Reader Defends the Use of Techs Doing NeoGraft Surgeries
This is in response to a post from earlier this week about technicians performing most or all of FUE procedures with a NeoGraft tool:
Specialty Techs are in nearly every aspect of medicine and they all are equally skilled in their own field. Phlebotomy, radiology and even hair transplant techs to name a few, all have to maintain a high level of skill and responsibility as they are dealing with the health and well being of a patient. The question is, who would you rather have working on you? A doctor with an MD behind his/her name who just took a weekend course in some new procedure or a highly skilled tech with 5 or 10 years of experience doing the same thing, day in and day out with a high level of pride and commitment.
With regard to the techs who operate NeoGraft…how is what they do any different than when they are handling, dissecting and transplanting human tissue from a strip method? If anything, NeoGraft is a “tool†which in “experienced hands†has the ability to offer fewer complications, lower rate of transaction, faster recovery times and an overall better procedural outcomes.
I would encourage those who throw around the term “surgery†when speaking about NeoGraft to exercise a little common sense because handling, dissecting and transplanting strip tissue should be considered “surgery†as well if you really think about it.
Personal Note: I have seen the techs that use the NeoGraft systems with my own eyes and every time I am extremely impressed with the level of skill, dedication and pride these individuals posses.
“FUE performed by non-physicians is a grey area and illegal in most states. Legally, a procedure where there is a cut on the skin requires an MD to do it. There are cases where a registered nurse or a PA (Physician’s Assistant) can perform certain tasks, but it has to be supervised by the physician. A surgical tech performing FUE is a dark grey area.â€
One more thing…I’m not sure where you get your information but it is completely inaccurate and misleading. Please provide everyone with just ONE state that mandates what you claim along with the link to the official state website where the rule is listed. Otherwise, please stop making things up.
Thank you for your comments.
To put it simply, no matter how minor of a surgery (suturing a cut on the skin, making a cut on the skin, or even just giving a prescription pill or IV to a person) it requires some form of license issued by the state where the act is performed. You may not have to be a surgeon, but you have to have had some medical training and hold a license (nursing license, PA license, etc). A normal person off the street, no matter how talented, cannot perform FUE even if they are trained or are better than the surgeon at doing it.
The focus here should be the protection of the public. When the person who is doing the surgery has a license to do it, that means that they were officially trained and certified to do surgery in the state. I know that there are many, many doctors who perform hair transplant surgery and do not have a clue on what they are doing. Many of these doctors use technicians to perform almost every step in the surgical process (in their medical offices) and it would be clear that the technicians are more competent than the doctors they work for. But this is not an argument for allowing non-licensed people to perform surgery, but rather that we need some protection for the public when a doctor is not competent in delivering a surgical service, not in allowing non-licensed people to perform surgery. Unfortunately, an MD in almost every state in the United States can do any surgery he wishes (brain, heart, hair, etc..) and will only be held accountable when someone experiences irrevocable harm or death. It is insane that the only protection for the public against these doctors is our criminal system after the damage is done. One can look at the cardiologist who administered Propofol to Michael Jackson, who is being held accountable by the criminal justice system for manslaughter.
I have found two interesting situations where non-physicians have performed surgery (one good and one bad).
- Example 1: The incredible story of African American lab tech that wasn’t formally educated beyond high school, but became a pioneer in heart surgery and actually operated on white Americans in the 1940s: Vivien Thomas
- Example 2: Title of the post is self-explanatory: Non-Doctors Doing Hair Transplants?
Now to the issue where you insist that I’m making things up, here’s the Medical Board of California’s Business and Professions code #2051: “The physician’s and surgeon’s certificate authorizes the holder to use drugs or devices in or upon human beings and to sever or penetrate the tissues of human beings and to use any and all other methods in the treatment of diseases, injuries, deformities, and other physical and mental conditions.” Emphasis mine. That’s just one of many examples that I found, but that should be satisfactory.
So to cut into your scalp, no matter how minor and safe it seems, the issues are one of license (legitimacy) and competence. Both, in my opinion, need to be considered as you make the decisions on who is going to do your hair transplant. I am sure that the NeoGraft system works in the hands of competent operators and that most doctors who now do surgery (with or without that tool) are probably less competent when compared to the standard of care that we perform in our office on a daily basis. I know that this is true, because I see the results of less-than-competent hair transplant surgery on a near daily basis as patients come to see me for repair advice, to address the failures of their surgery or the next step in their hair restoration process that was started elsewhere.
i have personally viewed the neograft system in use at demostration in california. Frankly i was surprised how much of the procedure the technicians performed. Unlicensed individuals cutting hair tissue while it is attached to the scalp are performing surgery without a license in california.
