Barry Bonds, Batting Averages, and Hair Transplants

Hi Doctor. Thank you for this blog and your honest responses. The fee that you charge to perform a procedure yourself is nearly double the fee to have one of your other doctors perform the procedure. I am sure that you are in high demand and as the laws of supply and demand go you are able to command double. What I really want to know is if the QUALITY of the results of a procedure performed by you would be noticibly better than that of a procedure performed by one of your doctors? I also see that there is only one other doctor and if I’m correct he is new to your practice. Bottom line is that when it comes to something such as a hair transplant, Quality and not Price would be a deciding factor as to who I went with. To use a baseball analogy, If you and John were baseball players would you both be batting .350 or would you be batting .400 and John .250 :)

Thanks again!

Great question! Like any good baseball team, you need to have the team work together to get a winning result. What I have consistently said is that a great hair transplant doctor can not produce great work without a great team. In 1991, the quality of the work performed by the hair transplant industry was not acceptable to me, so I had to redesign the surgical techniques to make them acceptable. I have published a massive amount of work defining the standards in hair transplantation techniques (see: Medical Publications).

If you took me out of the team today and moved me to a 2nd class team, I might produce 2nd class work if I would allow myself to do just that. Back in the late 1980s and early 1990s, the quality of the work done by all hair transplant doctors was poor because the techniques were crude. The pluggy ‘dolls’ head appearance was the standard of care. So, on the first day I started to do hair transplants, I changed the technique I offered to one that allowed for delicacy of the transplants with a larger and larger number of smaller grafts, but this took manual techniques that had yet to be invented and lots of labor to produce and place these smaller grafts. Since I have never allowed myself to produce 2nd class work in anything I do, I had to build a 1st class team that understood all of the nuances that made for great hair transplants so that I could increase the number of small grafts in a single session so my patients would not have to have a surgery many times to get their hair back. You can not imagine the number of things that are controlled by the processes we developed and implemented at NHI. If I had to start all over again, I am one of the few physicians worldwide capable of doing every single part of the transplant process and I have been teaching process and techniques (one on one) to dozens of doctors and many, many medical assistants over the years. I have personally trained and retained the best people with me over the years. I pay them well and create a festive and positive work environment for the team and they return to me a diligent focus on quality and an attitude that most patients feel is imparted to them when they experience a hair transplant from this team. When I have ‘terminated’ a staff member, they always find work with other hair transplant doctors (many doctors want a medical assistant trained by me), but as I would never ‘fire’ someone great, these doctors get medical assistants that could not meet or sustain my first class standards.

In my practice, there is no such thing as a batting average of less than 1000 (400 just does not cut it, because it means that the doctor and team get great results only 40% of the time). Barry Bonds does not bat 1000 when he is at the plate, but I can bat consistently at 1000 with the NHI team and a batting average in a hair transplant reflects great results consistently. Without the team, particularly in these larger session transplants, I doubt that I would bat 1000, unless I reduced the size of the sessions to meet what I could do alone in a single day, as I did in 1992 as I evolved the megasession.

Simply put, my fees are higher because of supply and demand issues competing for my time (as you discussed).