removed. For instance, two members of the IAHRS that I can think of off the top of my head that do not have their names on the door would be Dr. Cooley at Carolina Dermatology, aka "Haircenter", and Dr. Konior at Chicago Hair Institute. They are perfect examples of what I'm talking about. I don't think the lack of their name on the doors affects the quality of care nor the quality of results.

I'm sure that you are very proud of having your name on your practice, as you should be, and your story is a strong one in that it highlights one of the age old problems associated with the hair restoration field in that some clinics (some with a doctor's name, some without) are actually larger companies that look at the business of doing hair first rather than the quality of care. I'm glad you were able to move on and set up your own practice that allows you to control all aspects of the patient experience. That is what counts to me and is what I look for in my travels to various clinics around the world. Coincidentally, my Hair Transplant Mentor™ Doctor Interview form that is available for patients to download and use asks the question about who performs the procedure and to what extent they are involved. Using this, along with ensuring IAHRS acceptance, is another way to help weed out the vacuum FUE people or "business first" hair transplant clinics in general.

I think this is a good topic of discussion for tonight's show, which is live at 5 pm. PST, 8 pm. EST.

[Ken Anderson, MD, FISHRS, ABHRS]

Hi Dr. Anderson,

It's good to see you engage on BTT. Thank you for your points, which I do understand. Your experience working for such a clinic (that doesn't have a doctor's name on the door) makes sense and I absolutely know what you're talking about. The revolving door that some clinics have is a problem as it does take the focus away from the doctor and puts it on the company and the doctor is just a hired hand. Of course, your neighbors down the road are the biggest problem in the industry today, as I see it, because it's turning surgical hair restoration into 1-800-Dentist.

I think that if we were to remove the vacuum FUE clinics out of the equation (that's my new reference to such clinics), the ones that do these butt lifts and tummy tucks as well, and simply assume that anyone seeking out surgical hair restoration should use the IAHRS as a baseline of reference then the "hesitation" would be removed. For instance, two members of the IAHRS that I can think of off the top of my head that do not have their names on the door would be Dr. Cooley at Carolina Dermatology, aka "Haircenter", and Dr. Konior at Chicago Hair Institute. They are perfect examples of what I'm talking about. I don't think the lack of their name on the doors affects the quality of care nor the quality of results.

I'm sure that you are very proud of having your name on your practice, as you should be, and your story is a strong one in that it highlights one of the age old problems associated with the hair restoration field in that some clinics (some with a doctor's name, some without) are actually larger companies that look at the business of doing hair first rather than the quality of care. I'm glad you were able to move on and set up your own practice that allows you to control all aspects of the patient experience. That is what counts to me and is what I look for in my travels to various clinics around the world. Coincidentally, my Hair Transplant Mentor™ Doctor Interview form that is available for patients to download and use asks the question about who performs the procedure and to what extent they are involved. Using this, along with ensuring IAHRS acceptance, is another way to help weed out the vacuum FUE people or "business first" hair transplant clinics in general.

I think this is a good topic of discussion for tonight's show, which is live at 5 pm. PST, 8 pm. EST.

Joe,

Thanks for the welcome! I love your term "vacuum FUE" clinics......that is just a perfect name for them. Not only in terms of how those machines work by sucking the harvested grafts through silastic tubing, but in terms of surgical hair restoration, those doctors will find themselves practicing in a knowledge and experience vacuum, as hair restoration as taught by the vendors of the various devices that are popping up in the market is certainly not hair restoration. When the ARTAS trainers showed up at my office in 2013, they were ready to train me on the new robotic system. They had pictures of grafts, and other very elemental, basic aspects of hair restoration, and it was pretty obvious that their training was geared towards a physician who has literally never performed a hair restoration in their careers. When I attend the ARTAS Users Meeting I run into a lot of new faces I've never seen at the ISHRS educational meeting or any other meeting, which means these folks acquired a new tool for hair restoration (eg: the ARTAS system) and are suddenly experts in the field. Which brings me back to the analogy. I'm not seeing these doctors at the educational meetings for hair restoration, which means they aren't there, and I have to wonder: where are they getting their training and experience in hair restoration? Sadly I believe that answer all too often is "from the vendor" or "from this book here" and not from any actual interaction with experienced physicians. I've referred to practicing in these types of set ups "practicing in a vacuum" because when you're just starting out in a new field and you have nobody experienced to guide you, it's difficult to acquire new information and/or techniques to add to your practice. I can tell you from experience these surgical and practice pearls are not in the journals or in forums; they are delivered in presentations by experienced surgeons at hair restoration surgery educational meetings. You have to physically be there to learn these pearls and techniques.