I think what this really boils down to is, Doctor’s who are “Hair Only” transplant docs, are mad that someone made a better tool and priced it out of their price range.
And now Board Certified Doctors from Plastic Surgery and Dermatology are now spending $100K and playing in the Hair Transplant game and doing quite well.
It won’t be long until someone makes a better cheaper tool and even more doctors get into the Hair Transplant business. And then another company will make an even better cheaper tool and eventually you will see FUE Hair Transplants advertised for $1 per graft, just like you see FUT advertised now.
When that happens the Plastic Surgeons and the Derms will get back out of the Hair Business and the “Hair Only” docs can have their industry back.
As far as FUE Hair Transplant being an actually surgery. What does it tell you as doctors when techs clearly do a better job than the vast majority of doctors.
As evidence of this, there was only a handful of docs even performing FUE a few years ago. And such a back lash to anything FUE.
Now the FUE business is booming and Techs are in demand again. But the “Hair Only” docs are seeing lost revenue and crying foul. When they know full well that they have had techs in their office peforming the bulk of the procedure for pennies on the dollar.
Now the techs are actually getting paid what they are worth.
I am guessing there are 100’s of NeoGrafts on the market, but yet where are all the FUE Patients Complaints over the last 3 years. I am sure by now you would have 100’s of patients complaining that they were being butchered by “Hair Techs” and the machine was spinning out of control and drilling holes in their head, but not one complaint. Happy Patients, Happy Docs and Happy Hair Techs.
In fact the only people who are complaining are the “Hair Only” doctors who do not like paying the higher fees to the Hair Techs who have served you loyally for so many years while being underpaid.
Personally I hope that only Plastic Surgeons and Derms get into FUE Hair Transplants, these doctors do not treat Hair Techs as slave labor and pay for the quality work which is being peformed on a daily basis.
The doctors who do Strip surgery on a hair transplant patient have all formed the belief that their techs are working within proper medical guidelines. The strip techs have been dissecting the excized piece of scalp for so many years, without anyone questioning them, that everyone feels very complacent about the role of the Strip techs.
It has been explained to me that a hair transplant is an organ transplant procedure. Each follicle is a mini organ, a complete factory. A follicle is not just a piece of dermis. As you know strip technicians are the ones in a STRIP transplant to make alterations to these organs. The techs separate them (follicle organs), trim them, and alter them. They even damage some of them at times.
Most of the strip hair transplant consists in separating the follicles in the piece of scalp that was excised. These follicles are not discarded pieces of dermis. They are mini organs that are going back into the body of the patient!! Oh, and it should be pointed out that it is often the techs that place these live delicate mini organs back into the scalp.
Can you think of any other surgical procedure with organ involvement that a tech is in charge of altering the organ and re-attaching it? If someone severed a hand or other body part, that needed trimming, altering and reattaching would a tech be allowed to do so? Why is a strip of scalp any different? It is part of the body that became separated from the head, and that piece of scalp is going back to the head in an altered form as decided by a tech!
Just because there is a historical precedent to the techs surgical duties does not mean that their actions fall within the law. This has been strongly pointed out to me by someone familiar with medical/legal issues. If you look at the techs actions this way, can you see that there might be a possibility that the procedures the techs do in a strip hair transplant are beyond a technician’s scope of practice.
YOu made the statement: “So to cut into your scalp, no matter how minor and safe it seems, the issues are one of license (legitimacy) and competence.” I believe the same could be said of strip techs. No matter how minor the follicle organs are or how safe the procedure seems, the issues are one of license (legitimacy) and competence.
The last part of your statement about competence is one that should be addressed. Your former writer pointed out that a tech who does the same procedure over and over again for years, is usually more competent than the doctor.
To complicate the issue further, there are persons in every State who are not Medical doctors, who have the right to “pierce, cut, and alter the body.” Examples are persons who do body piercing, tattoos, and body alteration such as purposely stretching the earlobes with large insertions in the lobe.
In addition, as was pointed out there are some medical personnel such as Physician assistants, army medics, etc. that can cut skin, under the supervision of a doctor. There are nurses also that can take blood and insert intravenous lines. Many doctors do the harvesting in a NeoGraft procedure. But I do not know of any strip doctors who dissect the excised scalp.
I cannot understand doctor’s like Dr. Umar who does FUE and other doctors, who do both FUE and strip surgery, denouncing any techs when they all use techs themselves. The techs who know how to use NeoGraft understand that they must follow the guidelines of the State they work in.
I think there are some complex issues to this tech matter that are not only an FUE tech problem but also a strip tech problem.