Senior Member wantego Posted August 25, 2008 Senior Member Share Posted August 25, 2008 Originally posted by Bill - Associate Publisher:bullitnut, I agree that patients should understand all aspects of what they are getting into before surgery. Doctors/clinics should be educating their patients not only about surgery and realistic expectations, but policies also. It appears that there was a misunderstanding in this case. Best wishes, Bill Bill, To be fair to Dr Rahal as I said above I think I remember (I'm not 100% sure) Dr Rahals pre surgery paperwork did mention being charged for a portion of the extra grafts. 4374 grafts-7/2/2008-Dr Rahal 485 singles 2336 doubles 1526 triples 16 quads 9809 total hairs Link to comment Share on other sites More sharing options...
Rahal Hair Transplant Posted August 25, 2008 Share Posted August 25, 2008 Our policy re extra grafts is written in the consent form which is signed PRIOR to the surgery. So, before surgery each patient would have seen it, agreed to it and signed it. There are no surprises or misrepresentation. Majority of our patients travel from out of town and we rely on the pictures that are sent to us, to give estimates on how many grafts are needed. We always clarify with our response that this graft number may change after we examine the patient in person. Once we have examined the patient, identified the goals of the exact area and what level of density, the estimated number of grafts are discussed and then agreed to. To anyone who is familiar with strip surgery, getting an exact number is difficult; our approach is to review the density of the donor site and the laxity. We then map out the donor strip and proceed to remove it. In most cases we are close to the projected number but in rare cases we are plus/minus a few. In the event we are lower, then we will REIMBURSE the difference back to the patient. In the event we are higher, we do give some FREE grafts, to patient and charge for the rest. Remember this would have been discussed prior to start. In absolutely no circumstance will grafts be discarded. When we have to charge for extra grafts (beyond what is given free of charge) we follow our policy as agreed to prior to surgery (as are our prices are on our website www.rahalhairtransplant.com). In the event we do get a lot of extra grafts (it happens) we do discuss it with the patient after the procedure and the grafts are already placed (throwing any out is NOT an option) as to what is reasonable. Our experience is that most patients are happy with the extra grafts and are happy paying for the extra. Please remember that we do not intentionally try to get extra grafts to boost the bottom line. It is NOT our style of practice. In omviki's case we knew he had a good density going in but we still got surprised with the amount of extra grafts.. We had spent alot of extra time in preparing the extra grafts and then planting them. (700 grafts) was at no extra cost. Yes some was charged (400 grafts). Even decision was reached after a thorough discussion with omviki as to what is reasonable for his budget. We have been very fair and we will always be fair to every patient when it comes to this issue. For Dr Carman: we appreciate your generosity for your patients, but we feel it is inappropriate to come on to this thread to plug in your practice at the risk of making Dr Rahal look bad. Rahal Hair Transplant Institute - Answers to questions, posts or any comments from this account should not be taken or construed as medical advice. All comments are the personal opinions of the poster. Dr. Rahal is a member of the Coalition of Independent of Hair Restoration Physicians. Link to comment Share on other sites More sharing options...
Regular Member alwayswaiting1 Posted August 25, 2008 Regular Member Share Posted August 25, 2008 Just to share my experience: Prior to my surgery with Dr.'s True and Dorin I signed an agreement stating how much I would pay per graft in the event there were extras. The surgical "goal" was 2500-3000. I paid for the 2500 initially knowing how much extra I would be charged if 3000 grafts were harvested. During further examination Dr. Dorin was downplaying the actual number of grafts that could be harvested and was hoping that the initial 2500 could be attained. When the precise number of grafts was known, I was elated to find out that we had exceeded our goal. I gladly paid for the extra 500 grafts and, to my surprise, was not charged for the remaining 200 plus. I'm sure this is what most patients experience. Personally speaking, I am a health care provider and believe it is totally reasonable to charge patients for extra work. Especially when the work in question involves the time and skill of this magnitude. My Hair Loss Website - Hair Transplant with Dr. Wong 715 grafts at Bosley, 2004 3238 grafts by Dr.True, Mar 2008 3393 grafts by Dr. Wong, Jul 2009 Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted August 25, 2008 Share Posted August 25, 2008 Adrian, I appreciate you explaining your policies and how you inform your patients of them before surgery. It sounds like Omviki may have overlooked this section of the paperwork that he signed. I also feel that these policies are very reasonable and that Dr. Rahal was more than fair. Omviki is going to have a great head of hair after his hair grows in. Best wishes, Bill Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted August 25, 2008 Share Posted August 25, 2008 wantego, Thanks also for your input on Dr. Rahal's written policies. Best wishes, Bill Link to comment Share on other sites More sharing options...