In any case, thanks for the background on what you're doing. I think you can really help a lot of people who are just wondering what is marketing fluff and what is substance out in the field of hair restoration surgery practices and all the different flavors they come in. We're on the same page regarding the name on the door, I do believe. I have great respect for the men you mentioned; I've met them at the educational meetings and have heard nothing but good things about each of them. There are exceptions to every rule, and those are two prime examples.

The "business first" people in this industry as so much more common than I ever imagined when I started out full time in hair restoration surgery in 2003. It's almost hard to believe. When these folks display their "profits-before-everything-else" beliefs in the way they run their practices and the way they treat patients it's tough to take. Having worked in a generic clinic like this as the only doctor, I can tell you first hand that the pressure to perform questionable surgeries is always present, and it is a strong one. I had to be very adamant in my convictions whenever I turned down a case, as the owner (who is a lawyer) did not understand the subtleties and nuances of hair restoration, and I found it difficult at times to convey why I was not going to be doing a case. The objections and sometimes threats directed at me over turning down cases were all about one thing: money. The patients' well-being is what I was trying to talk about, and I got the money argument from the lawyer. It was sad and disheartening. I am very happy to be out from that pressure, and be able to deliver this surgery in the very best way I can, drawing from the experiences and pearls of the acknowledged masters in this field. I find a true joy in helping patients manage and address their hair loss, and these successes are what we live for. Unfortunately I have found the my sentiments are not as commonly shared among those providing this important service for people suffering with hair loss.

I'm interested to hear your show. I will try to check it out tonight.

[JoeTillman]

Dr. Anderson,

Again, thank you for your input. I think, from the sounds of it, you got your start in the field of surgical hair restoration much like the average patient. You expect appropriate conduct and ethics to guide the practice toward the betterment of the patient but are blind sided by the business motivations that can (in some clinics) overpower the basic moral and ethical duty that any medical practice is bound to. I'm sorry you had to go through that but at the same time I'm certain that it has made you appreciate your freedom that much more Kudos to you for taking the better path.

Part of my participation in this thread is due to my own early experiences as a hair transplant patient. Again, I understand Pkipling's and even agree with his initial statement but ultimately I believe this type of issue comes down to being a case by case issue. A final point is based on my own original hair transplant doctor from 24 years ago. Dr Norris who operated the clinic known as ....wait for it....Norris Hair Transplant Clinic (see what I did there?) in Knoxville, Tennesses not only had his name on the door but he had his family assisting with the procedure. It doesn't get any more "mom & pop" than that! His wife and daughter were both RN's and with the photos of celebrities on the wall and the box of donuts in the patient area, what could go wrong?



From the outside nothing looked more like a sure thing than a man who had his name on the door and his own family doing the work but of course this misinterpretation changed my life so drastically that 24 years later I'm living in Canada, 7 more surgeries later, talking to bald guys about their own hair loss problems. Life has surprising twists and turns, of course, but this is just ridiculous In the end, I'm glad how things worked out of course but this is why I chimed in on this thread in the first place and felt the need to speak my peace.

[pkipling]

Joe and Ken - I'm just now catching up on this thread, and I must say that this has all been very educational and a fantastic conversation all around. You both made very valid points and gave me (and I assume others) lots to think about in regards to this topic. I also just appreciate you both sharing your stories from your own experiences.

For patients looking for a surgeon, I think this thread highlights the importance of doing very sound research when choosing who to go to for a hair restoration procedure. And for surgeons who operate under a generic name, it also highlights how (valid or not) some people may be initially turned off by the fact that there name is not on the door. If they have a solid reputation already, it may not be an issue. But for surgeons like Dr. Anderson in the beginning of his career, it may be hindering their longterm success.

Joe - I've been familiar with you on the forums for quite some time now, but never knew of your hair transplant beginnings until now. All I can say is that photo has nearly left me speechless. Talk about a journey....

I am a patient advocate for Dr. Parsa Mohebi in Los Angeles, CA. My opinions/comments are my own and do not necessarily reflect the opinions of Dr. Mohebi and his staff.

[mhopton07]

What was the bad start?

The Private Clinic, Birmingham...