I just met a patient who, while doing comparative shopping, came to me as the fifth doctor on his shopping list. He was 46 years old and had some thinning in his crown. He lost the first inch of his hairline, but his hairline did not bother him and therefore was not his focus. He was fine with where the frontal hairline was. He was able to see through the crown for the first time in years. Below, is the spirit of what he told me his experiences were, I simulated quotes of a conversation to demonstrate what he described to me —

Doctor #1:
“You are going bald in the crown”, he was told. He was quoted a surgery cost of $12,000 for 1400 grafts.
“Will I lose any hair from the transplant?”, he asked.
“It happens sometimes,” the doctor answered, “but if it does happen, it will grow back”

Doctor #2:
“I can fix it with 800 grafts for $3,000 and if you do that now, I will throw in another 100 free grafts”.

Doctor #3:
The man had researched this doctor and found that there were reputation problems evident through industry-specific bulletin boards and in internet reference sites. He felt that the visit to this doctor reeked of sleaziness.

Doctor #4:
On the visit, he met a patient in the crowded lobby. The patient (who already had surgery) warned him to stay away for his own good. When he visited the doctor, he was told that for $12,000, he could get 2000 grafts into the crown and it would make his crown appear full.

Dr. Rassman (Doctor #5):
I mapped out his scalp for miniaturization and found that less than 50% of the crown hair was miniaturized (no other doctor did this). The frontal area had 80% miniaturization just behind the balding area, suggesting that his hair loss will continue in the frontal area. I told him that with only 50% miniaturization in the crown, a drug treatment would be the best approach, not surgery. When the hair is 50% miniaturized, there is usually reasonably good cover and surgery runs the risk of causing irreversible hair loss (which usually does not grow back in men). If this happened, it could make his crown more see through than it was now. I recommended against any surgery.

I was personally frustrated with my colleagues in the hair transplant field, particularly for what appeared to be a lack of moral fiber in managing this man’s problem. I have always believed that doctors should put their own welfare behind the patient’s welfare. What the above cases clearly showed me was that the first four doctors were behaving like used car salesmen, selling this man the car driven by that little old school teacher who never abused it. I have no difficulty condemning the opinions of these other doctors and their behavior. Every one of the four wanted to take this man’s money and preyed upon his vanity.

Of interest, when he first started talking with me, he was at first baffled by the wide discrepancies between the recommendations and the pricing, but after receiving my explanation of the miniaturization assessment (something that none of the other doctors did on his examination), his confusion cleared up. His initial question to me was why was there such a wide descrepency between the estimates of work and price. That was not his focus after the consultation with me. In his case, good comparative shopping saved him from being victimized by doctors who behave like crooks and con men. They are still out there.

Again and again, I warn people, ‘Let the Buyer Beware!’