Senior Member wantego Posted August 25, 2008 Senior Member Share Posted August 25, 2008 Originally posted by Bill - Associate Publisher:wantego, Thanks also for your input on Dr. Rahal's written policies. Best wishes, Bill You are welcome. Thank you for running such a good board. 4374 grafts-7/2/2008-Dr Rahal 485 singles 2336 doubles 1526 triples 16 quads 9809 total hairs Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted August 25, 2008 Share Posted August 25, 2008 For Dr Carman: we appreciate your generosity for your patients, but we feel it is inappropriate to come on to this thread to plug in your practice at the risk of making Dr Rahal look bad. Adrian- I am very sorry if you took my post to be anything other than a statement of the policy here at La Jolla Hair Restoration Medical Center. It was placed following Dr Cooley's policy statement, and as well was in response to a request made in this thread by bullitnut (see below). I most certainly had NO intention of making Dr Rahal "look bad"; that perspective/mode of operation does not enter into my everyday interactions with the world in general, let alone my fellow colleagues. I apologize for any slight you or Dr Rahal may have garnered from my post. Originally posted by bullitnut: Quote: "i think it would be interesting to hear what a few other clinics would do in this situation as its a very helpful aide in the research process every little bit of info helps no matter how small.Before anyone makes a potentialy life changing decision its nice to have ALL the answers and have all bases covered because i would imagine that if some one travelled thousands of miles and didnt have all the money it could be a little embarrasing all round especially if these extra ones were planted" Again Adrian, I apologize if you were in any way offended. Sincerely, Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Senior Member Dewayne Posted August 25, 2008 Senior Member Share Posted August 25, 2008 Originally posted by bullitnut:i think it would be interesting to hear what a few other clinics would do in this situation as its a very helpful aide in the research process every little bit of info helps no matter how small.Before anyone makes a potentialy life changing decision its nice to have ALL the answers and have all bases covered because i would imagine that if some one travelled thousands of miles and didnt have all the money it could be a little embarrasing all round especially if these extra ones were planted C'mon Adrian, Obviously Dr. Carmen was just answering a request by this poster.... I'm thinking you didn't see that post for sure. 100? 'mini' grapfts by Latham's Hair Clinic - 1991 (Removed 50 plugs by Cooley 3/08.) 2750 FU 3/20/08 by Dr. Cooley My Hair Loss Website - Hair Transplant with Dr. Cooley Current regimen: 1.66 mg Proscar M-W-F Rogaine 5% Foam - every now and then AndroGel - once daily Lipitor - 5 mg every other day Weightlifting - 2x per week Jogging - 3x per week Link to comment Share on other sites More sharing options...
Senior Member thanatopsis_awry Posted August 25, 2008 Senior Member Share Posted August 25, 2008 I missed the "request", also, my first readthrough, like Adrian clearly did, and thought it sounded a bit tacky -- or backhanded as Adrian thought. Dr. Carmen is a stand-up guy, and it came as no surprise to see the "request" on 2nd notice, and his responses showed (predictable) poise and class. ----------- *A Follicles Dying Wish To Clinics* 1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash. Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician. Enough is enough! Give me documentation or give me death! Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted August 26, 2008 Share Posted August 26, 2008 I can understand why Adrian felt that Dr. Carman's post may have unintentionally made Dr. Rahal look bad. On the other hand, knowing Dr. Carman, I have full faith that this was truly not his intention. Idealistically, the discussion of other surgeon's policies may be best discussed on another thread however, both Ailene and Dr. Carman did answer bullitnut's question posted in this thread. In my opinion, no harm, no foul. Best wishes, Bill Link to comment Share on other sites More sharing options...
Senior Member bullitnut Posted August 26, 2008 Senior Member Share Posted August 26, 2008 I agree with Bill dr carmen didnt come on here with the intention of making ANYONE look bad he posts on here most days and was only answering a direct question i posted on this thread to ALL doctors. If anyones to blame its ME for asking questions on another guys thread but i can assure you that making any clinic look bad was not my intention i pride myself on being an honest individual with good morals and principles so theres no way i could be so vindictive and malacious as to post on here with the intention of making rahal clinic look bad i have the upmost respect for them they post great results week in week out i simply was trying to gain as much knowledge as possible regarding different clinics so as to make the big decision as to which clinic to choose next. AGAIN SORRY IF IVE CAUSED BAD FEELINGS THIS WAS NOT MY INTENTION REGARDS BULLIT. 2 poor very poor UK ht's 2 world class repairs with Shapiro Medical Group original thread http://www.hairrestorationnetwork.co...d.php?t=134995 Dr Paul's procedure http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=1710 Dr Ron's procedure http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=1128 Link to comment Share on other sites More sharing options...
Senior Member Rick055 Posted August 26, 2008 Senior Member Share Posted August 26, 2008 I appreciate Dr. Carman's input on the situation. Correct me if I'm wrong, but the main purpose of this forum is to educate patients. Further, Dr. Carman (and others) were invited to reply. If the thread were about the mechanical aspects of the transplant and a patient was considering a doctor who used needles -- but wanted to know how other doctors did things -- would anyone mind if another doc mentioned his practice used blades? Policies are what they are; Dr. Carman can't make Dr. Rahal's practices look bad, and I did not understand that to be his intent. 1.25 mg finasteride EOD Rogaine Foam 5% QD am Kirkland minoxidil 5% QD pm Nizoral Q2W American Crew Revitalize Shampoo Link to comment Share on other sites More sharing options...
Rahal Hair Transplant Posted August 26, 2008 Share Posted August 26, 2008 Thank you Dr. Carman for clarifying, I misread the intention of the post. Just wanted to clarify that we are always upfront with how we charge for the surgery. As when it comes to extra grafts , we are also clear prior to the start of the procedure(it is actually on our consent form that has to be signed prior). We always strive to do the fair thing for our patients and be fair to ourselves as well. Rahal Hair Transplant Institute - Answers to questions, posts or any comments from this account should not be taken or construed as medical advice. All comments are the personal opinions of the poster. Dr. Rahal is a member of the Coalition of Independent of Hair Restoration Physicians. Link to comment Share on other sites More sharing options...
Senior Member Rick055 Posted August 26, 2008 Senior Member Share Posted August 26, 2008 Originally posted by Adrian:Thank you Dr. Carman for clarifying, I misread the intneton of the post. Just wanted to clarify that we are always upfront with how we charge for the surgery. As when it comes to extra grafts , we are also clear prior to the start of the procedure(it is actually on our consent form that has to be signed prior). We always strive to do the fair thing for our patients and be fair to ourselves as well. And IMO if everybody understands the situation there's absolutely nothing wrong with that. Nor can anyone doubt the quality of Dr. Rahal's work. 1.25 mg finasteride EOD Rogaine Foam 5% QD am Kirkland minoxidil 5% QD pm Nizoral Q2W American Crew Revitalize Shampoo Link to comment Share on other sites More sharing options...
Senior Member omviki Posted August 27, 2008 Author Senior Member Share Posted August 27, 2008 in my case for the extra grafts dr. rahal gave me the reasonable price. i have never complained about that. Not only that he is very clear and fair to all his patiens. i am very sorry if i have said anything which is not right about the dr. rahal's policy for extra grafts. #1 HT by Dr. Rahal on 08-21-08 Strip 26.6 cm Total 4308 grafts -1116 single grafts -2287 double grafts -898 triple grafts -7 quad grafts Total Hairs: 8412 Medications: Minoxidil 5% Finasteride 1 mg daily Link to comment Share on other sites More sharing options...
Senior Member Rick055 Posted August 27, 2008 Senior Member Share Posted August 27, 2008 It's never wrong to speak openly and honestly about a situation; there's always room for misunderstanding among people with good intent. "Transparency" is one of the reasons this forum is so great. You had a question, the question was answered, the community opined, misunderstandings allayed, everybody's happy! 1.25 mg finasteride EOD Rogaine Foam 5% QD am Kirkland minoxidil 5% QD pm Nizoral Q2W American Crew Revitalize Shampoo Link to comment Share on other sites More sharing options...
Senior Member omviki Posted August 27, 2008 Author Senior Member Share Posted August 27, 2008 rick, you are right. thanks #1 HT by Dr. Rahal on 08-21-08 Strip 26.6 cm Total 4308 grafts -1116 single grafts -2287 double grafts -898 triple grafts -7 quad grafts Total Hairs: 8412 Medications: Minoxidil 5% Finasteride 1 mg daily Link to comment Share on other sites More sharing options...
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